Why Family Medicine Burnout Is Different (and How Docs Fight Back)

Interviewer: Laurie Scudder, DNP, NP; Interviewee: H. Clifton "Clif" Knight, MD, FAAFP


September 06, 2017

Editorial Collaboration

Medscape &

Promoting Resilience

Medscape: While burnout is well recognized as a concern, increasingly our focus has turned to well-being and the need to better understand the factors that allow some clinicians to avoid burnout. What about the factors—both personal and system—that are associated with higher levels of resilience?

Dr Knight: As I've said, a sense of autonomy is very important. For physicians who are employed or part of larger organizations, feeling a connection to the values of the organization, believing that their values are reflected in the values of the organization, is also important. When physicians are told to focus on quality of care and provide the best care that they can for patients, but are measured on productivity and relative value units (RVUs)—metrics that look at finances rather than quality of care—that mismatch is incredibly frustrating. Physicians lose confidence in the organization, which leads to less satisfaction and higher rates of burnout.

There are strategies—some personal, some directed at the organizational level—that we know work. Practicing mindfulness, setting priorities, and being aware of the heroic-physician culture which can get in the way of setting appropriate boundaries and leads to burning the candle at both ends are all important personal factors. At the system level, ineffective workflow and lack of autonomy and meaningful performance measures are barriers to resilience, and we know that there are effective strategies to address them.


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