Physicians’ discontent: burnout and the deterioration of medical practice

Bernardo Moreno-Jiménez, María del Carmen Yeo Ayala, Ana Fresán-Orellana



It is a well-known fact among professionals that medical well-being has eroded in recent decades (Schrijver, Brady, & Trockel, 2016), together with the mental health of medical professionals. The root of medical mental problems is clinical practice. Practicing medicine is not an easy task since it involves constantly confronting disease, pain, suffering, the progressive loss of quality of life, and even death (Boorse, 2016). Eventhough coping with and accompanying these processes to suppress or alleviate them provides satisfaction and personal fulfillment (Janus et al., 2008), it also has a cost. Being involved in improving the health of others often compromises the physical and mental health of physicians, and their professional quality of life (Mingote Adán, Moreno Jiménez, Gálvez Herrer, 2004). Engaging in a difficult clinical relationship is compounded by the problems of a system of working conditions that contribute to medical mental exhaustion (Milner et al., 2017).

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Boorse, C. (2016). Goals of medicine. In Giroux, É. (Ed.) Naturalism in the philosophy of health: History, philosophy and theory of the life sciences (pp. 145-177). Switzerland: Spinger.

Brower, K. J., & Riba, M. B. (2017). Physician mental health and wellbeing: Research and practice. New York: Springer.

Center, C., Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., … Silverman, M. M. (2003). Confronting depression and suicide in physicians: A consensus statement. JAMA, 289(23), 3161-3166. doi: 10.1001/jama.289.23.3161

Federation of State Medical Boards (FSMB). (2018). Supplemental Resource: Report and Recommendations of the FSMB Workgroup on Physician Wellness and Burnout. Journal of Medical Regulation, 104(2) 37-48. doi: 10.30770/2572-1852-104.2.37

Firth-Cozens, J. (2003). Doctors, their wellbeing, and their stress. BMJ, 326(7391), 670-671. doi: 10.1136/bmj.326.7391.670

Gazelle, G., Liebschutz, J. M., & Riess, H. (2015). Physician burnout: Coaching a way out. Journal of General Internal Medicine, 30(4), 508-513. doi: 10.1007/s11606-014-3144-y

Janus, K., Amelung, V. E., Baker, L. C., Gaitanides, M., Schwartz F. W., & Rundall T. G. (2008). Job satisfaction and motivation among physicians in academic medical centers: Insights from a cross-national study. Journal of Health Politics, Policy and Law, 33(6), 1133-1167. doi: 10.1215/03616878-2008-035

Jha, A. K., Iliff, A. R., Chaoui, A. A., Defossez, S., Bombaugh, M. C., & Miller, Y. R. (2019). A crisis in health care: A call to action on physician burnout. Waltham, MA: Massachusetts Medical Society, MHaHA, Harvard TH Chan School of Public Health, and Harvard Global Health Institute.

Kumar, S. (2016). Burnout and Doctors: Prevalence, Prevention and Intervention. Healthcare, 4(3), 37. doi: 10.3390/healthcare4030037

Lacy, B. E., & Chan, J. L. (2018). Physician burnout: The hidden health care crisis. Clinical Gastroenterology and Hepatology, 16(3), 311-317. doi: 10.1016/j.cgh.2017.06.043

Landrigan, C. P., Barger, L. K., Cade, B. E., Ayas, N. T., & Czeisler, C. A. (2006). Interns’ compliance with accreditation council for graduate medical education work-hour limits. JAMA, 296(9), 1063-1070. doi: 10.1001/jama.296.9.1063

Mache, S., Klapp, B. F., & Groneberg, D. A. (2014). The well-being and mental health of male and female hospital physicians in Germany. World Hospitals Health Services, 50(4), 17-22. Retrieved from

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99-113. doi: 10.1002/job.4030020205

Miller, C. (2016). What is the price of physician stress and burnout? Retrieved from:

Milner, A., Witt, K., Spittal, M. J., Bismark, M., Graham, M., & LaMontagne, A. D. (2017). The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine in Australia Balancing Employment and Life (Mabel) survey. BMC Health Services Research, 17(1), 609. doi: 10.1186/s12913-017-2554-z

Mingote Adán, J. C., Moreno Jiménez, B., Gálvez Herrer., M. (2004). Desgaste profesional y salud de los profesionales médicos: revisión y propuestas de prevención. Medicina Clínica, 123(7), 265-270. doi: 10.1016/S0025-7753(04)74484-X

Mirkovic, D., & Bianchi, R. (2019). Physician burnout: let’s avoid unsubstantiated claims. Nature Reviews Clinical Oncology, 16(2), 136. doi: 10.1038/s41571-018-0150-8

Myers, M., & Gabbard, G. O. (2008). The Physician as Patient: A Clinical Handbook for Mental Health Professionals. Washington DC: American Psychiatric Publishing.

Noseworthy, J. H. M. J., Madara, J., Cosgrove, D., Edgeworth, M., Ellison, E., Krevans, S., ... Harrison, D. (2017). Physician burnout is a public health crisis: A message to our fellow health care CEOs. Health Affairs Blog, 10. doi: 10.1377/hblog20170328.059397

Physicians Foundation. (2018). Survey of America’s Physicians: Practice Patterns & Perspectives. Retrieved from https:// 2018/09/physicians-survey-results-final-2018.pdf

Raso, R. (2020). Burnout: Is resilience enough? Nursing Management, 51(4), 5. doi: 10.1097/01.NUMA.0000657276.13359.65

Schrijver, I., Brady, K. J., & Trockel, M. (2016). An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center. PeerJ, 4, e1783. doi: 10.7717/peerj.1783

Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Satele, D. V., ... Dyrbye, L. N. (2019). Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clinic Proceedings, 94(9), 1681-1694. doi: 10.1016/j.mayocp.2018.10.023

Talbot, S. G., & Dean, W. (2018). Physicians aren’t ‘burning out.’ They’re suffering from moral injury. Stat, 7(26), 18. Retrieved from -are-suffering-moral-injury/

Tyssen, R. (2018). What is the level of burnout that impairs functioning? Journal of Internal Medicine, 283(6), 594-596. doi: 10.1111/joim.12769

Wallace, J. E. (2012). Mental health and stigma in the medical profession. Health (London), 16(1), 3-18. doi: 10.1177/1363459310371080

Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009). Physician wellness: a missing quality indicator. Lancet, 374(9702), 1714-1721. doi: 10.1016/S0140-6736(09)61424-0

World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems:11th revision (ICD-11). Genève: World Health Organization. Retrieved from

Wright, A. A., & Katz, I. T. (2018). Beyond burnout—redesigning care to restore meaning and sanity for physicians. N Engl J Med, 378(4), 309-311. doi: 10.1056/NEJMp1716845