Although the epidemic of burnout among physicians is now widely recognized, a lack of awareness of the economic costs of this problem has been a barrier for many organizations to take action.  While there is a moral and ethical imperative to address this issue, there is also a strong business case. The impact of physician burnout on the economic health of healthcare organizations is multifaceted, and includes costs associated with turnover, decreased clinical productivity, an impact on quality and safety, effects on patient satisfaction and reputation, and malpractice litigation risk.

a. The Business Case to Invest in Physician Well-being

1. Shanafelt T, Goh J, Sinsky C. The Business Case for Investing in Physician Well-being. JAMA Intern Med.2017;177(12):1826–1832. doi:10.1001/jamainternmed.2017.4340

2. Windover AK, Martinez K, Mercer MB, Neuendorf K, Boissy A, Rothberg MB. Correlates and Outcomes of Physician Burnout Within a Large Academic Medical Center. JAMA Intern Med. 2018;178(6):856-858. doi:10.1001/jamainternmed.2018.0019

3. Hamidi MS, Bohman B, Sandborg C, et al. Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study. BMC Health Serv Res. 2018;18(1):851. Published 2018 Nov 27. doi:10.1186/s12913-018-3663-z

4. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374(9702):1714-1721. doi:10.1016/S0140-6736(09)61424-0

5. Balch CM, Oreskovich MR, Dyrbye LN, et al. Personal consequences of malpractice lawsuits on American surgeons. J Am Coll Surg. 2011;213(5):657-667. doi:10.1016/j.jamcollsurg.2011.08.005

6. Welle D, Trockel MT, Hamidi MS, et al. Association of Occupational Distress and Sleep-Related Impairment in Physicians With Unsolicited Patient Complaints. Mayo Clin Proc. 2020;95(4):719-726. doi:10.1016/j.mayocp.2019.09.025

7. Welp A, Meier LL, Manser T. Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol. 2015;5:1573. Published 2015 Jan 22. doi:10.3389/fpsyg.2014.01573\

8. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272-2281. doi:10.1016/S0140-6736(16)31279-X

b. Physician Distress: What Hospital Boards Should Know

1. Shanafelt T, Swensen SJ, Woody J, Levin J, Lillie J. Physician and Nurse Well-Being: Seven Things Hospital Boards Should Know. J Healthc Manag. 2018;63(6):363-369. doi:10.1097/JHM-D-18-00209

2. 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

3. 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):1377-1385. doi:10.1001/archinternmed.2012.3199

4. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374(9702):1714-1721. doi:10.1016/S0140-6736(09)61424-0

5. Shanafelt T, Goh J, Sinsky C. The Business Case for Investing in Physician Well-being. JAMA Intern Med. 2017;177(12):1826-1832. doi:10.1001/jamainternmed.2017.4340

6. Panagioti M, Panagopoulou E, Bower P, et al. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017;177(2):195-205. doi:10.1001/jamainternmed.2016.7674

7. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272-2281. doi:10.1016/S0140-6736(16)31279-X

c. Assessment

TBD