The Lesson Healthcare Leaders Can’t Afford to Miss from The Pitt
Why Dr. Robby’s breakdown is a cautionary tale, not a leadership model.
The gritty, chaotic world of The Pitt (a recent television series on MAX) has received rave reviews from healthcare providers and the public as one of the most accurate portrayals of a shift in the emergency department ever broadcast. Viewers are thrust into the chaotic heart of a fictional ED in a teaching hospital in Pittsburgh. We experience everything from overfull waiting rooms and trauma cases to the scourge of addiction and accidental overdose. The audience sees the truth of healthcare on the frontlines.
The series is more than just a medical drama, it’s also a masterclass in leadership under pressure, human dynamics, and ethical decision-making. One of its most important plot lines emerges through a single character: Dr. Michael “Robby” Robinavitch, the senior attending physician in the ED, who hides the emotional pain associated with his job until it nearly undoes him.
The Cost of Silent Struggle
From the first scene, Dr. Robby is visibly off balance. It’s the anniversary of his mentor’s death, a mentor he couldn’t save during the height of the COVID-19 pandemic. Instead of acknowledging the emotional weight of the day (which he is invited to do by those in the know) or leaning on his colleagues, he deflects, detaches, and isolates. As the shift unfolds and the pressure mounts, he becomes increasingly erratic and withdrawn. We are watching cognitive/emotional overload and physical burnout play out in front of us.
His staff notices. So do the viewers. But inside the hospital, no one intervenes, because Dr. Robby, like many leaders in healthcare, believes he must perform even while secretly suffering. We see examples of this every day among our ourselves and our colleagues. As we put our patients, our colleagues, and our organizations first we run the risk of having nothing left to give.
This is the real lesson of The Pitt. Hiding our pain, fatigue, or stress isn’t strength. It’s a threat to our leadership, our teams, and ourselves. In the series, we see why this is a major cause of physician and administrator retirements and turnover. The Pitt is right to bring this to society’s attention. We’ve talked about this problem for some time amongst ourselves. The show is now inviting others into our conversation.
Leadership Requires Emotional Modeling
Healthcare leaders, both clinical and administrative, are often trained to believe that showing emotion undermines authority. But The Pitt asks us to flip that belief on its head. Dr. Robby’s deterioration doesn’t inspire respect or trust. It sparks confusion, concern, and eventually detachment from the people who rely on him most.
What should he have done instead? He should have acknowledged that he was struggling, not in a self-indulgent way, but in a human way by naming the significance of the day, taking a pause, and checking in with himself and his staff. These actions would have modeled healthy emotional regulation, giving permission for others to do the same.
Clinical leaders, especially those supervising or mentoring younger providers, should remember that those who look up to us absorb not just medical technique but emotional norms. If we pretend nothing affects us, they’ll think they must do the same. When they can’t, they’ll suffer in silence as we do.
Non-clinical leaders are tone-setters too. If administrators only celebrate productivity, policy, and procedural success without speaking about grief, compassion, fatigue, and personal struggle, we reinforce a dangerous culture of suppression. We become the villains when we can be the heroes.
The Pitt portrays this beautifully. In one scene, Dr. Robby attempts to break that silence around the pain of loss (and his loss in particular) with his team after the death of a young patient. He begins to speak openly, acknowledging the emotional toll of the case (something healthcare leaders rarely can take time for). But just as he starts, a new crisis arrives at the ED’s front door, and he is pulled away mid-sentence.
That moment to care for himself and his team, like so many in real clinical settings, was lost to the demands of the job. Yet that moment of self and other care was just as important as the chaos unfolding in the waiting room. Dr. Robby should have been encouraged to return to that conversation and to complete the emotional check-in he started. When we allow those moments to be dismissed or deprioritized, we unintentionally teach our teams that emotional presence is optional, or even a weakness. And that’s how burnout culture is reinforced; not by what we say, but by what we fail to protect.
What Healthcare Leaders Should Do Instead
If Dr. Robby’s arc is a cautionary tale, then the alternative is clear. Here are three ways healthcare leaders can act differently, considering his example:
- Acknowledge the Weight of What We Do
Working in healthcare is hard. It really can be life or death. So, say it out loud. Acknowledge anniversaries of loss, community traumas, or hard seasons. Normalize the fact that even seasoned professionals carry grief and loss alongside clinical our clinical successes and cures.
- Share Selectively, Don’t Keep Secrets
We don’t want to overshare, but a leader who says, “Today is hard for me, so I’m leaning on the team more,” creates room for others to be honest too. This isn’t weakness, it’s honesty.
- Build Systems for Self-Checks and Team Check-Ins
Have mechanisms in place, such as brief huddles, peer support, and check-ins, that encourage emotional presence as a routine part of the workday, not just a sign of crisis. What we don’t talk about becomes a disease. When we choose to talk about our pain/fatigues/loss/fears, our conversations can become the cure.
The Hidden Message of The Pitt
Dr. Robby’s journey in the series isn’t just character development, it’s the problem list facing our healthcare system. It asks, “What happens when a leader feels they can’t be open?” “What’s lost when stress and trauma are invisible, and pain must go unspoken?”
The answer is what healthcare leaders grapple with every day. Silence in leadership is not stoicism, it’s toxic. If we want sustainable leadership in medicine, we need to rewrite the story. Not with superheroes, but with humans who can lead, feel, and speak, even in the face of personal difficulty. If we don’t treat this problem, we won’t solve the pressing issues of leadership turnover, provider shortages, declining job satisfaction, and increasing burnout. Our sick healthcare system will remain sick.
How Do the Series (and This Problem) End?
Will Dr. Robby be back for another shift? The series leaves us unsure. I hope he continues, because we need leaders like Dr. Robby. Our patients and our organizations need us to be able to come back every day. Especially now, as we face a post-COVID landscape, new economic/productivity pressures, and the sweeping changes we see coming at the state, federal, and societal levels. Our patients and organizations will struggle to survive the brain drain ahead if we don’t do something different.
So do something different. Learn from Dr. Robby. Don’t be afraid to say something when things get hard. I guarantee your patients, colleagues, and organizations will benefit from your leadership. So will you.
-Eric Schulz, MBA
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About Eric Schulz
Eric Schulz is the Director of Consulting Services at Health e Practices. He brings a seasoned perspective to the complex challenges facing today’s healthcare organizations, shaped by years of leadership across hospitals, health systems, medical groups, and nonprofit organizations.
Eric specializes in supporting leaders through periods of change by guiding teams as they work to reduce burnout, strengthen culture, and realign around shared goals. His approach combines strategic insight with emotional intelligence, helping healthcare organizations address not only what’s happening on the surface, but also the deeper dynamics that impact performance and well-being.
If your organization is navigating uncertainty, leadership fatigue, or cultural disconnect, Eric is available to help. Connect with him at eric@healtheps.com to learn more.
