Addicted to Achievement | Ep8

Michael Hersh, MD

[00:00:00] What if the very thing that made you a great doctor, the drive to achieve has quietly become the thing that's holding you back? Stick around, because today we're unpacking how the same mindset that got you here might be keeping you stuck and what you can do to move forward without losing yourself in the process.

Hey there and welcome back to Better Physician Life. I'm Dr. Michael Hersh and I'm so glad you're here today. In today's episode, we are exploring something that comes up a lot for physicians, but it's also something we don't talk about much. Being addicted to achievement. It's a topic I've been wanting to tackle for a long time because if you're a physician, chances are this story will sound uncomfortably familiar.

We are gonna talk about how achievement became our drug of choice, how [00:01:00] the pursuit of success changed our lives for better and for worse, and most importantly, how we can begin to untangle ourselves from the web of endless striving and start building a life that finally feels like our own. Okay, so let's get into it.

And let's start at the beginning. For most of us, the pursuit of achievements started pretty early on. Maybe it was the gold star in elementary school, the perfect report card, the good job from a parent or a coach, whatever it was, we learned quickly. Success gets rewarded. Achievement brings praise and being the best means you're safe, you're respected, and maybe worthy.

By the time we hit high school, the game was on AP classes, varsity [00:02:00] sports leadership positions, SAT scores. The message was clear. Keep climbing, keep winning, don't let up. And then came the gauntlet of pre-med and medical school residency. And each phase had its own set of metrics, grades, test scores, class rank, research, publications, honors awards, and every step, there was a new hoop to jump through, a new finish line to cross.

A new reason to push harder and sacrifice more, and we did it. We became the people who could outwork outlast and out achieve almost anyone. We became the ones who always get it done, the ones who never quit and the one everyone can count on. But then somewhere along the way. [00:03:00] Something shifted.

Achievement wasn't just something we pursued. It became who we were. And when your worth gets tied to what you do, how much you produce, how much you win, it gets harder and harder to remember who you are without it. And the more we accomplished, the more the bar moved. You get into med school, great. Now it's about matching into the best residency you match.

Now it's the fellowship, the job, the salary, the title. Each win feels good for a moment, but then it fades and suddenly you're chasing the next one. And somehow, despite hitting all the marks, it still didn't feel like enough. That's when we start to realize we're not climbing a mountain. We're on a treadmill, a [00:04:00] never ending treadmill.

Psychologists call it the hedonic treadmill. The idea that no matter what we achieve, our happiness quickly resets to baseline that first big win acing an exam, landing your top residency, it feels incredible, but then it fades. Just like that. The next goal appears, the next thing to chase. You get into med school now.

You want the best residency. You match. Now you're gunning. For the top fellowship. You get the fellowship. Now. It's the prestigious job, the title, the corner office. Every time you arrive, the finish line moves. Every high is followed by another climb, and with each step, the treadmill speeds up. You run faster, but you never quite arrive.

Meanwhile, the world around you keeps cheering you on to keep [00:05:00] running more RVs, more publications, more leadership, more productivity. Colleagues, administrators, even family feeding the cycle often without even realizing it. And so you just keep going. Always striving, never arriving. The joy is fleeting. The pressure is constant, and the life you thought you were building starts to feel a little more like a performance you can't step away from.

Now, I wanna be very clear here. Achievement isn't the enemy for a long time. It served us well. That drive to excel, it got us through brutal training. It pushed us to learn, to grow, to care deeply about our work, and it made us resilient and disciplined, resourceful. It gave us purpose and pride and a sense of direction.

It's what makes you the kind of physician people trust with [00:06:00] their lives. And let's be honest, there are real rewards. The financial stability, the social status, the respect of peers, the intellectual challenge, the satisfaction of mastering something so complex, The sense that what you do matters.

But here's the catch. What starts as a tool for growth can quietly become a trap. So what happens when achievement stops serving us and starts running the show? Achievement Addiction is real. It's when the pursuit of success becomes compulsive, when your self-worth hinges entirely on your latest accomplishment.

When you can't stop chasing the next win, even if it costs you, your health, your relationships. Or your sense of self. And it's not always dramatic. [00:07:00] Sometimes it's subtle, quiet, creeping in through the cracks of your everyday life. Maybe you feel restless or anxious between wins. Maybe free time makes you uneasy.

You start to feel guilty if you're not being productive. And I'll just add here, man, is that a big one for me? Feeling guilty when I'm not being productive. It's something I've continued to work on relentlessly, but maybe you keep setting bigger and bigger goals. Even when you're exhausted, you can't seem to enjoy the successes you do have.

