Battling Burnout and Helping Physicians Feel Whole

This Clinician's View is written by Omayra Mansfield, MD, AdventHealth Apopka Chief Medical Officer.

Nearly half of physicians in the U.S. are feeling burned out according to national surveys, and those who specialize in emergency medicine report the highest burnout rates. Additionally, physicians typically have higher suicide rates than the general population with psychiatrists and anesthesiologists at highest risk. To someone charged with leading and supporting physicians, these statistics are disheartening but not surprising to me. Because I am a trained emergency medicine physician married to an anesthesiologist and raising two young children together, these figures hit especially close to home.

To quote the most recent Medscape Physician Burnout & Depression Report released earlier this year, “We have much work to do.”

Battling Physician Burnout

While the concept of burnout is not new, it grew significantly during the COVID-19 pandemic and remains high today. It has been defined as long-term, unresolved, job-related stress leading to exhaustion, cynicism, depersonalization and decline in a sense of personal accomplishment. Digging deeper into the numbers of the 2024 Medscape survey, which the compiled the input of over 9,000 U.S. physicians across 29 specialty areas:

• Eighty-three percent of doctors surveyed cited professional stress as the primary contributor to their burnout and/or depression.
• The number of work-related bureaucratic tasks was cited as the primary reason for burnout (62%).
• Spending too many hours at work (41%) and lack of respect from administrators, employers and coworkers (40%) also were contributing factors.

I often explain physician burnout as death by 1,000 cuts. It typically isn’t one incident but an accumulation of stressors or injuries over time. Unfortunately, health care organizations and leaders have too often missed the mark and framed the solution as a need for physicians to simply “build more resilience.” However, the challenges are complex, and therefore the answers are multifaceted. They include creating a more collaborative culture, celebrating personal and professional growth, building trust and community, supporting physician well-being and implementing strategies to ease physician workload.

Moving Beyond Resilience to Embrace Collaborative Solutions

Resilience is defined as the capacity to withstand or recover quickly from difficulties, something physicians do every day in their clinical practice settings. Our efforts to address physician burnout must be about so much more than that. To better illustrate this, consider the analogy where we describe and characterize strong, durable bones as resilient. Like our bones, even the healthiest and most mentally strong physician is susceptible to a stress fracture due to repetitive force and overuse. To help our physicians, we must recognize the daily insults they endure and collaborate with them on tangible solutions what will allow them to heal.

At AdventHealth, our work is rooted in delivering whole-person care. Living whole means being physically healthy, mentally well, spiritually connected and socially content. It’s about fulfilling potential and overcoming challenges. This approach applies not only to the patients we treat but also to our entire team, including our physicians. In fact, we view our physicians through the same service standards that apply to caring for our patients:

• Keep Me Safe
• Love Me
• Make It Easy
• Own It

Furthermore, we recognize that improving physician well-being must be a collaborative, organizational effort. It is important that our work is physician-generated and physician-led. We want to empower our physicians to speak up about the challenges and obstacles they face, to share their ideas and potential solutions, and to help us evaluate new opportunities. We may not be able to fix everything, but we can certainly help remove some of the rocks in their shoes.

Celebrating Personal and Professional Growth

Despite efforts to remove obstacles, medicine is hard. It is also a team sport. That is why it’s important that we give each other encouragement and celebrate even the small victories.

As we engaged our physicians in identifying new opportunities to enhance their experience and well-being, the need for positive recognition kept rising to the top so we created a program to identify, recognize and honor the successes. Through the “Physician Serving in Excellence” recognition program, we created a QR code that all AdventHealth physicians and team members can easily access. It links to three simple questions:

• What physician should be recognized?
• Which AdventHealth campus do they work at?
• Why should they be recognized?

Individual physicians are then recognized, and we celebrate their success as a team. The honored physician receives two lapel pins — one to wear and one to “pay it forward” to another physician they would like to acknowledge for a job well done. This program’s simplicity has been essential to its success. It has really caught on and fostered a positive, caring culture of growth and development – one where we lift each other up. In fact, it was so successful in Florida that AdventHealth has implemented it company-wide across all nine states where we have facilities.

