Physician Burnout


Deborah Wing, M.D. 

Senior Client Partner

Korn Ferry

May 21, 2018

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How prevalent is burnout among your faculty?” is a question often asked of the leadership of the institutions whom Korn Ferry serves. The question can provide important insight into the health of a work environment and could suggest potential recruitment and retention risks. Burnout is defined as a work-related syndrome caused by chronic stress and excessive work demands for which inadequate resources exist. It has been reported to affect up to 50% of healthcare providers who report feelings of cynicism, loss of enthusiasm for work, and/or a low sense of personal accomplishment. Research indicates rates of physician burnout are increasing despite implementation of awareness and wellness programs to combat it.


The impact of physician burnout is immense. It can result in lower patient satisfaction scores, increases in medical errors, suboptimal clinical outcomes, liability claims, inappropriate prescriptions and higher referral rates (to other services or physicians). The latter may be a surrogate marker for overuse of resources leading to unnecessary interventions for patients and increased healthcare costs. Lower productivity and self-efficiency, less job satisfaction, as well as threats to the integrity of the physician workforce are also byproducts as dissatisfied healthcare providers seek early retirement or alternative methods of employment. This is particularly troublesome as the horizon features physician workforce shortages soon.


Specialties within medicine appear to be more at risk for burnout include neurology, which ranked among the specialties most at risk for burnout and dissatisfaction with work-life balance, along with radiology, general internal medicine, orthopedic surgery, family medicine, and urologic surgery. The tripartite mission of academic medicine which similarly prioritizes the competing demands of education, research and patient care may be somewhat protective against burnout as academic physicians appear to be a slightly lower risk compared to physicians in private practice.


Physician burnout may result from a combination of systematic causes, including the added regulation resulting from healthcare reform, threats to income, and the degradation in the doctor-patient relationship resulting from use of electronic health records. High degree of personal responsibility coupled with a perceived loss of control and unsupportive work environments may also be contributors.  The increasing competition for NIH-funding – described by one of my candidates as “vicious” recently – only adds to the burden for clinician scientists.


Targeted approaches to reduce the frequency and mitigate the risks of burnout appear to be effective. Structural, organization-level interventions include shortened length in attending rotations, clinical work process modifications, shortened resident shifts, individual-focused interventions including facilitated small group curricula, among others. Personal approaches include stress management and self-care training, communication skills training, mindfulness-based meditation approaches and “belonging" interventions. Reductions in overall work load may also mitigate burnout.


Shanafelt and colleagues from the Mayo Clinic suggest that “healthcare organizations should focus on improving the efficiency and support in the practice environment, select and develop leaders with the skills to foster physician engagement, help physicians optimize ‘career fit,’ and create an environment that nurtures community, flexibility, and control” to mitigate the risks of burnout. The authors also encouraged organizations to “establish principles that help facilitate work-life integration.” Art Caplan, PhD, director of the Division of Medical Ethics at New York University Langone Medical Center, an ethicist who views burnout in medicine as a looming public health crisis, encourages that in addition to personal and organizational methods designed to address burnout, healthcare providers should also get involved in public policy work and advocacy as a means to address the matters related to professional satisfaction and fulfillment and possibly restore some of the sense of lost control and purpose in their work.


Leadership and talent consulting work among physician executives and within academic medical centers often involve discussions regarding physician burnout. Awareness of how physician burnout affects organizational behavior, hiring for anticipated change in work environments, and assessing organizational fit on the front end are key elements for successful appointments during this time of turbulence for healthcare in this country.