By Pamela Hartzband, M.D., and Jerome Groopman, M.D. June, 25, 2020, N Engl J Med 2020; 382:2485-2487 DOI: 10.1056/NEJMp2003149.
Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care system, most prominently the widespread implementation of the electronic health record (EHR) and performance metrics.1 Initially, the prevailing attitude was that burnout is a physician problem and that those who can’t adapt to the new environment need to get with the program or leave. Some dismissed the problem as a generation of “dinosaur” doctors whining and pining for an inefficient, low-tech past. But recently, it has become clear that millennials, residents, and even medical students are showing signs of burnout. The unintended consequences of radical alterations in the health care system that were supposed to make physicians more efficient and productive, and thus more satisfied, have made them profoundly alienated and disillusioned. The problem has become even more urgent with the realization that it’s costing the health care system approximately $4.6 billion a year.2
Relatedness is the psychological feeling that one belongs, has interpersonal attachments, and is connected to the social organization. Doctors want to give patients the time and support they need, and they want the system to value and recognize their efforts to provide this kind of care. While much lip service is given to “patient-centered care,” many doctors feel that the system is increasingly driven by money and metrics, with rewards for professionals who embrace these priorities.
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