In addition to the recognition program, I review and share positive patient comments gathered through our Press Ganey surveys with both individual providers and hospital leadership. These combined efforts have helped to show our physicians that we see them and appreciate them.

Building Trust and Community

As John Donne so eloquently wrote, “no man is an island,” and this is especially true in health care. Growth, innovation, transformation and restoration occur through relationships, and trust builds the foundation of strong relationships and effective communication. Furthermore, high-trust relationships help mitigate some effects of burnout by up to 40%!

Helping physicians improve their relationships with a more intentional focus on trust is an area I am especially passionate about. In fact, I recently co-authored and published The Trust Transformation with Roy Reid. It is based on an evidence-based training program we developed at AdventHealth during the challenging times of the COVID-19 pandemic. Our work focuses on cultivating four attributes of transformational trust:

• Be trustworthy.
• Be authentic.
• Be dependable.
• Be influential.

We continue to work with our physicians to share insights and exercises that will help build, nurture, repair and restore trust in both their personal and professional relationships. The Trust Transformation framework has already helped achieve the following reported outcomes among participants:

• A more optimistic outlook and positive expectations for successful outcomes
• Less fear of confronting situations and bringing important issues to light
• Greater self-confidence in both decision-making and dealing with change

The overarching goal through of this work is not only to strengthen individual physician levels of well-being but also to build a more supportive and stronger physician community.

Promoting Physician Well-being

At AdventHealth, we have also invested in a variety of programs designed to support the mental, emotional and spiritual wellness of our physicians. Our Center for Physician Wellbeing offers various types of virtual and in-person counseling to meet the needs of physicians, advanced practice providers and their family members. This includes individual counseling, marital or couples counseling, family counseling and group therapy designed to help participants learn interventions and strategies to reduce symptoms, improve functioning and develop coping skills. Additional services include coaching and workshops where physicians can give and receive support from fellow health care providers.

We recognize that physicians are often reluctant to seek formal counseling services out of privacy concerns or fear of judgement by colleagues. As a result, we are working to not only destigmatize seeking mental health support, but also ensure physicians’ privacy and make it easy for them and their families to access the services they need to feel whole and thrive in both their personal and professional lives.

Easing Physician Workload

Since bureaucratic tasks like charting and paperwork are one of the leading contributors to burnout, AdventHealth has also been exploring ways to introduce artificial intelligence (AI) technology to make daily clinical operations and functions more efficient while also providing physicians more focused face time with their patients.

Under the leadership of AdventHealth Chief Medical Informatics Officer Andrew Svetly, MD, we have been gradually implementing the Nuance DAX Copilot Software system this year. An AI-powered scribe tool with ambient listening, DAX allows a physician to focus solely on talking to their patient while it transcribes the relevant information for the patient’s record and documentation in a confidential, HIPAA-compliant manner. After the patient visit, the doctor simply reviews, adjusts as needed and signs off on the visit. This has been a major game-changer for our physicians, helping to increase their satisfaction while also improving clinical efficiency.

Committing to Long-term Improvement

While AdventHealth is certainly making progress in our battle against physician burnout, we know our work is far from over. Our own AdventHealth Research Institute recently launched a research study to evaluate an evidence-based intervention designed to address physician burnout. Additionally, in 2025, we are exploring a new companywide physician leadership program along with a customized physician burnout assessment.

With the support of our Chief Clinical Officer Michael Cacciatore, MD, we want to continue to listen, learn and leverage best practices that will arm our current and future physicians with the tools they need to thrive. We also want to empower them to feel like they have a voice and encourage the sharing of ideas and feedback.

As an organization, we believe in loving each other well, healing wounds when we can, helping each other grow toward our goals and aspirations, and accompanying one another along the journey so we can live our lives in community and service. This is more than a professional responsibility for me, it is a personal calling – one I remain steadfastly committed to nurturing and growing.