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Am J Med. 2018 Dec 13. pii: S0002-9343(18)31155-0. doi: 10.1016/j.amjmed.2018.11.028. [Epub ahead of print]

Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level.

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Administrative Affairs, Humanities in Medicine, Penn State College of Medicine, Hershey. Electronic address:
Lifespan, Providence, RI.
Lifespan, Providence, RI; Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
Penn State Health, Hershey.


Burnout has been implicated in higher physician turnover, reduced patient satisfaction, and worsened safety, but understanding the degree of burnout in a given physician or team does not direct leaders to solutions. The model proposed integrates a long list of variables that may ameliorate burnout into a prioritized, easy-to-understand hierarchy. Modified from Maslow's hierarchy, the model directs leaders to address physicians' basic physical and mental health needs first; patient and physician physical safety second; and then address higher-order needs, including respect from colleagues, patients, processes, and the electronic health record; appreciation and connection; and finally, time and resources to heal patients and contribute to the greater good. Assessments based on this model will help leaders prioritize interventions and improve physician wellness.


Burnout; Physician wellness; Systems

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