By Dr Daniele Carrieri, Lecturer in Public Health, University of Exeter, and Project Partner for Reading Bodies
In preparation for our creative workshop on burnout and resilience, Dr Daniele Carrieri explores research perspectives on related workplace issues. For more information about this research theme, please visit our Resources page.
Introduction
I have come across, but never investigated, the term ‘quiet quitting’. This creative writing workshop on burnout, overload and resilience offers an excellent opportunity to start filling this gap in my research on mental ill-health and wellbeing in a high-stress work context: healthcare.[1] Quiet quitting is newer and possibly less known than ‘burnout’, ‘stress’ or’ resilience’. It also has some evocative potential – which I hope will inspire creating thinking and writing. I believe there is a poetic flare in ‘quiet quitting’ (perhaps also due to its alliteration?), as well as echoes of cultural references such as Thoreau’s ‘quiet desperation’ (Thoreau, ed. 2006), or, more recently, the introversion highlighted by Cain in her book ‘Quiet’ (Cain, 2013).
‘Quiet quitting’
The term ‘quiet quitting’ was apparently introduced in 2009 by the economist Mark Boldger as ‘quitting the idea of going above and beyond at work’ (Formica & Sfodera, 2022).[2] Its popularity was then sparked in the summer of 2022, after a viral TikTok video (Scheyett, 2022).[3] Its current definition varies, and there are ongoing efforts to achieve conceptual clarification of the term (e.g. see Kang et al., 2023). There are also alternative expressions, the most common being ‘silent resignation’ – which probably echoes the so called ‘Great Resignation’ denoting the trend, for those who could afford it, to leave jobs after the COVID-19 pandemic (Scheyett, 2022). Overall, quiet quitting refers to employees’ behaviour of not literally resigning (quitting their jobs), but intentionally limiting themselves to perform assigned tasks and strictly adhering to their job description (without going beyond what is expected, without working longer hours etc.).
The behaviour is probably not entirely new, but the term is. Apart from the TikTok video, the 2022 surge in popularity – and widening of definitions (Formica & Sfodera, 2022) – of quiet quitting has been linked to the effect of the COVID-19 pandemic, particularly the increase of remote working (and the blurring of work-home boundaries), and the exacerbation of general work (and life) stress/pressures. Scales to assess quiet quitting among employees have also been developed e.g. (Galanis et al., 2023). The term may become as popular as ‘burnout’ – which also has scales, the most famous one being The Maslach Burnout Inventory (MBI) (Maslach et al., 1997).
In current debates, there appear to be two main different connotations and uses of quiet quitting. The ‘positive’ one denotes fulfilling assigned tasks, but not taking on additional, non-remunerated work, especially in order to facilitate career progression or rewards. This positive facet of the term – which is probably closer to Mark Boldger’s original definition – has also been interpreted as an attempt to reclaim a healthy work-life balance and boundaries, resisting the ‘hustle culture’ (the idea that one should always be working hard to achieve success), the standardisation of the ‘burnout shop’ business model introduced by Silicon Valley startups (Maslach & Leiter, 2022),[4] and the many other variations of the ‘culture of overworking’ theme, very prevalent in many societies and sectors.
The more ‘negative’ connotation of quiet quitting refers to employees’ deliberate strategy to disengage from work, and doing the bare minimum can also become a way to ‘safely’ (in terms of avoiding to get fired) expressing dissatisfaction and revenge towards employers (and work cultures/environments) who are perceived as not caring about and/or not willing to motivate or develop their employees (Scheyett, 2022). The more positive connotation appears to be centred around the idea of separating work from life (perhaps rediscovering the value of life by putting work more into perspective). The more negative connotation seems to introduce an additional element of conflict between the spheres of work and life. However, in the messy reality of daily work, it may be difficult to clearly demarcate these more positive and negative facets of quiet quitting. It can also be difficult even for a ‘positive’ quiet quitter to establish what ‘limiting oneself to the bare job description’ may entail, and then to adhere to it – particularly in a ‘people facing’ profession.
‘Quiet quitting’ as another individual level ‘solution’ to workplace issues
I have researched mental ill-health and wellbeing of healthcare professionals for several years. Research on this global, pressing and intractable problem (The Lancet, 2019) focuses on understanding the causes of and addressing work related pressures (e.g. stress, burnout), and related issues such as: presenteeism (working whilst unwell), absenteeism (taking short or long-term sick leave), and workforce retention (leaving the profession temporarily or permanently) (Carrieri et al., 2020; Taylor et al., 2024).
