Iris Schrijver: "Many physicians learn to tolerate burnout symptoms despite negative personal consequences."

Iris Schrijver (2016) Pathology in the Medical Profession?. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Pathology in the Medical Profession?

Taking the Pulse of Physician Wellness and Burnout

Iris Schrijver,MD

Reprints: Iris Schrijver, MD, Department of Pathology, Stanford University School of Medicine, 300 Pasteur Dr, Room L235, Stanford, CA 94305-5627 (email: ischrijver@stanfordhealthcare.org).

Context.— In the past decades, physician wellness has diminished in every aspect of professional life. Burnout symptoms in the United States affect 30% to 68% of physicians overall—exceeding the levels of any other professional group. The ramifications of burnout present an underrecognized crisis in the health care system that carries the consequences of personal, professional, institutional, and societal costs.

Objective.— To bring to light the elements of current medical practice that contribute to physician professional fulfillment and burnout. Intervention measures, steps toward burnout prevention, and the present limitations thereof are also addressed.

Data Sources.— This narrative literature review was performed by using studies in PubMed (National Center for Biotechnology Information) and large online physician surveys, published through December 2015. Because of geographic differences, the review is primarily concentrated on physicians across specialties in the United States. Small studies and those of single disciplines were excluded.

Conclusions.— Many physicians learn to tolerate burnout symptoms despite negative personal consequences. Long-term work-related stress, however, may lead to the potential for negative effects on the quality of patient care, and to attrition. Interestingly, the factors that enhance physician fulfillment and those that may precipitate burnout symptoms are distinct. Optimization of physician well-being, therefore, requires tailored approaches in each of these 2 dimensions and is most likely to succeed if it includes approaches that are customized to career phase, physician specialty, and practice setting. Importantly, organization leaders must prioritize this issue and provide sustained support for wellness initiatives, to foster a culture that is conducive to physician well-being.