multi-sectoral approach to burnout
must include health systems, political
leaders, public and private payers, the
food and pharmacy industries, and
both regulatory and certifying organizations.
There are ways to change our current workplace culture and improve
our patients’ experience and outcomes.
Some of the leading health care organizations are prioritizing compassion
as a core tenet of care delivery and as
a mechanism to mitigate workforce
burnout. The essentials of such models
address the interrelationships between
building provider resilience (the individual); nourishing caregiver-to-caregiver compassion (the team); and embedding organization-wide initiatives
that support workforce well-being
(organizational leadership).( 12)
Although no specific method for
building individual resilience has been
shown to be better than other types
of interventions, mindfulness, stress
management and small group discussions can be effective approaches to
reduce burnout scores.( 13) Our clinical
teams must level their hierarchy and
be given protected time to nourish
caregiver-to-caregiver compassion by
having open and honest discussion of
technical, social and emotional issues
that arise in caring for patients. Driving
change through organizational leadership begins with making compassion
a core value, articulating it, and establishing metrics to measure it. A culture
of compassion requires structured programs and policies implemented by the
organization itself.( 14)
So Dr. Martin, let’s engage our
fellow caregivers, our organization
leaders, and our professional medical
societies to recognize the dangers of
burnout. Let’s harness the resources
needed to prevent and treat it, and in
its place create cultures of compassionate, collaborative care.
Your friends and colleagues,
Fernando and Michael
Dr. Stein is AAP president, and Dr.
Goldberg is scholar-in-residence at the
Schwartz Center for Compassionate
2. McHugh MD, Kutney-Lee A, Cimiotti JP.
Health Affairs. 2011; 30:202-210
3. Lown BA, Rosen J, Marttila J. Health Affairs. 2011;30:1772-1778
4. Mata DA, et. al. JAMA. 2015; 314:2373-
5. Goldman ML, et al. JAMA Psychiatry.
7. Shanafelt TD, et.al. Mayo Clin Proc. 2016;
8.Shanafelt TD, et.al. Ann Surg.
9. Maslach C, et al. Annu Rev Psychol. 2001;
10. Singer T, Klimecki OM. Curr Biol. 2014;
11. The World Bank IRD.IDA UN In-
ter-agency Group for Child Mortality
Estimation (UNICEF, WHO, World
Bank, UN DESA Population Division)
12. Chadwick RJ, Lown BA. Medicine
13. West CP, et. al. Lancet 2016; 388:2272-
14.Shanafelt TD, Noseworthy JH.
Mayo Clin Proc. 2016. http://dx.doi.
Dr. Stein Dr. Goldberg