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REVIEW

Physician Burnout: Evidence-Based Roadmaps to Prioritizing and Supporting Personal Wellbeing

ORCID Icon, & ORCID Icon
Pages 15-27 | Received 13 Sep 2023, Accepted 19 Dec 2023, Published online: 26 Feb 2024

References

  • Banerjee G, Mitchell JD, Brzezinski M, et al. Burnout in academic physicians. Permanente J. 2023;27(2):142. doi:10.7812/TPP/23.032
  • DePorre A, Banerjee G, Mitchell JD, et al. Burnout in medicine: are we asking the right questions? Permanente J. 2023;27(2):123. doi:10.7812/TPP/23.033
  • American Medical Association. Physician burnout. Available from: https://www.ama-assn.org/topics/physician-burnout?page=4. Accessed November 30, 2023.
  • Freudenberger HJ. Staff burn-out. J Socl Issues. 1974;30(1):159–165. doi:10.1111/j.1540-4560.1974.tb00706.x
  • World Health Organization. International disease classification ICD-11. 2022. Available from: https://www.who.int/classifications/icd/en/. Accessed August 15, 2023.
  • Berg S. WHO adds burnout to ICD-11. What it means for physicians. American Medical Association, Physician Health; 2019.
  • Nordgren L, Schonthal D. The Human Element: Overcoming the Resistance That Awaits New Ideas. Hoboken: Wiley; 2022.
  • Dyrbye LN, Gordon J, O’Horo J, et al. Relationships between EHR-based audit log data and physician burnout and clinical practice process measures. Mayo Clin Proc. 2023;98(3):398–409. doi:10.1016/j.mayocp.2022.10.027
  • Moss J. Burnout is about your workplace, not your people. Harvard Bus Rev. 2019;1(1):1–10.
  • Slavkin HC, Dubois PA, Kleinman DV, Fuccillo R. Science-informed health policies for oral and systemic health. J Healthc Leadersh. 2023;31:43–57. doi:10.2147/JHL.S363657
  • Aljazeera. Burned out doctors or broken healthcare system? 2020. Available from https://www.aljazeera.com/program/the-stream/2020/2/20/burned-out-doctors-or-broken-healthcare-system. Accessed August 21, 2023.
  • Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians. JAMA. 2018;320(11):1131. doi:10.1001/jama.2018.12777
  • Maslach C, Leiter M. Understanding burnout: new models. In: The Handbook of Stress and Health: A Guide to Research and Practice. Wiley Online Library; 2017:36–56. doi:10.1002/9781118993811.ch3
  • Shakir HJ, Cappuzzo JM, Shallwani H, et al. Relationship of grit and resilience to burnout among U.S. neurosurgery residents. World Neurosurg. 2020;134:e224–e236. doi:10.1016/j.wneu.2019.10.043
  • Wisniewska I, Holt GR. Burnout in academic medicine: a peripandemic assessment. Permanente J. 2023;27(2):150–159. doi:10.7812/tpp/23.042
  • Jumat MR, Chow PKH, Allen JC, et al. Grit protects medical students from burnout: a longitudinal study. BMC Med Educ. 2020;20(1). doi:10.1186/s12909-020-02187-1
  • Kaczor EE, Carreiro S, Stapp J, Chapman B, Indic P Objective measurement of physician stress in the emergency department using a wearable sensor. Proceedings of the Annual Hawaii International Conference on System Sciences Annual Hawaii International Conference on System Sciences; 2020:3729–3738. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996921/.
  • Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377. doi:10.1001/archinternmed.2012.3199
  • Dyrbye LN, Shanafelt TD, Sinsky CA, et al. Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM Perspectives. Washington, DC: Discussion Paper, National Academy of Medicine; 2017. doi:10.31478/201707b
  • Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians. JAMA. 2015;314(22):2373. doi:10.1001/jama.2015.15845
  • Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681–1694. doi:10.1016/j.mayocp.2018.10.023
  • Amanullah S, Ramesh Shankar R. The impact of COVID-19 on physician burnout globally: a review. Healthcare. 2020;8(4):421. doi:10.3390/healthcare8040421
  • Kruse CS, Mileski M, Dray G, Johnson Z, Shaw C, Shirodkar H. Physician burnout and the electronic health record leading up to and during the first year of COVID-19: a systematic review (Preprint). J Med Internet Res. 2022;24(3). doi:10.2196/36200
  • Macaron MM, Segun-Omosehin OA, Matar RH, et al. A systematic review and meta analysis on burnout in physicians during the COVID-19 pandemic: a hidden healthcare crisis. Front Psychiatry. 2023;13:1071397. doi:10.3389/fpsyt.2022.1071397
  • Melnikow J, Padovani A, Miller M. Frontline physician burnout during the COVID-19 pandemic: national survey findings. BMC Health Serv Res. 2022;22(1). doi:10.1186/s12913-022-07728-6
  • Patel R, Bachu R, Adikey A, Malik M, Shah M. Factors related to physician burnout and its consequences: a review. Behav Sci. 2018;8(11):98. doi:10.3390/bs8110098
  • Gazelle G, Liebschutz JM, Riess H. Physician burnout: coaching a way out. J Gen Intern Med. 2015;30(4):508–513. doi:10.1007/s11606-014-3144-y
  • Grossman Z, Chodick G, Kushnir T, Cohen HA, Chapnick G, Ashkenazi S. Burnout and intentions to quit the practice among community pediatricians: associations with specific professional activities. Isr J Health Policy Res. 2019;8(1):1–9. doi:10.1186/s13584-018-0268-2
  • Grow HM, McPhillips HA, Batra M. Understanding physician burnout. Curr Probl Pediatr Adolesc Health Care. 2019;49(11):100656. doi:10.1016/j.cppeds.2019.100656
  • Stewart MT, Reed S, Reese J, Galligan MM, Mahan JD. Conceptual models for understanding physician burnout, professional fulfillment, and well-being. Curr Probl Pediatr Adolesc Health Care. 2019;49(11):100658. doi:10.1016/j.cppeds.2019.100658
  • Yeluru H, Newton HL, Kapoor R. Physician burnout through the female lens: a silent crisis. Front Public Health. 2022;10:880061. doi:10.3389/fpubh.2022.880061
  • Hlubocky FJ, Symington BE, McFarland DC, et al. Impact of the COVID-19 pandemic on oncologist burnout, emotional well-being, and moral distress: considerations for the cancer organization’s response for readiness, mitigation, and resilience. JCO Oncol Pract. 2021;17(7):365–374. doi:10.1200/op.20.00937
  • Hagemann TM, Reed BN, Bradley BA, et al. Burnout among clinical pharmacists: causes, interventions, and a call to action. J Am Coll Clin Pharm. 2020;3(4):832–842. doi:10.1002/jac5.1256
  • Alkhamees AA, Aljohani MS, Kalani S, et al. Physician’s burnout during the COVID-19 pandemic: a systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20(5):4598. doi:10.3390/ijerph20054598
  • Gomez T, Anaya YB, Shih KJ, Tarn DM. A qualitative study of primary care physicians’ experiences with telemedicine during COVID-19. J Am Board Fam Med. 2021;34(Supplement):S61–70. doi:10.3122/jabfm.2021.S1.200517
  • American Medical Association. Physician health and well-being during the COVID-19 pandemic: how the AMA can help; 2021. Available from: https://www.ama-assn.org/member-benefits/ama-physician-health-and-wellness/physician-health-and-well-being-during-covid-19. Accessed August 25, 2023.
  • Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2017;94(9):1681–1694.
  • Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med. 2017;15(5):419–426. doi:10.1370/afm.2121
  • Shortell SM, Burns LR, Hefner JL, editors.. Responding to the Grand Challenges in Health Care via Organizational Innovation: Needed Advances in Management Research. Emerald Publishing Limited; 2022.
