~ In other words: the physician who is quietly measuring their worth against the colleague down the street is not just distracted — they are actively undermining their own happiness.

A CMT Leadership Essay – 

There is a conversation happening in break rooms, at medical conferences, and in text threads between physicians that almost no one talks about publicly.

It goes something like this: “Did you hear what she’s making now?” “He converted to concierge and works how many hours now?” “She only sees 400 patients. Must be nice.” “I heard his practice is struggling.” “She gave up a real career for that.”

It sounds like small talk. It isn’t.

What’s actually happening in those moments is something psychologists have studied for decades — social comparison — and for physicians, it may be quietly doing more damage to careers, practices, and personal happiness than any administrative burden, EHR system, or insurance denial ever could.

The Science Behind the Trap

Social comparison theory, first formally described by psychologist Leon Festinger in 1954, holds that human beings have a persistent drive to evaluate their own circumstances against those of others around them. The closer the peer group — professionally, socially, geographically — the sharper and more consequential that comparison tends to become.

Research published in PNAS Nexus (2022) found that the income-happiness correlation has increased substantially since 1972 in the United States, and tends to get higher when both GDP per capita and income inequality are high. In plain terms: the more economically stratified the environment, the more corrosive financial comparison becomes to personal wellbeing.

For physicians — a profession with wide income variation across specialties, practice models, and geographies — this is not an abstract finding. It is a daily lived reality.

A study published in PMC found that frequent social comparison may negatively impact subjective wellbeing, as it shifts focus from internal self-assessment to external standards. Conversely, subjective wellbeing improves when individuals focus inwardly and reflect on their own life satisfaction and happiness.

In other words: the physician who is quietly measuring their worth against the colleague down the street is not just distracted — they are actively undermining their own happiness.

What Physicians Are Actually Comparing

The comparison trap in medicine is not limited to income. It runs across at least four dimensions — and each one carries its own cost.

Practice model. A physician in a traditional employed setting compares themselves to a colleague who transitioned to concierge medicine. The concierge physician compares their panel size to a colleague running a larger membership practice. The DPC physician wonders if they should have gone concierge, should I work with employers — or, should I be charging more? It is a loop with no finish line.

Lifestyle. Schedule flexibility, vacation time, time with family, physical health, and personal pursuits are all quietly benchmarked against peers. Many physicians still love what they do, but they just can’t keep doing it at this pace in the current practice environment, with its administrative burdens and regulatory burdens, and the proliferation of asynchronous messaging with patients through the electronic health record, according to Dr. Tait Shanafelt of Stanford Medicine. The lifestyle gap between practice models has become increasingly visible — and increasingly difficult to ignore.

Financial decisions. The business decisions physicians make — when to transition, whether to hire consultants, how to price a membership, what to invest in — are all subject to secondhand judgment from peers who may have made different choices under different circumstances. That judgment, whether spoken or implied, lands.

Happiness itself. Perhaps most insidiously, physicians compare their happiness. They observe a colleague who seems energized, fulfilled, and thriving, and wonder what’s wrong with them for feeling otherwise. The comparison becomes not just financial or professional, but existential.

The Burnout Connection

The stakes of this dynamic are not theoretical. After adjusting for age, gender, relationship status, and work hours, physicians were 82.3% more likely to be experiencing burnout than U.S. workers in other occupations, according to a Stanford Medicine-led study published in Mayo Clinic Proceedings in 2025.

For 2024, 43.2% of physicians reported experiencing at least one symptom of burnout, down from 48.2% in 2023 and 53% in 2022, according to the AMA’s national physician comparison report. Progress — but nearly half of the physician workforce still reporting burnout is not a footnote. It is a structural problem.

Social comparison does not cause burnout in isolation. But it functions as an accelerant. When a physician is already stretched thin and then layers on the weight of measuring their career against a peer who appears to be thriving, the psychological cost compounds.

Research published in PMC notes that sleep deprivation, unhealthy coping mechanisms, lack of self-care, social support, and self-critical tendencies are more prevalent among physicians — a profile that makes the comparison trap particularly dangerous in this population.

The Concierge Medicine Factor

The rapid growth of membership-based medicine has added a new and specific dimension to physician comparison culture.

Between 2018 and 2023, the number of concierge and direct primary care practices nationwide surged by 83.1%, and the number of clinicians working in them increased by 78.4%, according to a December 2024 study published in Health Affairs by researchers from Johns Hopkins, Oregon Health & Science University, and Harvard Medical School.

The researchers found that physicians in these models can choose their own schedules, dictate the length of their visits, and decide exactly what sort of care they’re going to be delivering without administrative oversight from a manager — and that this affects clinician autonomy, job satisfaction, and longevity in the field quite significantly.

