The Crux Of Burnout


The Crux Of Burnout


Leonard Zwelling

Matthew Matasar, MD is a medical oncologist at the Rutgers Cancer Institute and an associate editor of ASH Clinical News. He wrote an editorial in the March 2023 issue entitled “Battling Burnout.”

Even though there is a mounting pile of burnout literature, particularly as it applies to health care professionals, this short one-pager makes some great points.

First, Dr. Matasar defines what he’s talking about.

“Burnout is really a syndrome with three pieces: physical or emotional exhaustion, cynicism and disengagement, and a sense of a lack of meaningful accomplishment.” As he asks: ”Any of that resonate with you or what you are seeing around you?”

He goes on to note, “we’re burned out because of all the external factors that drive burnout. Overwork, increased administrative burden, exacerbated by the thrall of the electronic medical record. A diminution of autonomy over our daily lives.”

Dr. Matasar points toward a solution: “responsibility falls first and foremost on those with leadership roles, from leading a clinic team to leading a health system.” The leaders need to acknowledge the problem, call it by its name, and fix it.

Finally, he points to putting new emphasis on the sustainability of the health care system, not just on its productivity. That starts with the sustainability of the individuals in the system, aka doctors, nurses, and all patient care professionals.

Is that what is occurring where you are?

I recently spoke with a friend in private practice who has decided to hang up his spikes. He’s in great health and probably could go on, but as I told him, “you didn’t go to medical school to be a clerk.” He agreed. He’s done at the end of April and he is not alone. Doctors are moving on. As Dr. Matasar notes, “Look at the number of …docs leaving the practice of medicine for jobs in pharma, consulting, or the like.”

The truth is there for all to see. Medicine is in trouble and it starts with the manner in which institutions treat their doctors and health care staff. Furthermore, no program of wellness, despite the best of yoga instructors, is going to fix this. Fewer patients per clinic session to allow doctors to actually interact with their patients, fewer administrative tasks foisted on faculty (like endless HR training sessions), and a careful, thoughtful examination of whether or not the electronic medical record has improved patient care and doctors’ lives not just billing are topmost on the to-do list of all presidents of health care institutions.

If the leadership of academic centers wants the faculty to be around for the next few years, an emergent examination of the root causes of burnout must start immediately and don’t bring in a consultant to do it. The leadership of the center must do it because it is the perception of the rank-and-file faculty that the leadership does not feel its pain that begins the cycle that leads to burnout.

Check out this brief editorial. A lot is said in few words.

Len’s new novel, “Conflict of Interest: Money Drives Medicine and People Die” is available at

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