  • Messinger A, Das S. Erosion of the “ethical” doctor-patient relationship and the rise of physician burn-out. Med Humanit. 2022;medhum-2022–012506. doi:10.1136/medhum-2022-012506
  • Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133. doi:10.1001/jama.2020.5893
  • Dzau VJ, Kirch DG, Nasca TJ. To care is human—collectively confronting the clinician-burnout crisis. N Engl J Med. 2018;378(4):312–314. doi:10.1056/NEJMp1715127
  • Dyrbye LN, Burke SE, Hardeman RR, et al. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA. 2018;320(11):1114. doi:10.1001/jama.2018.12615
  • Bodendieck E, Jung F, Luppa M, Riedel-Heller S. Burnout and work-privacy conflict – are there differences between full-time and part-time physicians? BMC Health Serv Res. 2022;22(1). doi:10.1186/s12913-022-08471-8
  • Hu YY, Ellis RJ, Hewitt DB, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741–1752. doi:10.1056/nejmsa1903759
  • Golisch KB, Sanders JM, Rzhetsky A, Tatebe LC. Addressing surgeon burnout through a multi-level approach: a national call to action. Curr Trauma Rep. 2023;9(2):28–39. doi:10.1007/s40719-022-00249-x
  • Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52(1):397–422. doi:10.1146/annurev.psych.52.1.397
  • Figley CR. Compassion fatigue: psychotherapists’ chronic lack of self care. J Clin Psychol. 2002;58(11):1433–1441. doi:10.1002/jclp.10090
  • Gribben JL, Kase SM, Waldman ED, Weintraub AS. A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in pediatric critical care physicians in the United States. Pediatr Crit Care Med. 2019;20(3):213–222. doi:10.1097/PCC.0000000000001803
  • Dyrbye NL, West CP, Satele D, et al. Burnout among US medical students, residents, and early career physicians relative to the general US population. Acad Med. 2010;89(3):443–451. doi:10.1097/ACM.0000000000000134
  • Gagné M, Deci EL. Self-determination theory and work motivation. J Organ Behav. 2005;26(4):331–362. doi:10.1002/job.322
  • Pala AN, Chuang JC, Chien A, et al. Depression, anxiety, and burnout among hospital workers during the COVID-19 pandemic: a cross-sectional study. PLoS One. 2022;17(12):e0276861. doi:10.1371/journal.pone.0276861
  • Panagioti M, Geraghty K, Johnson J, et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction. JAMA Intern Med. 2018;178(10):1317. doi:10.1001/jamainternmed.2018.3713
  • Dyrbye LN, Satele D, West CP. Association of characteristics of the learning environment and US medical student burnout, empathy, and career regret. JAMA Network Open. 2021;4(8):e2119110. doi:10.1001/jamanetworkopen.2021.19110
  • Rialon KL, Mueller C, Ottosen M, et al. Drivers of distress and well-being amongst pediatric surgeons. J Pediatr Surg. 2021;56(5):841–848. doi:10.1016/j.jpedsurg.2021.01.001
  • Kinslow K, Sutherland M, McKenney M, Elkbuli A. Reported burnout among U.S. general surgery residents: a survey of the association of program directors in surgery members. Ann Med Surg. 2020;60:14–19. doi:10.1016/j.amsu.2020.10.012
  • Willard-Grace R, Hessler D, Rogers E, Dube K, Bodenheimer T, Grumbach K. Team structure and culture are associated with lower burnout in primary care. J Am Board Fam Med. 2014;27(2):229–238. doi:10.3122/jabfm.2014.02.130215
  • West CP, Dyrbye LN, Erwin PJ, et al. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2019;394(10193):221–231.
  • Berg S. Pandemic pushes U.S. doctor burnout to all-time high of 63%. American Medical Association; 2022. Available from: https://www.ama-assn.org/practice-management/physician-health/pandemic-pushes-us-doctor-burnout-all-time-high-63. Accessed August 11, 2023.
  • AMA-assn.org. 2023. Available from: https://www.ama-assn.org/practice-management/physician-health/measuring-and-addressing-physician-burnout. Accessed August 10, 2023.
  • HHS.gov. Available from: https://www.hhs.gov/surgeongeneral/priorities/workplace-well-being/index.html. Accessed August 11, 2023.
  • Psenka TM, Freedy JR, Mims LD, et al. A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research. Fam Pract. 2020;37(6):772–778. doi:10.1093/fampra/cmaa075
  • Eskander J, Rajaguru PP, Greenberg PB. Evaluating wellness interventions for resident physicians: a systematic review. J Grad Med Educ. 2021;13(1):58–69. doi:10.4300/JGME-D-20-00359.1
  • Khesroh E, Butt M, Kalantari A, et al. The use of emotional intelligence skills in combating burnout among residency and fellowship program directors. BMC Med Educ. 2022;22(1):127. doi:10.1186/s12909-022-03187-z
  • Norful AA, He Y, Rosenfeld A, Abraham CM, Chang B. Mitigating primary care provider burnout with interdisciplinary dyads and shared care delivery. J Eval Clin Pract. 2022;28(3):363–370. doi:10.1111/jep.13642
  • Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto: Consulting Psychologists Press; 1996.
