I am going to take a leap of faith here and post.
I normally stay away from these types of threads because (right or wrong) I don't feel like my own situation rises to the level of experience that is required from which to comment.
I do, however, have some ancillary life experience from which to draw.
Your wife is a physician?
This is a factor.
Getting an M.D. is a decidedly, uniquely, selfish endeavor.
It may not seem so, as it is (and it is, make no mistake) a profession of service.
A physician will sacrifice years of life just to have the credentials from which to practice- and that's just getting to the starting line, to the gates.
One may or may not get through undergrad and into medical school on one's own, but once one is in medical school, and absolutely once one is in residency, a "support staff" is paramount.
This is one reason why high income families/physician parent families produce physicians. The (physician or otherwise high demand professional) parents themselves may not have the time or the energy (or both) to be that support staff, but they have the means to supply it from other sources.
I am interested in your wife's family of origin. How much support was provided? Did she need (or feel the need) to provide her own nuclear family (for emotional support and sustenance) (i.e. spouse and children) and did she also have to provide the support structure for her emotional support supply?
Ergo a stay at home spouse- which seems unusual and awkward to those who are still operating from gender stereotypes- but female physicians are now in the same place in life that male physicians have occupied for hundreds of years.
Your wife may be servicing (or trying to service) all kinds of emotional, psychological, financial, infrastructure needs that intersect at one supply point- and that supply point is YOU.
At the same time she's the master of compartmentalization, not unlike a combat soldier (physician.)
And she's doing it with an analytical detachment- because that's how she's trained, because that's how things are done, because it's the most efficient way to get things done, because it's the only way it can be done.
Ask any female spouse of any male physician from 25, 50, 100, 200, 300 years ago.
It's only a gender thing because women haven't been physicians for thousands of years.
Dude, physicians do not have spouses. They do not have families. They do not even have lovers.
Physicians have staff.
And even the physicians themselves don't want it that way. It kills them too.
They have staff because they need staff. They need staff because the work and the life are so demanding.
Bonus round if they are the more unsung physicians, the non-specialists, the pediatricians, the internal medicine docs, the hospitalists, the family physicians, the general practioners, even the ER docs. All the stress, all the work, half the income. And all of the compartmentalization.
Ergo the AP becomes "Romance Central" and "Hot Sex Junction" and you become "Domestic Appliance" and "Childcare Provider Extraordinaire."
NOW, I've been on another thread where guys are rending their garments, gnashing their teeth and tearing their hair about whether it was ALL ABOUT THE SEX for their WWs. Got it.
I can tell you for sure- anyone working in a hospital environment can find sex anywhere, any time. It's the original Peyton Place. (Anybody here remember that reference, LOL?)
Your wife is showing signs that she's realizing that SEX can come from just about anything with a dick (that's interested in women) (seriously) but quality of life for her and the kids can only come from some man who gives a shit.
What does this mean for you? for her? for your kids? I have no idea.
Just know that you have a specific situation here- and it has to do with two highly educated people, one of whom has a super demanding career, and one who gave up a super demanding career to act as support staff.
Both are critical, neither is less than the other. Your situation has gotten out of balance.
You both need professional guidance (IC/MC) aimed at your particular career/infrastructure situation.
I've short-handed this and I've probably made a million errors, errors which others will not comprehend (understandably) and will misinterpret and critique. Have at it, Peeps!
I will add this:
You want to stay in this marriage?
1. Lawyer up. Get solid legal advice, on your own behalf. Your wife has, and will. She's trained to do so. She should. She has a huge investment to protect. So do you. You are no less than she. Behave accordingly.
2. Post-nup for both of you.
3. IC/MC, shared common goals that are respectful to both persons.
Your wife wants/needs (whether she's yet cognizant of this fact or not) a staff? Then she needs to hire a staff- with all that entails.
Did she "hire" a staff when she married you?
A good attorney and decent IC/MC will help you sort that out.
Ultimately, the answer is between you and her.
(Note: Neither Husband nor I are physicians. We are merely two people who negotiated/navigated a high demand career household, and not as efficiently nor as successfully nor as equitably as we could have.)