They never quite feel like enough. You start measuring your value by your resume, your title, your income, and the things that used to matter, like your health and your hobbies, your relationships. They slowly start to get pushed aside. Sound familiar? [00:08:00] If it does, you are not alone. Achievement Addiction is especially common in medicine because the whole system is built on external validation from board scores to patient reviews, from RVs to awards.

We are constantly being measured, ranked, and evaluated, and over time we start to believe that our worth lives in those numbers in our output. How impressive we look on paper, not in who we are, and when we forget that when achievement becomes the only lens we see ourselves through, we start to lose more than just our joy.

Let's talk about what gets lost in the endless chase. First, our bodies take the hit, sleep becomes optional. Exercise gets skipped. Meals turn into fuel [00:09:00] stops or afterthoughts. We tell ourselves we'll take care of it later. Once things settle down, but later doesn't come. And over time the stress builds elevated cortisol, high blood pressure, chronic fatigue.

Our bodies carry the cost of our ambition often silently and without any indication there's a problem. Then of course there's our relationships. When we're laser focused on the next goal, everything else starts to feel like a distraction. Family dinners, weekend plans, the small quiet moments that actually matter, we miss them or we show up, but we're not really there.

Our partners feel shut out. Friendships drift. And one day you look back and realize your happiest memories weren't the big wins. They were the ordinary [00:10:00] moments you barely noticed at the time. And mentally it's not any easier. Perfectionism, anxiety, burnout, they are not rare for high achievers. They're almost expected the pressure to perform never lets up.

Every mistake feels like a moral failure, and the fear of falling behind becomes the constant background noise of your life. we often treat that fear with more achievement, thinking the next win will finally make everything better. But it doesn't because the more you chase the emptier, it starts to feel.

And that's where the deepest loss happens, not in your schedule or your research work or your list of accolades, but in your identity in that quiet question that starts to surface when the noise [00:11:00] fades. Who am I without all of this? And sometimes we don't know. So why is it so hard to stop even when we know that Chase is hurting us?

Why can't we just step off the treadmill? Well, for one, the rewards are real. The praise, the paychecks, the recognition, they're not imaginary, they're powerful. And when you've built your life around those external wins. It's hard to imagine life without them. And let's be honest, medicine doesn't just tolerate this mindset.

It selects for it. It attracts people who are driven, obsessive, relentless, and then it reinforces that behavior. At every stage you're surrounded by colleagues who are just as competitive, just as exhausted, just as hooked on the next [00:12:00] win. So it feels normal, even necessary. And slowing down that starts to feel like falling behind.

Like you are not serious, like you're failing. And underneath all of that, there's a fear that if you stop pushing, if you stop producing, who are you? What's your worth, if not tied to your output? The alternative facing, the quiet, the uncertainty, the emptiness. That's scary. It's so much easier to just keep moving, keep checking boxes, keep proving yourself.

But here's the hard truth. The treadmill, it doesn't stop on its own. If you don't step off, it will keep running until you burn out, break down or [00:13:00] lose the things that matter most to you. Awareness. That's the first step out. Not action, not a plan, not a five point strategy, not another to-do list. Just awareness.

Start by asking yourself some uncomfortable, honest questions like, when was the last time you truly felt satisfied with what you had achieved? Not proud, but satisfied like you could rest. Do you feel anxious or empty when you're not working towards something? Does rest make you uneasy? Do you feel guilty if you're not being productive?

Are you afraid to slow down? What do you worry might happen if you did? How much of your self worth comes from your accomplishments? Not what you love, not who you are, just what you [00:14:00] do, and maybe the hardest question. What have you sacrificed for the sake of achievement? If these questions make you squirm a little, you're not alone.

I'm squirming just thinking about them. Most of us were never taught to ask these questions, and we were certainly not told how to answer them honestly. this is where change begins, not with some grand declaration. With a quiet moment of truth, a pause, a breath, a glimpse of who you might be without the striving.

So how do you begin to step off the treadmill? Okay, you're aware of it now. Now what? how do we keep our ambition alive without letting it take over our lives? There's no perfect map for this, but there are a few shifts, small, intentional moves that can really start to change the shape of your [00:15:00] days, and it is gonna start by redefining what success means to you.

