We’ve all heard the mantras: “Winners never quit” and “Don’t be a quitter.” They echo from locker rooms to boardrooms, shaping how we view persistence. In medicine, where long hours, delayed gratification, and relentless dedication are often worn as badges of honor, quitting can feel like failure.
But what if we’ve misunderstood quitting all along?
In her excellent book Quit: The Power of Knowing When to Walk Away, Annie Duke argues that persistence is often overvalued and that strategic quitting is not a sign of weakness—it’s a marker of wisdom.
In this column, I’ll explore how Duke’s ideas apply to physicians and other high-income professionals, exposing the hidden traps that keep us on the wrong path and offering practical tools for quitting smart. We’ll look at the psychology behind staying too long, stories that show when quitting is wise, and practical tools for knowing when to walk away.
The Biases That Bind Us
Sunk Cost Fallacy
The sunk cost fallacy is the irrational tendency to continue something because we’ve already invested time, money, or effort—even when it no longer serves us.
A classic example of the sunk cost fallacy: you buy tickets to a movie, and 10 minutes in, it’s terrible. But instead of leaving, most people stay, thinking they need to “get their money’s worth.” In truth, the money is already gone. Sitting through two more hours of a bad movie won’t bring it back. The rational choice is to cut your losses and spend your time doing something more enjoyable.
I encountered this in my own life when deciding whether to maintain my general pediatric board certification. I practice exclusively as a pediatric cardiologist, and I hadn’t done general pediatrics in years. Still, several colleagues urged me to keep it up. After all, I’d spent three years training, and it would be a waste if I let my certification go. But eventually, I realized I was paying money and jumping through hoops for a credential that offered me no practical benefit. I let it go. And nothing fell apart.
Loss Aversion
Losses feel about twice as painful as equivalent gains feel good. That’s why a physician might hold onto a sinking stock portfolio, hoping it rebounds, rather than reallocating wisely. Or why someone avoids switching to a lower-paying but more fulfilling role, fearing the loss of income or prestige.
When I moved across the country after residency and fellowship, I faced a tough decision. I had lived in my home for six years, but it was worth $40,000 less than I’d paid. I hated the idea of “realizing” that loss and considered renting it out, hoping the value would rebound. But then it hit me: I wouldn’t buy this house today just to be a long-distance landlord, so why hold onto it now? I finally sold it, eating the $40,000 loss and watching my hard-earned down payment disappear. A few years later, I’m so glad I did. The loss had already occurred—it just hadn’t been acknowledged. Holding on would have meant unnecessary stress and hassle trying to manage a rental from afar while working full-time as a physician.
Status Quo Bias
We tend to stick with what we know even when it no longer fits. A disillusioned physician may stay in academic medicine simply because it’s familiar. Structured career ladders and institutional inertia only deepen this pull.
I feel it in my own life: my default is to keep doing the same clinical work in the same job because it’s comfortable. Part of the reason I write for The White Coat Investor blog and teach a finance course is to push against that inertia—to try on other professional roles and intentionally shape a career I want, rather than just settle into the one I have.
Professional Identity Bias
Few professions wrap your identity as tightly as medicine. From early training onward, we don’t just do medicine; we are doctors. That over-identification makes transitions incredibly difficult.
Physicians often resist part-time roles, non-clinical work, or entirely new ventures that don’t “feel like doctoring.” One friend who left clinical work told me, “I didn’t just leave my job. I lost who I was.”
The solution? Start seeing yourself as more than your profession. You’re a parent, a mentor, a creator, a human being. Resilience comes from a diversified identity. One of the best reasons to stop defining yourself solely by your profession is this: it makes it easier to walk away when the time is right.
More information here:
Does Money Buy Happiness? What the Research Really Says
Flourishing at Work: What Physicians Get Wrong About Career Happiness
The Culture of Persistence in Medicine
This mindset is drilled into physicians from Day 1:
- “You owe it to your patients.”
- “Push through. That’s what we all did.”
- “Don’t be a quitter.”
This cultural messaging reinforces the very biases that trap us, making it harder to reassess whether our current path still serves us. As Green Bay Packers legendary coach Vince Lombardi famously said, “Winners never quit, and quitters never win.” But if taken as gospel, that quote can lead us straight off a cliff.
When Persistence Backfires — Real Stories
Muhammad Ali
Ali’s refusal to quit boxing, even in the face of clear neurological decline, has become a powerful cautionary tale. By the late 1970s, signs of damage were evident. His speech had slowed, and his movements weren’t as sharp. Yet he pressed on, driven by pride, identity, and the desire to reclaim former glory. His final fights, including the punishing bouts against Larry Holmes and Trevor Berbick, were painful to watch. They offered little of the brilliance that made him a legend and only deepened the toll on his health.
Ali was ultimately diagnosed with Parkinson’s syndrome in his early 40s. His persistence wasn’t noble—it was tragic. Sometimes, real courage lies not in pushing through, but in knowing when to stop.
Captain Ahab
In Moby Dick, Ahab’s obsessive quest for the white whale leads to ruin. Physicians, too, can chase prestige, legacy, or status long past the point of reason. That might sacrifice their health, families, or values along the way.
Smart Quitting Strategies — What You Can Do
How can we get better at quitting? Here are five proven strategies to help you decide when it’s time to move on:
- Kill criteria: Borrowed from Duke, a poker champion and decision strategist, “kill criteria” are decision points you set in advance to signal when it’s time to walk away. It’s the professional version of knowing when to hold ’em and when to fold ’em. For example: “If I still feel depleted after 12 months of coaching, I’ll explore non-clinical options,” or “If my side business earns $X/month for six months, I’ll reduce my clinical time.”
- Decision swearing: Make a public commitment to act based on specific outcomes. Tell a spouse, coach, or financial advisor your kill criteria—they’ll help keep you accountable when emotions cloud your judgment.
- Diversify your identity: Write down five roles outside of medicine that bring you meaning. The broader your identity, the more adaptable and resilient you’ll be when change comes, whether it’s by choice or by force. I’ll share a few of mine: husband, father, friend, child of God, speaker, writer, and (for good measure) fly fisherman.
- Use a trusted outside perspective: Sometimes we can’t see clearly from inside the storm. Trusted advisors—mentors, friends, financial planners—can help us cut through the noise and reevaluate with clarity.
- Normalize quitting: I know physicians who continued working clinically solely to avoid the guilt of quitting, even though the work left them drained. After finally stepping back, every one of them told me they had no regrets.
We need to stop treating career change like failure. Medical schools and institutions should talk openly about pivoting as a normal part of professional evolution.
More information here:
The Importance of a Career
Leaving Dentistry and Finding Happiness
When to Quit Financial Strategies
Quitting smart isn’t just about career. It applies to money, too.
- Still holding onto a real estate property that no longer fits your goals?
- Keeping an underperforming advisor because “you’ve already paid them so much?”
- Clinging to whole life insurance or complicated tax shelters out of fear of “losing what you already spent?”
These are financial versions of the sunk cost trap. Letting go isn’t failure. It’s a strategic decision to cut losses and improve future outcomes.
Quitting Is Not the Opposite of Courage; It Can Be the Highest Form of It
Quitting isn’t cowardly. It’s self-aware. It’s strategic. And sometimes, it’s the bravest move of all. Letting go doesn’t mean you’ve failed. It means you’re making space for something better.
How do you think about quitting? What are you holding onto just because you think you should? What would it feel like to let go and choose better?