  • American Medical Association. Practice transformation journey. Available from: https://www.ama-assn.org/system/files/2020-09/practice-transformation-toolkit.pdf. Accessed August 30, 2023.
  • Demerouti E. Oldenburg burnout inventory. APA PsychTests. 1999. doi:10.1037/t01688-000
  • Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207. doi:10.1080/02678370500297720
  • Swain JD, Soegaard Ballester JM, Luc JGY, Han JJ. Burning the candle at both ends: mitigating surgeon burnout at the training stages. J Thorac Cardiovasc Surg. 2021;162(2):637–642. doi:10.1016/j.jtcvs.2020.06.122
  • Anderson JC, Bilal M, Burke CA, et al. Burnout among US gastroenterologists and fellows in training: identifying contributing factors and offering solutions. J Clin Gastroenterol. 2022. doi:10.1097/MCG.0000000000001781
  • Eden AR, Jabbarpour Y, Morgan ZJ, Dai M, Coffman M, Bazemore A. Gender differences in personal and organizational mechanisms to address burnout among family physicians. J Am Board Fam Med. 2020;33(3):446–451. doi:10.3122/jabfm.2020.03.190344
  • Esquivel MK. Nutrition strategies for reducing risk of burnout among physicians and health care professionals. Am J Lifestyle Med. 2020;15(2):126–129. doi:10.1177/1559827620976538
  • Aman-Ullah A, Ali A, Ariza-Montes A, Mehmood W, Saraih UN. Nexus of workplace incivility, workplace violence and turnover intentions: a mediation study through job burnout. Kybernetes. 2023. doi:10.1108/K-02-2023-0299
  • Notice M, Johnson DJ, Caspari J. Using photography to elicit internal medicine physicians’ experiences with burnout and wellness. Trends in Psychology. 2023;1:1–21.
  • Weissman IA, Van Geertruyden P, Prabhakar AM, Fessell D, Alson M, Lexa FJ. Practice resources to address radiologist burnout. JACR. 2023;20(5):494–499. doi:10.1016/j.jacr.2023.03.007
  • Pearl A, Saleh K, Quick JC. Identifying and addressing burnout in the orthopaedic surgeon. J Am Acad Orthop Surg. 2023;31(5):229–238. doi:10.5435/JAAOS-D-22-00722
  • Belfi LM, Jordan SG, Chetlen A, et al. Self-care and storytelling for radiologists: a feasibility study. Curr Probl Diagn Radiol. 2022;51(4):445–449. doi:10.1067/j.cpradiol.2021.06.010
  • Bradford L, Glaser G. Addressing physician burnout and ensuring high-quality care of the physician workforce. Obstet Gynecol. 2021;137(1):3–11. doi:10.1097/AOG.0000000000004197
  • Quinn MA, Grant LM, Sampene E, Zelenski AB. A curriculum to increase empathy and reduce burnout. WMJ. 2020;119(4):258–262.
  • Medisauskaite A, Kamau C. Reducing burnout and anxiety among doctors: randomized controlled trial. Psychiatry Res. 2019;274:383–390. doi:10.1016/j.psychres.2019.02.075
  • Rich A, Aly A, Cecchinato ME, et al. Evaluation of a novel intervention to reduce burnout in doctors-in-training using self-care and digital wellbeing strategies: a mixed-methods pilot. BMC Med Educ. 2020;20(1):1. doi:10.1186/s12909-020-02160-y
  • Ghannam J, Afana A, Ho EY, Al-Khal A, Bylund CL. The impact of a stress management intervention on medical residents’ stress and burnout. Int J Stress Manag. 2020;27(1):65. doi:10.1037/str0000125
  • Sinsky CA, Panzer J. The solution shop and the production line—the case for a frameshift for physician practices. N Engl J Med. 2022;386(26):2452–2453. doi:10.1056/NEJMp2202511
  • Sanft T, Winer E. Rekindling joy in medicine through thoughtful communication: a practical guide. Am Soc Clin Oncol Educ Book. 2023;43(43):e100034. doi:10.1200/EDBK_100034
  • Bohman B, Dyrbye L, Sinsky CA, et al. Physician well-being: the reciprocity of practice efficiency, culture of wellness, and personal resilience. NEJM Catal. 2017;3(4). doi:10.1056/CAT.17.0429
  • Messinger A, Das S. Erosion of the ‘ethical’ doctor-patient relationship and the rise of physician burn-out. Med Humanit. 2022;49(3):390–395. doi:10.1136/medhum-2022-012506
  • Goldsack J. 8 digital health solutions poised to transform care. Healthleadersmedia.com; 2022. Available from https://www.healthleadersmedia.com/technology/8-digital-health-solutions-poised-transform-care. Accessed August 15, 2023.
