Leadership
Talk
Physician Burnout: Stop Blaming the Individual (09:35)

In 2011, 45% of U.S. physicians had at least one symptom of professional burnout, according to a study from the Department of Medicine Program on Physician Well-Being at Mayo Clinic. That number rose to 54% in 2014. And projections from the Department of Health and Human Services suggest that by 2020, the U.S. will face a shortage of 50,000 physicians. “The rising tide of burnout, coupled with its effects on quality of care and access, make burnout a major threat to the health care delivery system,” says Program Director Tait Shanafelt.

Burnout affects physicians across all specialties, but it is particularly acute in primary care. Yet only bandages have been applied to address the problem thus far, in the form of stress management, resiliency workshops, and teaching mindfulness to individual physicians.

“We tell physicians to get more sleep, eat more granola, do yoga, and take better care of yourself. These efforts are well intentioned,” says Shanafelt. “The message to physicians, however, is that you are the problem, and you need to toughen up.”

“We need to stop blaming individuals and treat physician burnout as a system issue,” argues Shanafelt. “If it affects half our physicians, it is indirectly affecting half our patients.”

To move to a better framework, Shanafelt says we must:

  1. Start trusting physicians again. Eliminate intrusive regulations that do not add value to patients’ medical care, and devise more accurate approaches to assessing quality.
  2. Let physicians focus on doing the work that only they can do. While physicians work at the top of their licensure, mini tasks should be delegated to support staff.
  3. Set workload expectations based on what it takes to provide good patient care. “The current reality of physicians working 14-hour days at the clinic or hospital and then going home to spend 2 to 3 hours charting in the EHR is not sustainable,” says Shanafelt. “We have the metrics and tools to determine the time necessary to provide good care.”
  4. Measure, track, and benchmark the well-being of physicians as a strategic imperative necessary to provide high-quality medical care.

Realizing these changes requires effective leaders to work in partnership with physicians. “Physicians and leaders working together constructively to identify, develop, and implement solutions for problems in the practice environment demonstrates to physicians that improvement is possible,” says Shanafelt. “The approach transforms physicians from victims in a broken system to partners working with leaders to create their own future.”

From the NEJM Catalyst event Leadership: Translating Challenge to Success at Mayo Clinic, June 2, 2016. See “The Dangers of Physician Burnout” to engage in the burnout conversation with other members of the NEJM Catalyst community.

More From Leadership
Women of Impact Checklist

Lead In: Women of Impact in Health Care on Advancing Equity in the Workplace

Raising the standards of equity and wellness in our workplaces so we effectively advance health for the populations we serve.

Historical and Projected Numbers of Physicians, Nurse Practitioners, and Physician Assistants.

Growing Ranks of Advanced Practice Clinicians — Implications for the Physician Workforce

The number of NPs and PAs is growing rapidly, while physician supply has slowed. This research projects the number of NPs, PAs, and physicians through 2030.

IBM solutions to physician burnout roundtable participants: Christina Maslach, Paul DeChant, Tait Shanafelt, Namita Seth Mohta, Karen Weiner, Edward Prewitt

NEJM Catalyst Roundtable Report: Seeking Solutions to Physician Burnout

An NEJM Catalyst roundtable sponsored by IBM Watson Health brought together four experts, all deeply engaged in reducing physician burnout from different perspectives, to share in a robust discussion.

Pottharst01_pullquote - value-based health care leadership personas

Personas of Leadership in Value-Based Care

The deliberate nurturing of specific types of leadership personas seems to be a critical factor in the success of value-based care organizations.

Few Truly High-Performing Health Care Organizations

Survey Snapshot: What the High Performers Have to Say

NEJM Catalyst Insights Council members from high-performing institutions share their perspectives on what’s working and what needs improvement.

Morris-Singer01 pullquote clinician burnout community-building

Combating Clinician Burnout with Community-Building

Improving morale and reducing turnover with peer-support meetings and shared group email lists for clinicians.

Time Is What Matters Measure Figure D - Time Saved Compared to FY17 Average

Measuring Patient Quality of Life: Time Is What Matters

How Anne Arundel Health System created a meaningful measure for patients and providers.

Little Consensus Over Definition of High-Performing Organizations in Health Care

Leadership Survey: High-Performing Organizations

Health care is rife with metrics and rating systems that purport to differentiate the good, bad, and mediocre. Every clinician and leader wants to be affiliated with a high-performing organization. But what constitutes high performance in health care?

Eisenstein01_pullquote burnout collective action SDOH

To Fight Burnout, Organize

The social determinants of health — and physicians’ sense of powerlessness in the face of them — seem crucially missing from the discussion of burnout.

Framework for Comprehensive Community Wellness

Public Health–Health System Coordination: Upending the Siloed Status Quo

A five-point plan unveils ways that leaders of health care and public health organizations can take action to enhance community wellness.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Leading Transformation

227 Articles

Safety-Net Providers Lead Disruptive Innovation

Improved targeting of resources must be a consideration if we want to ensure health care…

Leading Teams

150 Articles

Lead In: Women of Impact in…

Raising the standards of equity and wellness in our workplaces so we effectively advance health…

Physician Burnout

41 Articles

Esprit de Corps: Turning Vicious Cycle…

Esprit de corps is the single most important indicator in which health care organizations have…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now