Commentary on Physician Well-Being and Burnout

This article was authored by Chittur A. Sivaram MBBS, FACC, David Ross Boyd professor and vice chief of the Cardiovascular Section for Education and Training at the University of Oklahoma Health Sciences Center in Oklahoma City, OK.

Considerable amount of discussion focusing on the problem of physician burnout has been taking place nationally. The high prevalence and intensity of reported burnout in health professionals are of major concern to leaders in the health care field. Without appropriate steps aimed at reducing – if not eliminating – burnout stress, the health care system would likely face early retirement of many professionals and might even risk severe depression that leads to suicide. ACC President C. Michael Valentine, MD, FACC, recently unveiled the College's efforts in this regard described as the "Quadruple Aim," which integrates physician well-being as a major goal of the ACC.

In a recent issue of the Journal of the American Medical Association, two short commentaries on this topic also appear – a charter on physician well-being (also covered on and a new perspective on the genesis of the problem and how to mitigate it.

At the core of physician burnout are depersonalization, loss of job satisfaction and the inability to care. Interestingly enough, physicians were busier three decades ago and had less to offer to their patients in terms of treatment compared to the present time. However, they had greater professional satisfaction and the term "burnout" was not used in describing physician's lives. Thomas L. Schwenk, MD, attributes this reason to the opportunity physicians had in the past to engage in reciprocal relationships with their patients and actually care for them. Today's complicated, modern structure of health care delivery significantly impacts the amount of time a physician can spend face-to-face with a patient, particularly in the clinic setting.

Most of the recent literature on physician burnout calls for development of greater resilience in physicians, enhanced awareness of stress reduction techniques and more aggressive use of mental health services. However, attempts to fix burnout problems in the health care delivery system have been scarce. While efforts are being made in some institutions to reduce the burden imposed on physicians by electronic medical records, Schwenk proposes another novel idea. He points out that if we allow physicians more time and the appropriate set-up to provide old fashioned doctoring, the level of physician burnout might decline due to what he refers to as the "regenerative power of caring." All health care providers and those who manage health care professionals would benefit from reading Schwenk's thoughtful piece. It provides a fresh perspective regarding how to preserve the most valuable asset of the health care system – a team of engaged and committed health care professionals.

Keywords: Job Satisfaction, Burnout, Professional, Depersonalization, Personal Satisfaction, Prevalence, Depressive Disorder, Major, Delivery of Health Care, Leadership, Electronic Health Records, Mental Health Services

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