  • Sanchez-Segura MI, Dugarte-Peña GL, Medina-Dominguez F, et al. Digital transformation in organizational health and safety to mitigate burnout syndrome. Front Public Health. 2023;11:1080620. doi:10.3389/fpubh.2023.1080620
  • Regional Institute of Occupational Health and Safety (IRSST). Challenge C4DX 2023 – creativity for digital transformation in OHS; 2023. Available from: https://catedrairsst.uc3m.es/en/challenge-2023-c4dx-in-ohs/. Accessed August 15, 2023.
  • National Academies of Sciences, Engineering, and Medicine. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: National Academies Press; 2019.
  • Preiksaitis C, Sinsky CA, Rose C. ChatGPT is not the solution to physicians’ documentation burden. Nat Med. 2023;29(6):1296–1297. doi:10.1038/s41591-023-02341-4
  • Ayers JW, Poliak A, Dredze M, et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Intern Med. 2023;183(6):589–596. doi:10.1001/jamainternmed.2023.1838
  • Brender TD. Medicine in the era of artificial intelligence: hey chatbot, write me an H&P. JAMA Intern Med. 2023;183(6):507–508. doi:10.1001/jamainternmed.2023.1832
  • Diamond C, Rundle CW, Albrecht JM, Nicholas MW. Chatbot utilization in dermatology: a potential amelioration to burnout in dermatology. Dermatol Online J. 2022;28(6). doi:10.5070/D328659734
  • Matheny M, Israni ST, Ahmed M, Whicher D. Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. Washington, DC: National Academy of Medicine; 2019:10.
  • American Medical Association. Augmented intelligence in health care H-480.940; 2018. Available from: https://policysearch.amaassn.org/policyfinder/detail/augmented%20intelligence?uri=%2FAMADoc%2FHOD.xml-H-480.940.xml. Accessed August 20, 2023.
  • Crigger E, Khoury C. Making policy on augmented intelligence in health care. AMA J Ethics. 2019;21(2):188–189.
  • Nahar JK, Kachnowski S. Current and potential applications of ambient artificial intelligence. Mayo Clin Proce. 2023;1(3):241–246.
  • Stephens K. Using AI to create work schedules significantly reduces physician burnout, study shows. AXIS Imaging News. 2022.
  • Wu A. Solving healthcare’s big epidemic—physician burnout. Forbes; 2019. Available from: https://www.forbes.com/sites/insights-intelai/2019/02/11/solving-healthcares-big-epidemicphysician-burnout/?sh=37d4bed04483. Accessed August 15, 2023.
  • Cook DJ, Augusto JC, Jakkula VR. Ambient intelligence: technologies, applications, and opportunities. Pervasive Mobile Comput. 2009;5(4):277–298. doi:10.1016/j.pmcj.2009.04.001
  • Javanmardian M, Lingampally A. Can AI address health care’s red-tape problem? 2018. Available from: https://hbr.org/2018/11/can-ai-address-health-cares-red-tape-problem. Accessed August 15, 2023.
  • North F, Luhman KE, Mallmann EA, et al. A retrospective analysis of provider-to-patient secure messages: how much are they increasing, who is doing the work, and is the work happening after hours? JMIR Med Inform. 2020;8(7):e16521. doi:10.2196/16521
  • Cronin RM, Davis SE, Shenson JA, et al. Growth of secure messaging through a patient portal as a form of outpatient interaction across clinical specialties. Appl Clin Inform. 2015;6(02):288–304. doi:10.4338/ACI-2014-12-RA-0117
  • Bittar PG, Nicholas MW. The burden of inbox-messaging systems and its effect on work-life balance in dermatology. J Am Acad Dermatol. 2018;79(2):361–363. doi:10.1016/j.jaad.2017.12.026
  • Borre ED, Nicholas MW. The disproportionate burden of electronic health record messages with image attachments in dermatology. J Am Acad Dermatol. 2022;86(2):492–494. doi:10.1016/j.jaad.2021.09.026
  • Qgenda. The impact of outdated systems on healthcare workforce management: a call for change. Healthleadersmedia.com; 2023. Available from: https://www.healthleadersmedia.com/nursing/impact-outdated-systems-healthcare-workforce-management-call-change. Accessed August 15, 2023.