Not the kind printed on plaques or listed on your cv, but your own internal version. What's the meaningful life actually look like to you? Maybe it's being present for bedtime stories more than work meetings. Maybe it's doing work that feels aligned with who you wanna be, not just impressive. Maybe it's having the freedom to slow down when you need to without feeling guilty.

We've been trained to measure success by output and optics. At some point, it's worth asking who decided that and are those values still serving you? Okay, so next, self-compassion. Okay, I get it. This one sounds soft and maybe even a little uncomfortable to think about [00:16:00] self-compassion, but the truth is the voice in our heads matters.

For many of us, it's brutal. You wouldn't talk to a colleague or a friend the way you talk to yourself. You'd be nice. You'd offer some grace and understanding space for them to be imperfect. So how can you extend yourself the same courtesy? Because mistakes aren't a verdict. They're a part of the process.

We really do need to be aware of how we're talking to ourselves throughout the day and what we make those things mean. Okay. Next we get to talk about boundaries. Okay? This isn't just lip service. These are actual limits. Medicine. Our careers, the things we do will always ask for more. Your institution [00:17:00] won't tell you when to stop.

You have to decide where your line is, and then you have to protect it. That might mean saying no to another committee or leaving the hospital when your shift ends, or not adding another patient to the end of your day or putting your phone away at dinner and actually being home with your family. These things aren't a weakness, it's wisdom.

And then reconnecting with your original why, for why you chose this career in the first place. Most of us didn't choose this path for prestige. We chose it because we wanted to help people to heal, to contribute. This is what we all wrote about in our personal statements. Over time, that gets buried under RVU and administrative tasks and the [00:18:00] pressure to stay ahead.

So dig it back up. Remember the version of you who started this journey. What did he or she care about? What made him or her proud, and then cultivates some gratitude and presence. I know these words get tossed around a lot, but they're easy to forget about and they really do work. Gratitude doesn't mean ignoring what's hard.

It means noticing what's here and what you appreciate. It's about remembering the quiet moments, the human ones, the stuff you miss when you're always sprinting to the next thing. Maybe most important of all, they give you an opportunity to invest in your relationships because you get to be grateful and present in them.

You are not just a physician, you're a partner, you [00:19:00] are a parent, a friend, a human being. Make time for those parts of you. Put down the phone. Look your kid in the eye. Call your sibling. Sit on the porch with your spouse, and don't rush through it because achievement fades, but connections don't. You don't have to figure all of this out on your own.

Talk to somebody. Call a friend, a mentor, a coach, a therapist. Someone who doesn't need you to have it all together. Someone who can see you, really see you without the white coat. Because here's the thing, you're not weak for feeling tired. You're not broken for wanting something different. You're just human.

And there's real strength in honoring that. So here's the paradox. You don't have to kill your [00:20:00] ambition. You don't have to quit medicine or stop striving or pretend you don't care. You just have to put it in its proper place. Achievement isn't the villain here. It can be a powerful force for good when it's connected to your values, your relationships, your wellbeing, when you are in charge of it, when it serves your life, instead of running it.

This isn't about giving up, it's about getting honest about recentering your ambition. So it works with your life, not against it, and it's not easy. The world will keep rewarding you for running faster. Your culture, your colleagues, maybe even parts of you, they'll tell you to keep going, keep producing, keep proving, but you get to choose.

You get to decide what success looks like now, what you wanna protect, [00:21:00] what you're no longer willing to trade away, and that choice, that quiet, steady reclaiming of your own definition of a good life, that's the real win. If you take nothing else from this episode, let it be this. You are more than your achievements.

Your worth is not measured by your productivity, your title or your income, the life you want, the one with more space, more meaning, more presence. It is possible, but only if you're willing to step off the treadmill and claim it. So here's your challenge for this week. Take 10 minutes, write down what success means to you outside of work.

Outside of achievement, not what sounds impressive, what actually matters to you, then I want you to pay attention. Notice when you start chasing the next win, [00:22:00] and then pause. Ask yourself, what am I really after? What do I actually need right now? And you don't need to keep all of this inside. Reach out to someone you trust.

Talk about this episode, share your story. Ask about theirs. You don't have to do this alone. There is a whole community of physicians waking up to the quiet cost of endless striving, and quietly starting to choose something different, something more authentic, more human. Thanks so much for being here. If this episode resonated for you, please send it to a friend.

Leave a review. Let someone else know they're not the only one. Feeling this way and above all, remember this, you are enough right now exactly as you are. No further achievements necessary. [00:23:00] Thanks again for being here, and I'll see you next time on the Better Physician Life Podcast. Take care.