<p>Burned out, morally injured, and wondering if you’re the problem? Good news and bad news: it's not you, it's the system. This episode is for clinicians, group practice owners, and mental health leaders who feel trapped between their ethics, insurance demands, and the crushing weight of “doing it all.”</p><p></p><p>In this conversation, we unpack the evolving challenges facing clinicians in independent practice, especially the shift from “I’m just burned out” to recognizing true moral injury. We look at how systemic forces, insurance requirements, and changing rules in healthcare are reshaping what it even means to do ethical, sustainable clinical work.</p><p></p><p>You’ll hear how isolation in leadership, constant multitasking, and opaque power dynamics erode both capacity and integrity over time. The episode also explores why so many group practice owners feel like they “failed,” when in reality the rules changed without their consent or control.</p><p></p><p>What you’ll learn</p><p>➡️ Why your group practice didn’t fail just because you “couldn’t hack the rules”</p><p>➡️ The difference between burnout as a capacity failure and moral injury as an integrity failure</p><p>➡️ How clinicians become the vicarious “fall guy” for insurance companies and broken systems</p><p>➡️ Why burnout can stop being a phase and start to feel like an identity you can’t escape</p><p>➡️ How isolation at the top quietly harms clinical judgment, leadership, and well-being</p><p>➡️ What it looks like to reinvent your work using technology and AI without losing your humanity</p><p>➡️ Why “off the chair” means refusing to believe that suffering is the price of legitimacy in this field</p><p></p><p>If you’ve ever thought, “I can survive this if I can just see a way out,” this episode sketches the contours of that way out. It offers language, frameworks, and possibilities for clinicians who are ready to stop surviving in silence and start reimagining what practice can look like.</p><p></p><p>Episode chapters</p><p>00:00 – Introduction to the journey of clinicians</p><p>06:46 – The illusion of freedom in group practice</p><p>09:05 – The changing landscape of healthcare</p><p>10:26 – The new power dynamics in healthcare</p><p>12:53 – The burden of multitasking in practice management</p><p>13:11 – Understanding moral injury vs. burnout</p><p>17:55 – The impact of moral injury on clinicians</p><p>21:13 – The isolation of leadership in healthcare</p><p>25:07 – Navigating workplace turmoil</p><p>27:48 – The burden of leadership in mental health</p><p>30:27 – The impact of insurance on mental health practices</p><p>36:43 – The journey to selling a practice</p><p>40:24 – Reinventing mental health care in a changing landscape</p><p>45:58 – Embracing technology for sustainable practice</p><p>48:33 – Finding hope and healing in the chaos</p><p>50:33 – Understanding human behavior and cues</p><p>51:24 – Taking action for change</p><p></p><p>If this episode resonated with you, hit subscribe so you don’t miss future conversations. Leave a review to help other clinicians find this show, and share this episode with a colleague who is quietly burning out or carrying moral injury alone.</p><p></p><p>Connect with us!</p><p>Website: <a target="_blank" rel="noopener noreferrer nofollow" href="http://www.offthechair.com">www.offthechair.com</a></p><p>Instagram: @offthechairpodcast</p><p>YouTube: @offthechairpodcast</p><p>TikTok: @offthechairpodcast</p>