![]() The drivers of burnout are work overload, lack of control, insufficient reward, breakdown of community, absence of fairness, and conflicting values.Įxhaustion is closely related to work overload, which is a result of the chaotic, time pressured clinical work environment with poorly designed workflows exacerbated by insurance and regulatory requirements to enter data into the EHR, which is so poorly designed that physicians spend two hours documenting for every hour of direct patient care.ĭepersonalization is closely related to the other five drivers, which result from a dysfunctional management system and culture that does not recognize physicians for the highly competent knowledge workers that they are, instead treating them more like production line workers in a factory. Dean, Talbot, and Caplan, I strongly agree with one sentence in the next to the last paragraph: “The focus must shift to what will make a difference: eliminating unnecessary barriers that interfere with delivering good health care and recognizing the value of human experience and relationships-among clinicians, with patients, and with leadership.”Īttempting to differentiate between moral dilemmas, moral distress, and moral injury risks misses the most significant opportunities to reduce burnout.Īccording to Maslach, “Burnout is a sign of a major dysfunction within an organization and says more about the workplace than it does about the employees.” While I respectfully disagree with the basic premise of this Viewpoint from Drs. 3, 4 Shifting the language of distress to incorporate etiology could potentially allow better assessment and more targeted solutions to the crisis. ![]() Challenges with accurately identifying and measuring a subjectively assessed constellation of symptoms are interfering with efforts to quantify and address widespread clinician distress. The use of burnout to describe current occupationally related issues (such as stress, frustration, dissatisfaction, and depression) affecting physicians and other health practitioners has become widespread. 2 Today, it is possible that the term burnout may be approaching, and perhaps should have, the same fate. In 2019, member states of the World Health Organization accepted the International Classification of Diseases and Related Health Problems, Eleventh Revision, which retired neurasthenia, and replaced this term with bodily distress disorder. 1 The widespread use of the diagnosis had diluted its utility. Neurasthenia was once a diagnosis ubiquitous enough to be household vernacular, but by the 1930s, as physicians became interested in more precise, narrower diagnoses, fewer patients were diagnosed as having this condition.
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