Every day, as people from all walks of life deal with burnout, they often turn to health care professionals for help. Yet the very people who dedicate their lives to keeping others healthy are the ones increasingly suffering from burnout. More than half of U.S. physicians report significant symptoms of burnout — that’s more than double the rates among professionals in other fields. If we want our nation’s health to flourish, we need to care for those who care for us.
Burnout is characterized by emotional exhaustion, depersonalization (which includes negativity, cynicism, and the inability to express empathy or grief), a feeling of reduced personal accomplishment, loss of fulfillment from work, and reduced effectiveness. It has serious consequences for the way that health systems function and the way they deliver care. Burnout has been a challenge for the medical community for decades, and the problem starts early. I saw it firsthand among my peers in medical school in the early 1970s.
Challenges to well-being are pervasive and affect every member of the care team, every workplace, and every career stage — from physicians to nurses and other clinicians, from solo practitioners to those in large hospitals or health systems, from trainees to experienced practitioners.
As many as 400 physicians commit suicide each year. That’s double the suicide rate in the general U.S. population. This is a huge concern for the grieving family members, friends, and patients who are left behind, and for all of us in the health care field. We recognize that suicide is rare and at the extreme end of a wide spectrum of clinician well-being, but it represents a devastating outcome.
These trends in clinician burnout are startling in and of themselves, but even more so when we consider their impact on patient safety. Studies have linked clinician burnout with increased rates of medical errors, malpractice suits, and health care associated infections. Clinician burnout also places a substantial strain on the health care system, leading to losses in productivity and increased costs. One longitudinal study found that the annual productivity loss attributable to burnout may be equivalent to eliminating the graduating classes of seven medical schools.
Fortunately, there is growing recognition that the problem of clinician burnout and suicide cannot be ignored. Many organizations are already doing great work to confront this crisis. But they are largely operating in silos. It is important to understand that clinician burnout is a systems issue stretching far beyond an individual clinician or a single workplace. There is a need to coordinate and synthesize the many ongoing efforts within the health care community and generate momentum and collective action to accelerate progress.
As a neutral convener, the National Academy of Medicine (formerly the Institute of Medicine), which I lead, is uniquely suited to bring together these many threads, uniting the organizations that are already developing solutions and bringing to the table other key stakeholders, including policymakers, insurers, and health information technology experts.
Nearly 20 years ago, the Institute of Medicine report “To Err Is Human” called the nation’s attention to the high rates of medical error in the United States. It helped launch the modern patient safety movement. The National Academy of Medicine now aims to perform a similar service for alleviating clinician burnout through our Action Collaborative on Clinician Well-Being and Resilience, which we recently launched in collaboration with the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education.
The goals of this collaborative are to raise the visibility of the problem of clinician burnout; better understand the challenges to clinician well-being; elevate evidence-based, multidisciplinary solutions that will improve patient care by caring for the caregiver; and monitor the implementation of these solutions.
The collaborative is currently made up of 55 core organizations and a network of more than 80 others, including clinician groups that span many disciplines and specialties, plus payers, researchers, government agencies, technology companies, patient organizations, and trainees. The collaborative is divided into four working groups that will meet over the course of two years to identify evidence-based strategies to improve clinician well-being at both the individual and systems levels.
These groups will produce a series of National Academy of Medicine Perspectives discussion papers, an all-encompassing conceptual model that reflects the domains affecting clinician well-being, and a common set of definitions. Another key resource the collaborative will launch in the coming months is an online knowledge hub — a user-friendly repository for data, models, and toolkits that will provide opportunities for clinicians and others to share information and build productive relationships.
Our health system cannot sustain the current rate of clinician burnout and continue to deliver safe, high-quality care. Yet I am optimistic that the tide is turning. The overwhelming response of more than 130 national organizations declaring their commitment to the collaborative’s work is a clear signal that clinician well-being is a growing priority for health care leaders, policymakers, payers, and other decision makers capable of bringing about system-level change.
Through collective action, we can tackle the multiple factors contributing to burnout, stem this epidemic, and promote well-being, thereby helping clinicians to provide the very best care to their patients.
Victor J. Dzau, M.D., is president of the National Academy of Medicine.
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