There is a peculiar moment that occurs in modern professional life when a physician realizes that the measure of their worth has been reduced to the quality of the snacks provided. This realization often arrives quietly, usually while staring into a refrigerator containing a single, unlabeled yogurt of indeterminate age.

At that moment, a troubling question surfaces: Am I valued—or merely tolerated?

In theory, this is a ridiculous question. After all, the work being done is consequential. Lives are at stake. Decisions matter. Training took over a decade. Responsibility is immense. And yet, the refrigerator is empty.

Elsewhere—never where the actual work happens—there are espresso machines that hum like benevolent gods. There are sparkling waters in flavors nobody asked for. There are ergonomic chairs that appear to cradle the human soul. One cannot help but notice that these comforts tend to cluster around conference rooms, executive suites, and offices whose primary hazard is prolonged exposure to spreadsheets.

Meanwhile, those doing the work develop an impressive skill set: navigating twelve-hour days fueled by hallway air, conducting emotionally charged conversations while standing, and locating bathrooms that are both functional and psychologically survivable. These are not competencies taught in training. They are acquired the way trench skills are acquired: by necessity.

The paradox is this: the more indispensable the work, the more disposable the doctor appears to be.

Of course, it would be gauche to complain about food. Complaints about food suggest entitlement. Complaints about space suggest fragility. Complaints about dignity, however—those are more difficult to dismiss, though they are often waved away with a reassuring phrase like “This is about the patients.”

And it is. Always. That phrase has become the master key. It unlocks unpaid labor, extended hours, silent compliance, and the gentle disappearance of professional boundaries. It is the ethical equivalent of a shrug.

What makes the situation particularly fascinating is the wide range of reactions to it.

Some insist that none of this matters. They remind us that the job was never about comfort. They recall a time when professionals worked harder, complained less, and didn’t expect granola bars as a form of validation. In their telling, dignity was earned through stoicism, not refrigeration.

Others argue that the conversation is misplaced entirely. Why discuss the treatment of professionals when those they serve feel depleted and are themselves navigating a system that feels transactional, rushed, and oddly depersonalized? From this vantage point, a conversation about snack access is not just trivial—it’s offensive. The real loss, they argue, is relational, not culinary.

Then there are those who connect the empty fridge to something much larger. They speak of leverage lost quietly over decades. Of autonomy traded for stability. Of systems that no longer need persuasion because alternatives have evaporated. When movement becomes impossible, inducement becomes unnecessary.

In that context, the empty fridge is not a mistake. It is a message.

Some propose solutions. Collective action. Financial independence. Setting boundaries. Saying no. These ideas are met with equal parts enthusiasm and suspicion. Collective action feels noble until it feels dangerous. Independence sounds empowering until one calculates the risk. Saying no feels righteous until someone else says yes.

And so the system hums along, powered by predictability.

What truly animates the discussion, though, is not food. It is respect. And respect, it turns out, is an awkward thing to request.

Requesting respect feels perilously close to admitting its absence. Worse, it risks sounding like a demand for deference rather than a plea for basic acknowledgment. No one wants to be the person asking to be treated as though their time, training, and judgment matter. That should be implicit. Shouldn’t it?

Yet implicit respect has become strangely rare. It has been replaced by metrics, dashboards, satisfaction scores, and cheerful reminders about teamwork that somehow never include those making the decisions. Respect has been operationalized, standardized, and stripped of warmth.

The result is a profession that oscillates between resignation and resentment.

There are moments of dark humor. Jokes about being “providers.” About being interchangeable. About leadership flying overhead while those below adjust to smaller and smaller workspaces. Humor becomes a pressure valve. It is either that or rage.

Some eventually leave. Many unnoticed, without ceremony. They discover that the absence of constant urgency restores something essential. Others stay and adapt, carrying their own coffee, lowering expectations, learning not to notice what has been removed. Adaptation was always part of the training.

The most unsettling realization may be this: the system works precisely because it relies on people who will continue to show up regardless of how they are treated. Conscience is a renewable resource. It can be mined indefinitely, apparently.

And so, the refrigerator remains empty.

Not because no one noticed.

But because everyone did—and nothing happened.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine and the fictional series Real Medicine, Unreal Stories. His latest book, a novel, is Against the Tide: A Doctor’s Battle for an Undocumented Patient.