  • Glover WJ, Li Z, Pachamanova D. The AI-enhanced future of health care administrative task management. NEJM Catalyst Innovat Care Deliv. 2022;3(2). doi:10.1056/CAT.21.0355
  • Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians. JAMA Intern Med. 2017;177(2):195. doi:10.1001/jamainternmed.2016.7674
  • Berg S. Q&A: uncovering physicians’ needs is key to improving well-being; 2022. Available from: https://www.ama-assn.org/practice-management/physician-health/qa-uncovering-physicians-needs-key-improving-well-being. Accessed August 19, 2023.
  • American Medical Association. AMA STEPS Forward saving time playbook for physicians; 2022. Available from: https://www.ama-assn.org/practice-management/sustainability/amasteps-forward-saving-time-playbook-physicians. Accessed August 20, 2023.
  • American Medical Association. Measuring and addressing physician burnout; 2023. Available from: https://www.ama-assn.org/practice-management/physician-health/measuring-and-addressing-physician-burnout. Accessed August 20, 2023.
  • Resneck J. Burnout is a health crisis for doctors--and patients; 2023. Available from: https://www.ama-assn.org/about/leadership/burnout-health-crisis-doctors-and-patients. Accessed August 15, 2023.
  • Backus BE, Slagmolen K, May NM. A system based approach on burnout prevention of healthcare professionals. Eur J Emerg Med. 2022;29(2):101–102. doi:10.1097/MEJ.0000000000000873
  • Melnick ER, Sinsky CA, Dyrbye LN, et al. Association of perceived electronic health record usability with patient interactions and work-life integration among US physicians. JAMA Network Open. 2020;3(6):e207374. doi:10.1001/jamanetworkopen.2020.7374
  • Bacigalupo A. Clinical workflow efficiencies to alleviate physician burnout and reduce work after clinic. Fam Pract Manag. 2023;30(3):21–25.
  • Thomas Craig KJ, Willis VC, Gruen D, Rhee K, Jackson GP. The burden of the digital environment: a systematic review on organization-directed workplace interventions to mitigate physician burnout. J Am Med Inform Assoc. 2021;28(5):985–997. doi:10.1093/jamia/ocaa301
  • Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92(1):129–146. doi:10.1016/j.mayocp.2016.10.004
  • American Medical Association. AMA recovery plan; 2023. Available from: https://www.ama-assn.org/amaone/ama-recovery-plan-america-s-physicians. Accessed August 20, 2023.
  • Office of the Surgeon General. U. S. Surgeon General. Addressing health care worker burnout; 2022.
  • Kane L. “I cry but no one cares”: physician burnout & depression report 2023. Available from https://www.medscape.com/slideshow/2023-lifestyle-burnout-6016058. Accessed August 14, 2023.
  • Committee on the Learning Health Care System in America. The Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: National Academies Press; 2013.
  • Horwitz LI, Kuznetsova M, Jones SA. Creating a learning health system through rapid-cycle, randomized testing. N Engl J Med. 2019;381(12):1175–1179. doi:10.1056/NEJMsb1900856
  • Rotenstein LS, Sinsky C, Cassel CK. How to measure progress in addressing physician well-being: beyond burnout. JAMA. 2021;326(21):2129–2130. doi:10.1001/jama.2021.20175
  • Rotenstein LS, Melnick ER, Sinsky CA. A learning health system agenda for organizational approaches to enhancing occupational well-being among clinicians. JAMA. 2022;327(21):2079–2080. doi:10.1001/jama.2022.7461
  • Obregon M, Luo J, Shelton J, Blevins T, MacDowell M. Assessment of burnout in medical students using the Maslach Burnout Inventory-Student Survey: a cross-sectional data analysis. BMC Med Ed. 2020;20(1). doi:10.1186/s12909-020-02274-3