We discuss how efficiency in healthcare transforms into burnout and moral injury for clinicians. We explore the critical inflection point where clinicians shift from prioritizing patient care, compassion, and clinical outcomes to defaulting to productivity metrics—seeing a certain number of patients per hour, meeting unit quotas, and chasing bonuses tied to daily productivity emails. We examine how these incentive structures fundamentally change a clinician's decision-making and default mode, creating the conditions for moral injury rather than simply a busy schedule.