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Invited Commentary
July 2, 2020

Addressing Burnout—Focus on Systems, Not Resilience

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2General Internal Medicine Unit, Massachusetts General Hospital, Boston
JAMA Netw Open. 2020;3(7):e209514. doi:10.1001/jamanetworkopen.2020.9514

Even before the coronavirus crisis, the topic of burnout dominated discussions about the state of our health professions workforce, particularly as it pertains to physicians but not limited to them. The preponderance of reports has been descriptive, focusing on symptoms and speculating widely on causes. Many health care systems have responded by implementing measures to improve the personal resilience of their workforce. Initiatives for health care workers range from work site drop-in rooms for emotional decompression to team meetings focused on improving mutual support. “Happiness” committees have been formed to sponsor social events; some even offer massage therapy and meditation classes. At issue is the extent to which the emphasis on boosting caregiver resilience represents the best strategy for dealing with burnout among physicians and other health care professionals. The acute and unprecedented stress on physicians during the coronavirus pandemic tests even the most resilient among us, but it does not obscure the question of whether burnout requires giving priority to boosting resilience or to correcting the practice environment.

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    1 Comment for this article
    Life Threatening
    Steven Billet, M.D., FACP | Steven Billet, M.D.P.A.
    To every medical professional,

    As an ABIM board certified Internist with Added Qualifications in Geriatric Medicine and Hospice and Palliative care, I learned I had Attention Deficit Disorder at age 58, 9 years ago. My identical twin brother who is 3 minutes older than I told me, “I’ve known that for thirty years. He said, “I could never watch someone else operate. I was in the room, out of the room, in the room, etc. He retired 3 years ago after 33 years of working as a plastic surgeon. No additional burnout there. />
    Every physician, which is the term used for nurse practitioners in the Federal Hospice program, should never refer to the current SARS CoV-2 disease as pandemic.

    This is not a pandemic. What, like tuberculosis? No, this needs to be referred to as it is.

    Insert “LIFE THREATENING“ prior to the “pandemic.“ Apply the words from now on, in capital letters, until this threat is no longer life threatening. I believe every Scientific journal and newspaper should bold the word pandemic in every article.

    Impressions have great impact and we have not impressed upon the non-medical population that 200,000 residents of this country will have died this year.

    I would personally appreciate it if you could consider this and pass it along.

    Please, stay safe. After 42 years of medicine, excluding medical school, physicians learn to do the best they can.

    Steven Billet, M.D., FACP
    Eldersburg, MD