The Leash That Isn’t There: Learned Helplessness and the Doctors Who Stay Stuck

When I was a Cub Scout in the 80’s, we would sell Krispy Kreme donuts as a fundraiser for summer camp. Referring to it being used as a fundraiser, the box had printed, “It’s as easy as selling donuts!!” and for the most part, it was! That’s what I thought hiring physicians to do DPC with me would be like. But, it’s a harder sell than I thought. And, I want to know why! 

I’ve chatted with lots of DPC docs who have tried to hire other physicians and it’s been an uphill battle; one that was unexpected. They were paying more than average for their area, appropriate time off, and a much much better work environment, but nobody was buying those donuts. 

Here’s a hypothesis….

In the late 1960s, psychologists Martin Seligman and Steven Maier conducted a series of experiments that—though controversial by today’s ethical standards—unleashed a truth about behavior that still reverberates across disciplines. They took a group of dogs and exposed them to electric shocks, from which some could escape and some could not. Later, even when all the dogs were given a chance to flee, the ones who had learned that escape was impossible no longer tried. They simply lay down. They had learned helplessness.

This haunting lesson has never felt more relevant than when I look into the eyes of colleagues still caught in the clutches of the traditional healthcare system. Intelligent, compassionate physicians who once carried a calling like a candle now carry a clipboard like a ball and chain. They don’t like it. They don’t pretend to. And yet—they stay. They suffer. They succumb. They lie down.

Why don’t they leave? Why don’t we leave?

Not because the cage is locked.

Not because the leash is tight.

But because we have learned that it won’t matter. That trying will only exhaust us further. That someone else holds the keys to meaningful change.

Learned helplessness has set up shop in medicine.

We were shocked early.

Shocked by 28-hour shifts.

Shocked by system inefficiencies that stole time from our patients and peace from our homes.

Shocked by being treated as billing units instead of healers.

And when we asked, cried, or tried to change things? Nothing budged.

So we adapted. We absorbed the pain. We internalized the message: This is just how it is.

But here’s the thing: Seligman and Maier didn’t stop there. Later research showed that when the previously helpless dogs were physically guided to the escape route—when they were shown that escape was possible—they began to act differently. They began to hope.

So what would it take to gently guide our peers to the exit?

I believe it starts with us. Those of us in Direct Primary Care have seen what freedom feels like. We’ve watched trust bloom again in the doctor-patient relationship. We’ve practiced without prior authorizations and practiced presence instead. We’ve reclaimed our humanity and our weekends.

But the goal of this article isn’t just to celebrate our escape. It’s to extend a hand behind us.

Many physicians have never been shown that a better model exists, or if they have, it feels fantastical—financially risky, socially radical, administratively overwhelming.

But we know better…And we can do better.

We cannot shame the stuck. But we can name the phenomenon. We can point to the paradigm. We can make it easier to move.

Because at the end of the day, we are not dogs. We are doctors. And the path to something more soulful, sustainable, and sacred is open.

Let’s loosen the leash.

I’m interested in hearing in the comments why you think doctors don’t more readily make the change to DPC. Thank you!

Get our awesome newsletter by signing up here. It’s FREE!!! And we don’t share your email with anyone.