A systematic review published in The American Journal of Medicine (2025) found that concierge medicine is linked to higher physician job satisfaction and a stronger emphasis on preventive care, with physicians in concierge models describing greater autonomy in medical decision-making and the ability to build deeper patient relationships.

These are meaningful findings. But they also create a new surface area for comparison. A physician who has not yet transitioned — or who has chosen not to — now must navigate the visible success stories of peers who have. And a physician who has transitioned must resist the temptation to measure their panel size, their revenue, and their lifestyle against the colleague down the street who converted six months later and appears to be doing it differently.

Neither comparison is useful. Neither comparison is accurate. And neither comparison leads anywhere good.

“Don’t compare your beginning to someone else’s middle, or your middle to someone else’s end. Don’t compare the start of your second quarter of life to someone else’s third quarter.” — Jon Acuff

Jon Acuff is a New York Times bestselling author and one of INC Magazine’s Top 100 Leadership Speakers. The quote is definitively sourced to his book Start (2013) and has been widely cited and verified across Goodreads, Oprah.com, and his own platforms.

What the Research Actually Says About Happiness

Here is what the evidence — not the conference hallway chatter — actually supports.

Happiness is not primarily a function of income, panel size, or practice model. It is a function of autonomy, meaning, relationships, and alignment between one’s values and one’s daily work.

Research on subjective wellbeing consistently finds that frequent social comparison may negatively impact subjective wellbeing, as it shifts focus from internal self-assessment to external standards. Subjective wellbeing improves when individuals focus inwardly and reflect on their life satisfaction and happiness.

For physicians, this means the most important question is not “What is my colleague doing, and how do I compare?” It is “What does a sustainable, fulfilling practice actually look like for me — given my values, my patient relationships, my family, and my financial reality?”

Those are entirely different questions. And only one of them has a useful answer.

A Word on Business Decisions and Financial Comparison

CMT does not present financial advice, and this article is no exception. But the editorial position here is straightforward: the financial decision to transition to a membership model, stay in a traditional setting, or pursue any hybrid approach should be made on the basis of individual circumstances — not on the basis of what a peer appears to be earning or building.

Physicians who transition to concierge or membership medicine for the right reasons — alignment with their care philosophy, sustainability, patient relationship depth — tend to build practices that reflect those values over time. Physicians who transition primarily because a colleague appears to be doing well financially tend to find the grass was not as green as it looked from the parking lot of a medical conference that was full of napkin math and evangelists.

The operational infrastructure required to build a successful membership practice — legal compliance, pricing strategy, patient communication, panel management — is not visible from the outside. What is visible is a curated version of someone else’s outcome. That is not a business plan. It is a highlight reel.

The Leadership Reframe

At CMT, we have long held that the physician who thrives in concierge and membership medicine is not the one who wins a comparison contest. It is the one who stops playing.

The physicians we have interviewed over more than a decade at the Concierge Medicine Forum — from solo practitioners to multi-physician practices — share a common thread: they made decisions rooted in clarity about their own values, not anxiety about their peers. They sought mentorship and operational guidance. They built patiently. And they measured success by how their work aligned with the kind of physician and person they wanted to be — not by whether their numbers were better than someone else’s.

That is not a soft leadership principle. It is, according to the research, the actual driver of sustained professional satisfaction.

The Bottom Line

The comparison trap is real. It is scientifically documented, professionally costly, and quietly pervasive in medicine. And it is one of the most underacknowledged contributors to physician dissatisfaction — not because the system forces it, but because physicians are human beings who are extremely good at benchmarking and measuring things, including themselves.

The antidote is not ignorance of what peers are doing. It is clarity about what you are building — and why.

A sustainable, relationship-driven practice is not built by comparison. It is built by design.

If you take anything from this article and essay today, maybe it should be this… “It’s no longer about being the best Doctor in the world anymore, it is about being the best Doctor FOR the world, FOR your Patients and FOR your local community.”  ~Editor-In-Chief, Concierge Medicine Today

Concierge Medicine Today is an independent leadership publication. This article is for educational and informational purposes only and does not constitute medical, legal, or financial advice. Consult qualified professionals before making practice decisions.

Verified Sources Referenced in This Article

• Festinger, L. (1954). A Theory of Social Comparison Processes. Human Relations, 7(2), 117–140.
• Stanford Medicine / Mayo Clinic Proceedings (2025): med.stanford.edu
• AMA National Physician Burnout Survey 2024: ama-assn.org
• Health Affairs / Johns Hopkins (December 2024): carey.jhu.edu
• The American Journal of Medicine — Concierge Medicine Systematic Review (2025): amjmed.com
• PMC — Physician Burnout Evidence-Based Roadmaps: pmc.ncbi.nlm.nih.gov
• PMC — Income, Social Comparison, and Subjective Wellbeing: pmc.ncbi.nlm.nih.gov
• PNAS Nexus — Money and Happiness (2022): academic.oup.com