As a rural physician spouse, your family thanks you.

It is not one bit your fault. Incompetent government and educational institutions could see this coming for decades, but chose, and continue to choose to do nothing.

Boomers retiring and population growth are pretty obvious needs for more healthcare resources, not to mention not doing anything to help homelessness and addictions. Combined with that, med school faculty, at least in my home province, actively dissuade students from entering family medicine, and the university hasn't increased its intake volume in years.

Everyone in rural medicine feels this pressure. The responsible thing is to keep the balance that keeps you healthy, for a physician who is there working the hours a typical worker might work is still providing far better service than if they weren't there at all.

As long as you push the ama to push to educate more doctors and for universal health care, then I don't think you have anything to feel bad about. We should have as many doctors as we need and should not be rationed based on wealth of the patients. We should be weeding out physcicians based on capability and not on the ability to stay awake for massive amounts of time.

For a country with such a serious lack of doctors, why do we keep so many immigrants with medical degrees driving cabs?

Do what you need to do to take care of yourself. "First, do no harm" applies to you as much as to anyone else.

You didn't fail us.

We failed you.