Condition: Critical

Taylor Nichols, MD
3 min readOct 24, 2023

The US Healthcare system is collapsing.

Emergency Departments across the country are closing. Emergency Medicine physicians are in high demand now, as more physicians leave while the patient volume continues to skyrocket.

People stopped caring about us seemingly weeks into the pandemic, and then they vilified us.

Those who aren’t paying attention to the state of those currently in medicine, and more importantly the pipeline of those entering or potentially entering medicine, need to start paying attention and becoming significantly concerned.

I am already more than concerned. I’m watching this happen in real time. The system is already collapsing. The exodus from healthcare is well underway, and fewer are going to choose to enter these primary care, emergency medicine, and critical care fields. I know because I am part of that exodus, and yet I receive phone calls from recruiters for emergency medicine physician job opportunities multiple times daily, some offering exorbitant rates for positions requiring significant travel.

I have gone from working full time in emergency medicine to working only a third as much in the emergency department. As I have become eligible to take the board-certification exam in Addiction Medicine, having proven sufficient experience and expertise in the field, I now spend the rest of my time outside of emergency medicine working across the continuum of care for patients with substance use disorders.

The trauma that we experienced in clinics and hospitals and most especially in the emergency departments during the surges of COVID, along with the subsequent gaslighting of that experience and hostility towards our profession and our training from the general public on up to the President of the United States have broken us. Most of us will never be the same and many will never return.

I’m sorry, society, but you’ll never be able to take that trauma away or get us back. You need to start paying attention NOW while the system is actively collapsing, before everything implodes.

These are policy decisions. These are the political determinants of health at work and we are actively seeing the repercussions. This is the consequence of the policy choices and the political gamesmanship which has led us to see healthcare as less human and more as a commodity, of patients as widgets and physicians merely widget makers. We have corporatized a system that has always and will…



Taylor Nichols, MD

Humanist. Emergency Medicine and AddictiEmergency + Addiction Medicine | Health policy and advocacy | Health tech and innovation