For years, Dr. Menachem Jacobs thought rest meant sleep.

As a resident at Yale New Haven Hospital in New Haven, Connecticut, he did his best to get enough of it, which wasn’t often. Even when he managed a full night’s sleep, it didn’t bring the relief he expected. His body might slow down, but his mind didn’t.

“My mind kept racing through patient records,” Jacobs said. “So even sitting on the couch wasn’t helping.”

He was on the cusp of understanding what few healthcare workers figure out: True rest requires more than lying down. It requires something that pulls your attention out of the mental loops that medicine trains clinicians to spin 24/7.

That’s when Jacobs started hiking. On a trail, he has to focus on where he’s stepping. The terrain demands attention in a way that forces his mind into the present moment. “The physical activity helps me to cleanse my thoughts,” he said.

When he returns to work after a hike, he notices the difference. He feels steadier, less reactive, and more able to focus on the person in front of him. In a profession built around constant vigilance, that kind of intentional disconnection has become essential.

And yet if the prescription is so simple, why do so many clinicians find themselves unable to fill it?

Why Genuine Rest Is so Hard in Medicine

Medical education has long valorized endurance. From the earliest days of training, physicians are taught to push through fatigue. Long shifts, overnight calls, and constant responsibility are treated as rites of passage. In medical culture, chronic sleep deprivation is often interpreted as proof you’re doing the job right.

The implicit lesson is that a good doctor does not have needs or at least does not acknowledge them. Over time, that expectation becomes deeply internalized.

“In medicine, rest is often treated as a weakness rather than a priority,” said Stacey Elliott, DO, a psychiatrist in Manlius, New York, who treats physicians. “At best, it’s deprioritized. At worst, it’s actively shunned.”

Elliott sees the consequences regularly in her patients and her own life. Rest, she says , isn’t something most doctors naturally allow themselves. It has to be chosen deliberately, often in defiance of the culture they were trained in.

Several clinicians interviewed for this story described struggling to recognize when they were depleted because depletion had become the baseline. Feeling exhausted didn’t register as a warning sign. It felt normal.

That normalization makes it harder to intervene later, Elliott says. By the time physicians reach attending roles, many have spent a decade or more overriding their own limits.

Part of the problem is that medicine often confuses rest with collapse. After a long shift, clinicians may scroll, binge-watch, or numb out. Those activities can distract, Elliott says , but they rarely restore.

Why Time Out Is More Valuable Than Time Off

Tait Shanafelt, MD, chief wellness officer at Stanford Medicine in Palo Alto, California, and one of the country’s leading researchers on physician burnout, has spent years studying what predicts distress among clinicians. One of the strongest factors isn’t personality or resilience. It’s whether doctors can truly disconnect from work.

In a 2024 study published in JAMA, Shanafelt and his colleagues found that physicians who took fewer than 15 days of vacation per year were significantly more likely to experience burnout. About 1 in 5 physicians took less than a single week of vacation in the previous year. That’s not so surprising.

The more interesting tidbit: Burnout risk was even higher for doctors who lacked inbox coverage while away or spent more than 30 minutes a day handling work during vacation.

“These findings illustrate the importance of disconnecting from work to take time to recharge” Shanafelt said. “Making this possible requires actions by both organizations and individual physicians.”

Many health systems, Shanafelt notes, have invested heavily in wellness initiatives while leaving workloads largely unchanged. Yoga classes and mindfulness apps coexist with inboxes that follow physicians everywhere and schedules that make disconnecting nearly impossible.

The stakes extend beyond physician well-being. Burnout has been consistently linked to higher rates of medical error, lower patient satisfaction, and increased turnover across specialties. When clinicians are depleted, their attention narrows, decision-making slows, and empathy erodes.

Shanafelt’s research has also shown that burned-out physicians are significantly more likely to reduce their clinical hours or leave medicine altogether, compounding workforce shortages that many health systems are already struggling to address.

Real Rest vs Fake Rest

Part of the problem is that medicine often misidentifies “rest.”

“It’s often mixed up with dissociation, a complete mental disconnection from the self and the environment,” Elliott said. True rest, she argues, requires intention. It means giving the nervous system a chance to downshift rather than simply switching forms of stimulation.

For Elliott, true mental restoration is deliberate, though it might be small. It could involve ten minutes of meditation or sitting outside without a phone. Maybe reading a book or playing with her kids without electronics. Activities that allow her to be present rather than productive.

She encourages other physicians to schedule rest the way they schedule patients or meetings. Not as a reward for finishing everything else, but as a nonnegotiable part of the day.

