Reducing Burnout Among Health Care Workers

September 30, 2019

Burnout, defined as the “exhaustion of physical or emotional strength as a result of prolonged stress or frustration,” has been a highly studied topic in health care for over forty years.1-3 Researchers have hypothesized about the various individual factors leading to burnout, such as personality,2 as well as the results of burnout, such as lowered production and increases in absenteeism.1 Recently, however, studies have shifted their focus from the causes and outcomes of burnout to prevention efforts and solutions.4-7 Research acknowledges that burnout is a detrimental force in health care for patients and professionals alike; therefore, health professionals are moving toward industry changes and interventions to better their careers and prevent burnout.

For example, some studies have analyzed the relationship between workplace and burnout, and how a change in work environment might affect a health care worker’s mental and physical health. Shanafelt et al. surveyed almost three thousand physicians at the Mayo Clinic and found that better leadership qualities in a supervisor were correlated with the well-being and satisfaction of individual physicians.8 Additionally, increases in leadership scores were associated with decreases in likelihood of burnout. Another study by Sinsky et al. found that, in primary care settings, a “shared-care” model—that is, a model of work distribution and responsibility “with a higher level of clinical support staff per physician and frequent forums for communication”—resulted in high-functioning teams, improved professional satisfaction and greater joy in practice.9 Furthermore, a randomized controlled trial by Linzer et al. showed that interventions focused on improved communication, changes in workflow or quality improvement were effective in reducing burnout and increasing satisfaction as compared to control conditions.10 According to these data, work environments appear to have noticeable effects on burnout in health care workers.

Also, research shows that individual coping mechanisms can alleviate burnout and increase satisfaction in the health care field. For one, a case study by Gazelle et al. suggested that coaching can provide increased professional satisfaction and promote resilience, thus improving physicians’ quality of life and decreasing burnout.6 Meanwhile, a longitudinal study on a mindfulness-based stress reduction (MBSR) intervention showed that several measures of the Maslach Burnout Inventory—Emotional Exhaustion, Depersonalization and Personal Accomplishment—improved throughout an eight-week course for health professionals.7 Given these results, individualized interventions for health care workers have the potential to effect change in burnout rates.

In addition to conducting small-scale studies and trials, several researchers have used literature reviews to approach the prevention and decrease of burnout among health care workers. A systematic review by Busireddy et al. showed that work hour reductions and meditation interventions were associated with lower likelihoods of emotional exhaustion, while self-care workshops showed decreases in depersonalization among resident physicians.11 Also, West et al.’s systematic review and meta-analysis showed that individual-focused as well as organizational interventions can reduce burnout among physicians.5 However, Panagioti et al. found that physician burnout was better approached from a structural, rather than individual, position.12 Thus, it remains unclear whether interventions should focus on organizational or individualized interventions for reducing burnout. Further research is also needed to clarify the effects of such interventions on burnout in non-physician health care workers.

Taken together, studies on interventions for burnout in the health professions show that good leadership, distribution of work and communication, along with meditation and coaching strategies, may be effective in reducing burnout and increasing career satisfaction. Nevertheless, the current literature is lacking longitudinal studies and controlled trials on specific interventions. Future studies should address the effects of organizational versus individual interventions on burnout, especially among non-physician health care workers.

1.         Felton JS. Burnout as a clinical entity—its importance in health care workers. Occupational Medicine. 1998;48(4):237–250.

2.         Piedmont RL. A Longitudinal Analysis of Burnout in the Health Care Setting: The Role of Personal Dispositions. Journal of Personality Assessment. 1993;61(3):457–473.

3.         Siefert K, Jayaratne S, Chess WA. Job Satisfaction, Burnout, and Turnover in Health Care Social Workers. Health & Social Work. 1991;16(3):193–202.

4.         Le Blanc PM, Hox JJ, Schaufeli WB, Taris TW, Peeters MC. Take care! The evaluation of a team-based burnout intervention program for oncology care providers. The Journal of Applied Psychology. 2007;92(1):213–227.

5.         West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis. The Lancet. 2016;388(10057):2272–2281.

6.         Gazelle G, Liebschutz JM, Riess H. Physician Burnout: Coaching a Way Out. Journal of General Internal Medicine. 2015;30(4):508–513.

7.         Goodman MJ, Schorling JB. A Mindfulness Course Decreases Burnout and Improves Well-Being among Healthcare Providers. The International Journal of Psychiatry in Medicine. 2012;43(2):119–128.

8.         Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clinic Proceedings. 2015;90(4):432–440.

9.         Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices. The Annals of Family Medicine. 2013;11(3):272–278.

10.       Linzer M, Poplau S, Grossman E, et al. A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study. Journal of General Internal Medicine. 2015;30(8):1105–1111.

11.       Busireddy KR, Miller JA, Ellison K, Ren V, Qayyum R, Panda M. Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review. Journal of Graduate Medical Education. 2017;9(3):294–301.

12.       Panagioti M, Panagopoulou E, Bower P, et al. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine. 2017;177(2):195–205.