In this area of research, the term quiet quitting does not seem to be prominent. However, targeted searches reveal instances of this term being applied to the healthcare setting (e.g. Boy & Sürmeli, 2023; Kang et al., 2023). There is also research arguing that quiet quitting may be the prelude to actually leaving the job (Galanis et al., 2023). If quiet quitting is recognised as a real issue in healthcare, it would be worthwhile to understand how it may overlap with and contribute to the existing research landscape quickly sketched above, and the impact it may have on the workforce, and on the provision of excellent and equitable healthcare. For example, is the increasingly popular choice amongst doctors in the UK to delay entering formal postgraduate medical training and work in non-training posts (Church & Agius, 2021) a form of quiet quitting?
At this stage, I’d argue that quiet quitting (in both its more positive and negative connotations) aligns with a common trend of understanding and addressing workplace pressures by focusing on the individual level. Quiet quitting is mostly framed as a coping strategy based on some form of disengagement from work, which is enacted at the level of the individual employee. This mirrors current prevailing strategies, aiming for example at increasing ‘productivity’ and ‘resilience’, which understand the issue of and place responsibility for good mental health and wellbeing with employees themselves (Carrieri et al., 2018).
Complex issues require complex (i.e. system and not only individual level) strategies
In healthcare as well as in other sectors, workforce ill/wellbeing is a complex issue influenced by many interrelated factors – acting not only at the individual, but also at the occupational, professional, and broader societal levels. Complex issues require complex understandings and strategies. While a ‘quiet dimming of passion and disengagement’ from one’s work may seem like a reasonable reaction (or response) to a toxic working environment, and/or more broadly to a loss of trust in a profession, general disillusionment etc., it is unlikely to be a successful strategy, particularly longer term.
Consider the famous parallel between the canary in the coalmine and the burnout worker in the workplace: if there are toxic gases in the mine, the canary will die. To properly understand and address burnout, we need to take into account both the canary and the mine (Maslach & Leiter, 2022). It does not make a lot of sense to develop a strategy solely based on offering the canary some individual level resilience training, or for the canary to ‘quietly quit’ – as there will still be toxic gases in the work environment.
Connectedness
It is very challenging to understand and tackle complex issues, and very easy to reduce them to simpler individual level solutions. However individual level only approaches place responsibility for good mental health solely upon employees themselves, and may exacerbate the pressure experienced at work (who may think they are ‘bad employees’ if they are struggling at work) (Carrieri et al., 2020). On the other hand, even the awareness that one’s experience of stress/pressure/dissatisfaction at work may be the result of complex interrelated factors operating at the organisational, professional, social etc. levels can in itself be ‘therapeutic’ as it distributes responsibility and causality (and sites of intervention) from the sole shoulders of the individual employee to the work and social environment. But then how are system level strategies developed? A possible short answer is that multidimensional and multilevel approaches which involve multiple stakeholders, and which are regularly reviewed and readapted are more likely to work.
There is a strong body of evidence showing the importance of connectedness at work. For example, our evidence synthesis of interventions to tackle doctors’ and medical students’ mental ill-health and its impacts on the clinical workforce and patient care found that:
relationships and belonging (for example with colleagues, to a healthcare team or the profession) are more likely to promote wellbeing and improve workplace cultures […] The sense of belonging and connectedness, fostered by positive and meaningful workplace relations, can lead to an increased capacity to work under pressure […], can lead to an increased sense of meaning at work […] and can also contribute to normalise vulnerability and mental ill-health (Carrieri et al., 2020).
(You can also watch an animation developed for us by Matilda Tristram and Ian Williams about workplace stress and the value of meaningful connections here). The importance of connectedness encapsulated above extends also beyond the medical profession and the healthcare sector, and can be a strong contributor to (work) wellbeing in general (Haslam et al., 2018).
Anchor institutions
As a further departure from an individual only lens, and as a final example of a system level approach to workplace ill/wellbeing and connectedness, it may be interesting to reflect on the idea of anchor institutions. These are public and private organisations which have a significant presence (i.e. they are anchored) in the place they are located and aim to support the health and wellbeing of their local community. They can do so via ‘a combination of: being largescale employers, the largest purchasers of goods and services in the locality, controlling large areas of land and/or having relatively fixed assets’.[5] Underpinning anchor institutions is the idea that work is an important determinant of health, and part of the ‘causes of the causes’ of social inequalities (Marmot, 2018). Examples of anchor institutions in the UK include local authorities, NHS trusts, universities,[6] the police, trade unions, large local businesses, the combined activities of the community and voluntary sector and housing associations. Workplaces that become anchor institutions can foster meaningful connections within and beyond the workplace itself, making the workplace more meaningful and nourishing for employers and employees who may be less willing to (quietly) quit.
