Professional burnout and other forms of occupational distress among physicians has important personal and professional consequences. These consequences can erode patient safety and quality of care and come at a substantial cost to healthcare organizations and society at large.

a. Causes and Drivers

1. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-111. doi:10.1002/wps.20311

2. Bakker AB et al. J Managerial Psychol 232:309

3. 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

4. Sinsky C, Colligan L, Li L, et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. 2016;165(11):753-760. doi:10.7326/M16-0961

5. Shanafelt TD, Dyrbye LN, West CP. Addressing Physician Burnout: The Way Forward. JAMA. 2017;317(9):901-902. doi:10.1001/jama.2017.0076

6. Grant RW, Goitein L. Primary Care Practitioners’ Perspectives on Burnout and What to Do About It. JAMA Intern Med. 2020;180(3):345–346. doi:10.1001/jamainternmed.2019.6322

7. Shanafelt TD, Dyrbye LN, Sinsky C, et al. Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction. Mayo Clin Proc. 2016;91(7):836-848. doi:10.1016/j.mayocp.2016.05.007

8. Gunderman  R.  Poor care is the root of physician disengagement.   NEJM Catalyst. Published online January 10, 2017. Google Scholar

9. Shanafelt TD, West CP, Sloan JA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169(10):990-995. doi:10.1001/archinternmed.2009.70

10.  West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. doi:10.1111/joim.12752

b. The EHR

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c. The Physician Personality and Self-Valuation

1. Gabbard GO.  JAMA 254:2926

2. Trockel MT, Hamidi MS, Menon NK, et al. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019;94(10):2022-2031. doi:10.1016/j.mayocp.2019.04.040

3. Lemaire, J.B., Wallace, J.E. How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study. BMC Health Serv Res 14, 616 (2014). https://doi.org/10.1186/s12913-014-0616-z

4. Krasner MS, Epstein RM, Beckman H, et al. Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians. JAMA. 2009;302(12):1284–1293. doi:10.1001/jama.2009.1384

5.Dweck, C. S. (2012). Mindsets and human nature: Promoting change in the Middle East, the schoolyard, the racial divide, and willpower. American Psychologist, 67(8), 614–622. https://doi.org/10.1037/a0029783

6. Dweck, C. S. (2015). Growth [Editorial]. British Journal of Educational Psychology, 85(2), 242–245. https://doi.org/10.1111/bjep.12072

7. Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027

d. What is Well-Being?

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