Jordan Spencer, DO, a psychiatrist based in Charleston, South Carolina, draws a similar distinction between what he calls passive and active recovery. Simply zoning out, he says, doesn’t count. Rest, like training, requires effort.

“You need to rest as hard as you work,” Spencer said, pointing to elite athletes who build recovery directly into their training. Olympic athletes build massage, stretching, and recovery routines into their schedules because pushing without recovery leads to breakdown. The same principle applies to clinicians, he says, even if the work looks different.

For many clinicians, that realization comes late. After years of operating in a constant state of depletion, rest feels unfamiliar, even uncomfortable. Learning to rest, it turns out, often requires unlearning what medicine taught them in the first place.

When the Environment Works Against You

Even when clinicians understand what real rest looks like, many work in environments that undermine it, keeping them in a state of heightened alert.

Hospitals are designed for efficiency and constant readiness. Bright lights, persistent activity, and electronic records that extend the workday into home life can suggest a chronic mindset of productivity even when off the clock.

Many of those design choices were made with good intentions, noted Upali Nanda, PhD, a partner and executive vice president of the design firm HKS, who studies healthcare facility design and staff well-being. Centralized workstations improve communication. Bright lighting reduces error. Open layouts increase visibility. But over time, those features can contribute to sensory overload, especially when clinicians have no reliable place to step out of high-alert mode.

Nanda’s research showed that access to nature, art, and social connection can be cognitively restorative, even in short bursts. But those elements only help if they’re integrated into everyday spaces.

“Respite elements have to be baked into areas where people already spend time,” she said, including corridors and nurse stations.

Mark Linzer, MD, who directs the Institute for Professional Worklife at Hennepin Healthcare in Minneapolis, has seen the limits of treating rest as a perk rather than part of the job itself. In his research, rest only becomes possible when the structure of work makes room for it.

But efficiency alone isn’t enough. Without changes to pace and coverage, Linzer noted, even well-intentioned rest initiatives fall flat. “Structural changes to support rest time, breaks, and naps could be very helpful,” he said, particularly in settings where clinicians otherwise feel pressure to push through.

Taken together, the research from both Nanda and Linzer points to the same conclusion. Supporting rest in healthcare is less about creating symbolic spaces and more about reshaping how work is organized. Without changes to pace, workload, and efficiency, even well-intentioned design interventions struggle to make a meaningful difference.

When Rest Becomes a Form of Resistance

For some clinicians, the conversation about rest extends beyond logistics and into values. Relearning how to rest may require not just scheduling changes but a fundamental shift in identity.

Tavi Schlueter, CPNP-PC, PMHS, a nurse practitioner and director of growth initiatives at CollaboratingDocs.com, who works closely with clinicians across the country, says rest in healthcare is often defined too narrowly. “Rest is reduced to hours of sleep rather than genuine recovery,” she said. Rest still feels radical in medicine, she added, because endurance is equated with competence.

Schlueter describes effective rest as setting intentional boundaries and disengaging from productivity pressure. “These choices may not look traditional,” she said, “but they’ve been essential for sustainability.”

“Until rest is treated as a patient safety issue and a workforce retention strategy, not a personal weakness, it will continue to feel countercultural,” Schlueter said.

That tension is particularly pronounced as healthcare becomes increasingly shaped by corporate priorities. Productivity targets, billing codes, and efficiency metrics leave little space for restoration, even as the emotional demands of care grow heavier.

For clinicians in productivity-driven systems, choosing rest can feel quietly subversive. It challenges the idea that care requires self-erasure.

Rest as a Professional Skill

For Jacobs, rest stopped being something he tried to squeeze in after the work was done. He began treating it as part of the work.

Elliott treats rest as something that has to be scheduled and protected, especially in a profession that will happily fill every open space. In her view, rest is not a reward for finishing everything else. It is what allows her to keep doing the job well.

That difference matters. Across these interviews, rest is rarely described as escape. It is described as maintenance. It is what makes the work sustainable. This runs against the old mythology of medical professionalism. The ideal doctor is tireless and self-sacrificing, always available, always pushing through. In that framework, fatigue is expected and recovery is postponed. The personal cost is treated as part of the deal.

But a different definition is emerging, one grounded in competence rather than endurance. Competence requires clear thinking and emotional regulation. It requires knowing when judgment is being compromised by exhaustion. From that perspective, rest is not a luxury or a lifestyle preference. It is a safety practice.

Medicine depends on people who can think clearly under pressure and remain emotionally available in difficult moments. That clarity doesn’t come from running on empty. It comes from knowing when to stop, step back, and recover.

Rest isn’t the opposite of professionalism. It may be one of its clearest expressions.