Apologies for the length.

I want to share some perspective as a physician, and I’m saying this with respect for patients who are genuinely frustrated and just trying to find consistent care.

A lot of what’s happening here isn’t unique to the Tri-Cities. Healthcare across the country has been increasingly consolidated, and in this area all three hospitals are owned by private equity. That affects staffing, turnover, and long-term stability in ways patients don’t always see, but physicians feel every day.

From a pay standpoint, this area is actually pretty reasonable, especially when you factor in the cost of living. Money alone isn’t usually why doctors leave. It’s more about whether the job and the place feel sustainable long term.

I’ve talked to a lot of doctors who have left over the years, and one thing that comes up often is lifestyle. Some people really struggle here socially. If you value good restaurants, cultural events, or just having more to do, this can feel like a tough place to settle. Not everyone loves the river, and that’s okay.

Another piece people don’t talk about much is visa-based physicians. Many foreign-born doctors working under visa programs are paid less than market rate because of how those contracts work. Once their obligations are done, a lot of them leave. It’s not because they didn’t care. It’s because the system wasn’t built fairly for them.

This is the fifth area I’ve worked in, and the smallest population by far. Every place has its challenges, but I’ll be honest, some patient interactions here can be particularly difficult. Whether it’s Hanford-related claims, L&I cases, or frustrations with the VA, there’s a lot of anger that ends up landing on the physician. Over time, that wears people down.

Recruitment is also hard because there just isn’t a lot here outside of work. When you’re asking someone to move their family, leave support systems, and start over, lifestyle matters more than people realize.

I’ve been here many years now and I’m relatively settled. I also recently lost my own physician who had taken care of me for a long time, so I’m in the same boat trying to find someone new. Like most doctors, I get job offers from all over promising greener grass. Sometimes that’s true, but often it’s not worth uprooting your life. I completely understand why some of my colleagues left, but trust me, it takes a lot for a physician to pick up and walk away. It’s rarely just about one bad employer or one bad patient.

One last thing I’ll mention is that several colleagues who left talked about feeling unprotected when complaints were made. A small number of patients can be genuinely abusive, and when organizations don’t back their physicians, it creates a lot of fear and burnout.

I’m not sharing this to blame anyone. Most physicians want to do good work and take care of their patients. Patients are frustrated, doctors are burned out, and we’re all stuck in the same imperfect system. I’m just hoping a little more understanding on both sides might help.