The Loss of Social Connectedness as a Major Contributor to Physician Burnout: Applying Organizational and Teamwork Principles for Prevention and Recovery

Steven Mark Southwick; Frederick Seacrest Southwick

doi:10.1001/jamapsychiatry.2019.4800

Viewpoint

February 19, 2020

The Loss of Social Connectedness as a Major Contributor to Physician Burnout: Applying Organizational and Teamwork Principles for Prevention and Recovery

Steven Mark Southwick, MD¹; Frederick Seacrest Southwick, MD²

Author Affiliations Article Information

¹Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
²Department of Medicine, University of Florida College of Medicine, Gainesville

JAMA Psychiatry. 2020;77(5):449-450. doi:10.1001/jamapsychiatry.2019.4800

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As physicians, we are concerned that the role of social connectedness in combating burnout among medical professionals is not receiving the emphasis that it deserves. While many interventions to reduce burnout have been proposed, none is more important, in our view, than addressing the fundamental human need to belong. In this Viewpoint, we emphasize that social connectedness is a basic human need that when lost leads to burnout, and we encourage health care institutions to apply lessons from team and organizational literature to increase social connectedness and enhance well-being.

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2 Comments for this article

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February 19, 2020

Wonderful words of truth

Lori Davis, MD; Clinical Professor | Tuscaloosa VA Medical Center; University of Alabama at Birmingham

I agree with the esteemed authors that professional social connectedness is vital to occupational and emotional well-being. I would imagine that high social connectedness in the workplace reduces risk of suicide in physicians and healthcare providers. Burnout in the workplace threatens one’s core identity and shatters sense of self, narrowing hope for future. More research should be done to shed light on health care systems and how automation and our digital world are impacting mental wellness. What is the implication for the next generation of healthcare providers who have grown up in a world of social media and on-line learning? How will burnout manifest in this cohort? Thank you for bringing this topic to the forefront.

CONFLICT OF INTEREST: None Reported

February 29, 2020

Burnout, Learned Helplessness, and Suicide

Steven Reid, MD FAANS | Neurosurgeon, and president of DoctorLifeline.org, a 501(c)3 organization dedicated to prevention of physician suicide

"Burnout" becomes an official diagnosis when WHO ICD-11 takes effect in January 2022. The term originally referred to end-stage drug addiction, but through common usage we're now stuck with it to describe the mental illness characterized by: "1) feelings of energy depletion or exhaustion; 2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy." It tends to imply a deficiency of resilience or grit in the affected physician.

Burnout too often leads to suicide. Loss of social connectedness entails loss of access to objective social feedback and advice. Friends can serve as an early warning system and extend a helpful hand to a doctor on the slippery slope to depression and burnout. Socially isolated doctors lack this safety net.

Toxic practice environments promote learned helplessness in doctors. With sufficient exposure to seemingly immutable barriers and ever-increasing demands, many doctors conclude that they are powerless to effect positive change. Learned helplessness is also a major contributor to burnout and physician suicide.

Burnout, learned helplessness, and suicide are predictable responses to prolonged exposure to toxic practice environments. If gasses in the coal mine kill the canary, you don't say "lets make our canaries more resilient". Doctors are the canaries in the health care coal mine. We need to focus the spotlight of our attention on the toxic practice environments that are killing our colleagues.

CONFLICT OF INTEREST: I am the president of a non-profit organization dedicated to prevention of physician suicides

The Loss of Social Connectedness as a Major Contributor to Physician Burnout: Applying Organizational and Teamwork Principles for Prevention and Recovery

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