Works Cited
Boy, Y., & Sürmeli, M. (2023). Quiet Quitting: A Significant Risk for Global Healthcare. J Glob Health, 13, 03014. https://doi.org/10.7189/jogh.13.03014
Cain, S. (2013). Quiet: The Power of Introverts in a World that Can’t Stop Talking. In: Wiley Online Library.
Carrieri, D., Briscoe, S., Jackson, M., Mattick, K., Papoutsi, C., Pearson, M., & Wong, G. (2018). ‘Care Under Pressure’: A Realist Review of Interventions to Tackle Doctors’ Mental Ill-health and its Impacts on the Clinical Workforce and Patient Care. BMJ open, 8(2). https://doi.org/10.1136/bmjopen-2017-021273
Carrieri, D., Mattick, K., Pearson, M., Papoutsi, C., Briscoe, S., Wong, G., & Jackson, M. (2020). Optimising Strategies to Address Mental Ill-health in Doctors and Medical Students: ‘Care Under Pressure’ Realist Review and Implementation Guidance. BMC medicine, 18(1), 76. https://doi.org/10.1186/s12916-020-01532-x
Church, H. R., & Agius, S. J. (2021). The F3 Phenomenon: Early-career Training Breaks in Medical Training. A Scoping Review. Medical education, 55(9), 1033-1046. https://doi.org/https://doi.org/10.1111/medu.14543
Formica, S., & Sfodera, F. (2022). The Great Resignation and Quiet Quitting Paradigm Shifts: An Overview of Current Situation and Future Research Directions. Journal of Hospitality Marketing & Management, 31(8), 899-907. https://doi.org/10.1080/19368623.2022.2136601
Galanis, P., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Moisoglou, I., Gallos, P., & Kaitelidou, D. (2023). The Quiet Quitting Scale: Development and Initial Validation. AIMS Public Health, 10(4), 828-848. https://doi.org/10.3934/publichealth.2023055
Haslam, C., Jetten, J., Cruwys, T., Dingle, G., & Haslam, A. (2018). The New Psychology of Health: Unlocking the Social Cure. Routledge.
Kang, J., Kim, H., & Cho, O.-H. (2023). Quiet Quitting among Healthcare Professionals in Hospital Environments: A Concept Analysis and Scoping Review Protocol. BMJ open, 13(11), e077811. https://doi.org/10.1136/bmjopen-2023-077811
Marmot, M. (2018). Inclusion Health: Addressing the Causes of the Causes. Lancet, 391(10117), 186-188. https://doi.org/10.1016/s0140-6736(17)32848-9
Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach Burnout Inventory. Scarecrow Education.
Maslach, C., & Leiter, M. P. (2022). The Burnout Challenge: Managing People’s Relationships with their Jobs. Harvard University Press.
Scheyett, A. (2022). Quiet Quitting. Social Work, 68(1), 5-7. https://doi.org/10.1093/sw/swac051
Taylor, C., Maben, J., Jagosh, J., Carrieri, D., Briscoe, S., Klepacz, N., & Mattick, K. (2024). Care Under Pressure 2: A Realist Synthesis of Causes and Interventions to Mitigate Psychological Ill Health in Nurses, Midwives and Paramedics. BMJ Quality & Safety, bmjqs-2023-016468. https://doi.org/10.1136/bmjqs-2023-016468
The Lancet. (2019). Physician Burnout: A Global Crisis. Lancet, 394(10193), 93.
Thoreau, H. D. (ed 2006). Walden. Yale University Press.
[1] See the ‘Care Under Pressure’ research programme: https://sites.exeter.ac.uk/careunderpressure/
[2] https://www.wowrecruitment.com.au/latest-news/quiet-quitting-how-to-spot-it-and-what-to-do-about-it
[3] I do not use TikTok, but having consulted some sources (e.g. https://blog.hubspot.com/marketing/quiet-quitting) I understand this is the original video:
[4] The ‘burnout shop’ business model was introduced by startups during the emergence of Silicon Valley. A new company would deliberately and utterly overwork employees for a short and intense period, under a mutual agreement. After this small period e.g. two years elapsed, the startup would have established itself, the workload would ease, and the employee would reap the rewards of their labour in the form of stock options and compensation. This business model has subsequently been applied more longer term, more widely, and without any promise of relief and reward. See Maslach, C., & Leiter, M. P. (2022). The Burnout Challenge: Managing People’s Relationships with their Jobs. Harvard University Press.
[5] https://cles.org.uk/what-is-community-wealth-building/what-is-an-anchor-institution/
[6] The University of Exeter which hosts this workshop appears to be in the process of establishing Civic University Agreements with anchor institutions in the region: https://www.exeter.ac.uk/about/regionalengagement/civic-agreements