BAD NEWS: Did the WHO Just Classify Physician Burnout as a Disease?

Posted by Dike Drummond MD

physician-burnout-as-a-diseaseThe World Health Organization may have just classified burnout as a disease. I am pretty sure that would be a Very Bad Thing for over-stressed physicians!

Headlines today on the recently concluded WHO meeting in Geneva, are blaring news that burnout has been reclassified as a disease. Here is my input on that potential development.
[this story has been updated, see below]

Let me say right up front that burnout is a NORMAL RESPONSE to overwhelming stress in any person who takes on the role of a helper. For physicians, that role is the core of our professional activities, encapsulated perfectly in the mantra, "The Patient Comes First". 

An official disease designation is a Big Deal ... and Not in a Good Way, IMHO

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Burnout is much more often a diagnosis that the WORKPLACE is SICK ... NOT THE DOCTOR! This potential disease designation would drop all burned out physicians into the gaping maw of the mental health industry -- rather than continuing current trends focused on making workplace changes to lower stress.

Here is my fear

If physician burnout is now a disease, I predict many leaders will become much more comfortable with Blaming the Victim ... and then NOT Changing the Work Site Stresses that are the Main Cause!

In our work with thousands of doctors on four continents, in all specialties and career phases, we KNOW FOR A FACT that recovery from physician burnout is a Balancing Act. Recovery ALWAYS involves small changes in the doctor's awareness and reactions to stress AND additional changes in the workplace to lower the stress of getting your job done.

You cannot address physician burnout without addressing the workplace stresses that are the cause. And when you are successful in lowering workplace stress, the physician will recover. 

Burnout As A Disease Questions:

Will the healthcare industry now be more likely to blame the doctor as evidenced by:

  • Taking them offline on disability leave
  • Putting them on medication
  • Forcing them into psychotherapy and ignoring coaching as an alternative
  • Focusing on the doctor and not the workplace conditions that created their burnout

These are now Even More Interesting Times


It will be fascinating to see how the healthcare industry responds to this call-it-a-disease development -- in several areas:

  • What will Senior Leadership Teams of the Large Physician Employers do?
  • What will the Mental Health/Psychiatry Industry do?
  • What will the Pharma Industry do (SOMA anyone?)



Here are details and quotes from online reports of this WHO meeting and its conclusions:

"The World Health Organization (WHO) for the first time put burnout on its International Classification of Diseases (ICD) list, which is used globally as a benchmark for health diagnosis.

The international body reached the decision to categorize burnout as a medical condition during its recently concluded World Health Assembly in Geneva.

Following recommendations from health experts around the world, the updated ICD list was drafted in 2018 and was approved on Saturday May 25th, 2019"

Their definition of burnout is as follows:

"a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed."

They describe the official WHO burnout symptoms as 

"1) feelings of energy depletion or exhaustion;
2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job
3) reduced professional efficacy."

The official announcement also points out:

"Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."

They also suggest:

"Doctors should first rule out adjustment disorder as well as anxiety and mood disorders."


Later reporting from NPR and others revealed that the change in the description of burnout did not rise to the level of reclassification as a disease:

Seems the press' initial headlines on this one were 60% hype and the change in description is relatively minor - thank heavens. I still have faith that a disease designation for burnout would not be good for the burned out.

From the NPR Post:

"The new definition calls it a "syndrome" and specifically ties burnout to "chronic workplace stress that has not been successfully managed."

Despite earlier reports to the contrary, WHO does not classify the problem as a medical condition. It calls burnout an "occupational phenomenon" and includes it in a chapter on "factors influencing health status or contact with health services."

According to WHO, burnout is characterized by "feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."

Burnout was also included in the previous version of WHO's disease handbook, the ICD-10, in the same category as it now appears. But it was defined simply as a "state of vital exhaustion," Tarik Jasarevic, a spokesperson for WHO, wrote in an email."


What do you think a disease designation for Burnout would mean to struggling doctors going forward?