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You Were Trained to Hide Yourself. Here Is What That Is Costing You. Episode 181

There is a version of professionalism in medicine that looks like competence from the outside and feels like self-erasure from the inside. Dr. Kathleen Muldoon is an anthropologist who teaches in a medical school, coaches doctors through burnout, and navigates the healthcare system daily as the mother of a medically complex child with 22 specialists on his care team.

In this episode, she brings all of those lenses to a conversation about psychological safety, curiosity, and what it actually costs doctors when they are trained to hide who they are. The question she keeps coming back to is one worth sitting with: what kind of clinical environment are you co-constructing, and what small things could you do differently starting today?

 

Highlights

[04:00]: Dr. Muldoon explains what burnout looks like from her vantage point, and why she sees it less as exhaustion and more as a detachment that builds quietly in environments where asking questions does not feel safe.

 

[08:00]: She describes what it is like to be a parent of a medically complex child navigating a care team of 22 specialists, and why staying curious in clinical encounters matters to her in a way that is deeply personal.

 

[14:00]: Dr. Muldoon defines psychological safety in clinical environments, and why the ability to ask a question or challenge a protocol without it being received as a threat is the foundation of both good learning and good medicine.

 

[19:00]: She introduces improv theater as a tool for practicing psychological safety in low-stakes environments, and explains why the techniques were originally developed for building empathy across difference, not for getting laughs.

 

[27:00]: The hidden cost of professionalism. Dr. Muldoon describes what happens when the cultural ceremonies of becoming a doctor teach students to erase themselves, and why that self-erasure may be one of the least examined drivers of burnout.

 

[36:00]: A five-second check-in practice she uses at the start of every workshop she runs, and why something that small can shift the entire dynamic of a clinical team.

 

Three Key Takeaways

1. Psychological safety is not about being comfortable. It is about being able to ask the question.

Dr. Muldoon is precise about what she means by psychological safety in clinical settings. It is not warmth, friendliness, or the absence of conflict. It is the specific experience of being able to ask a question, name a concern, or push back on a protocol without it being received as a challenge to someone's authority. In hierarchical environments like medicine, that experience is rarer than most people acknowledge. And without it, doctors stop asking, students stop questioning, and teams stop learning. The cost is not just cultural. It is clinical.

2. The hidden cost of professionalism is self-erasure.

Dr. Muldoon uses the language of anthropology to describe something doctors will recognize immediately. The white coat ceremony, the board exams, the residency rituals, all of the cultural markers that induct someone into the profession of medicine also teach a specific lesson: hide what you are feeling, perform competence, and leave the full version of yourself outside the clinic door. She argues that this inculcation of professionalism, however well-intentioned, is masking emotional suppression on a systemic scale. And that suppression, accumulated over years of training and practice, is one of the most underexamined contributors to burnout.

3. Change in a system that feels immovable starts with influence, not control.

Dr. Muldoon is clear that she is not asking anyone to burn the system down. What she offers instead is a reframe: trade control for influence. You may not be able to change the appointment schedule, the EMR, or the staffing model. But you can ask a better question in a difficult encounter, check in with your team before a shift, keep a parallel chart of moments that did not feel right, and model a different way of being in the room. Those small acts compound. And in her experience, they matter more than most people expect.

 

Guest Bio

Dr. Kathleen Muldoon is an anthropologist, medical educator, and coach based in Arizona. She is a professor at a medical school where she teaches anatomy and human development, and brings her training in applied improvisational theater into workshops designed to build psychological safety, team connection, and humane clinical environments. Dr. Muldoon coaches doctors and medical students navigating burnout and career transitions, and writes about humanity in medicine through her Substack publication and on KevinMD. She also draws on her experience as the mother of a medically complex child to bring a patient and caregiver perspective to her work with clinical teams.

 

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