Practicing medicine in the U.S. is rapidly changing, often no longer resembling the profession physicians pursued for years during training. Computers are a focal point in the exam room, new practice standards have evolved and business models are topsy-turvy – all contributing to dramatic increases in stress and burnout.

The turmoil from this revolution and its negative effects are increasingly recognized by all health care stakeholders as an important problem to be addressed. Today's Louis F. Bishop Keynote will examine the data tracking the effects of changes on health care professionals, the repercussions and how to address the issue from a system perspective rather than simply blaming individuals.

"There is now widespread acceptance that there is a large problem with important implications for our health care delivery system," says Tait Shanafelt, MD, who will deliver the Keynote during the Clinician Wellness Intensive I. "There is great momentum to act at the institutional and national levels to address the underlying causes of the problem and improve the professional work environment."

Shanafelt is recognized as a pioneer and leader in the field of physician wellness. Over the last 20 years his research has helped define the problem and its consequences, and develop system-based approaches to make progress. In 2017, he was appointed the first chief wellness officer at Stanford Medicine.

He also leads the Stanford Medicine WellMD Center and is associate dean for the Stanford School of Medicine. Before joining Stanford, he spent a decade leading successful initiatives to reduce burnout and improve physicians' sense of fulfillment at the Mayo Clinic.

Shanafelt has published more than 125 manuscripts on the topic, including an influential 2017 article outlining nine organizational strategies to promote physician engagement. Many of the interventions were inexpensive but made a great impact and have been adopted at other institutions and practices of all sizes. Effective organizational strategies can be implemented at work-unit, clinic, department, hospital and organization levels, Shanafelt says.

On a larger scale, over the past two years the National Academy of Medicine has been leading a national effort to engage all stakeholders in countering burnout among health care professionals.

National efforts led by the National Academy, the American Medical Association and other large professional societies seek to engage payers, regulators and electronic health record vendors, and drive improvements. Shanafelt says the fact that these diverse stakeholders are working together to find solutions makes him optimistic that the efforts are on the cusp of meaningful progress.

"I hope the audience walks away with a better understanding of the structural drivers underlying occupational distress in physicians as well as examples of tangible organization-based approaches to address them," he says. "For too long, the attention has focused on blaming the individuals, suggesting that the remedy was physicians taking better care of themselves and learning to be more resilient. We need to address the structural drivers in the work environment that are the underlying problem."

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Keywords: ACC Publications, ACC Scientific Session Newspaper, ACC Annual Scientific Session, ACC19, American Medical Association, Physicians, Delivery of Health Care, Burnout, Professional, Medicine, Leadership, Electronic Health Records

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