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According to a new Mayo Clinic report, America’s doctors—especially those in primary care and emergency medicine—are experiencing increased levels of burnout. From lower-quality patient care to physician shortages, the ramifications of physician burnout have been fairly well-documented. But as Janice Lloyd of USA Today reports, we’re entering an era in which this upward trend could be particularly problematic:

While the medical profession prepares for treating millions of patients who will be newly insured under the health care law, the Mayo Clinic (Rochester, Minn.) reports nearly 1 in 2 (45.8%) of the nation’s doctors already suffer a symptom of burnout.

‘The rates are higher than expected,” says lead author and physician Tait Shanafelt. “We expected maybe 1 out of 3. Before health care reform takes hold, it’s a concern that those docs are already operating at the margins.’

The experts Lloyd interviews position interprofessional, team-based care as one potential approach to reducing burnout. We explored that highly promising approach to primary care delivery on this blog last week. Today, though, we’ll spotlight an overarching philosophical approach that our president, Lachlan Forrow, has promoted at a series of Pri-Med conferences across the country: preventing burnout through “good work” that reunites medicine, healing, and social service and reinforces the reasons physicians entered medicine in the first place.

Nearly twenty years ago, three psychologists named Mihaly Csikszentmihalyi, William Damon, and Howard Gardner launched what would become the GoodWork Project: a pioneering effort to “identify individuals and institutions that exemplify good work … and to determine how best to increase the incidence of good work in our society.”

They conducted thousands of interviews and studied hundreds of organizations that seek to make the world a better place (including us). Their broad conclusion? If you want to try to understand what good work is, think in terms of a three-way pun on the word ‘good.’ First, work is good in the sense that it’s skilled. Second, work is good in the sense that those skills are used for morally good purposes. Third, work is good in the sense that it feels good to do.

“The three dimensions of good work are highly synergistic,” Forrow says. “A professional who develops good skills is able to accomplish morally good things, derive from that a high sense of moral satisfaction and pride in his or her work, and is then energized to improve his or her skills even further. Then, when our skills are even stronger, we’re looking for even tougher challenges, we’re able to accomplish even more morally valuable things, and we’re even more satisfied. It’s a wonderful, positive feedback loop. That’s when we love being a doctor or a nurse.”

“But the opposite, negative cycle happens as well,” Forrow says. “If our skills are not good, and we’re not accomplishing something that’s morally valuable, that’s not satisfying at all. We don’t have a lot of energy for our work. We drag our feet. We’re not looking forward to coming in. And it’s not just that we don’t like our work as much, it’s not just that our skills are not improving—it’s that our patients are not going to be getting good care. Barriers to good work, therefore, whether they’re individual or systemic, don’t just impact us individually—they impact those we serve.”

Here at ASF, we’re working to equip emerging health professionals with the skills and support to overcome those barriers (or boulders), break that negative cycle, avoid burnout, and consistently carry out “good work” throughout their careers. Our U.S. Schweitzer Fellows Program prepares graduate students to lead lives in which their personal and professional passions are aligned, the skills they need to impact community health are developed but always evolving, and they have a support network of mentors and other Fellowship alumni from whom to draw inspiration when they’re feeling beaten down.

It’s clear that broader opportunities to promote the alignment of skills, passion, and purpose in medicine—as well as tactical and systemic changes—are needed in order to fully address physician burnout. But the good work model offers real insight into making medicine, as Forrow says, “a profession that is joyful to work within, and is of the greatest possible benefit to the patients, populations, and communities that need us.”

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