Is a Burned Out Doctor Better for Patients?

Posted by Dike Drummond MD

Here is my nominee for the all-time Worst Physician Burnout Article Headline

An article last week in Medpage Today by Kristina Fiore used this headline:

Is a Burned Out Doctor Better for Patients?

My concern is this headline and study provide some C-Suite Healthcare Executives an excuse to abandon their reluctant support of Physician Wellness and the Quadruple Aim.

I predict this provides more ruthless healthcare leaders with a perfect one-liner to defend abusive staffing levels and toxic workloads in the defense of the organization's bottom line. I sincerely hope I am wrong, but given current trends, I doubt that is the case.

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In the article, Ms. Fiore reported on a study by Lawrence Casalino, MD, et al, from Weill Cornell Medical College in New York City that compared

  • Burnout and callousness surveys of 1064 family physicians
  • And those physician's Medicare claims on costs and "care-sensitive admissions"

From the article:

"Casalino and colleagues selected four outcomes from Medicare claims data -- ambulatory care-sensitive admissions, ambulatory care-sensitive emergency department (ED) visits, readmissions, and costs -- and paired them with burnout survey results. The survey had a 100% response rate because it was administered by the American Board of Family Medicine and was tied to recertification.


Their Null Hypothesis?

A connection between burnout/callousness and more sensitive admissions and higher expenses.

Pretty standard thinking, right? But hang on for a second before you proceed; is that your null  hypothesis given this setup?? How might the actual results surprise you with a different finding?

What They Found?

The hint of a Donut Hole - a Sweet Spot

There was a group of physicians with MILD burnout/callousness with the best performance numbers.

And the world's worst burnout prevention article headline was born.


Let's be clear ...

One who is rested, ready to go, eager to continue their Lightworker's Quest, engaged in their practice, bringing their "A" game, happy to be with you today. 


  • Please keep that in mind as I give you some more details from the study and its authors.
  • You may also want to do a little self check on how that description above aligns with how you feel at work this week.


From the article:

"In adjusted analyses, patients of doctors with any level of burnout had lower rates of sensitive admissions and readmissions than those whose doctors reported never being burned out. However, not all of these results were statistically significant.

While the researchers acknowledged that the finding "might be spurious," they noted it could also mean that "physicians who report at least some burnout are highly conscientious and give extra effort to providing good care to their patients."

"This effort, and their concern about their patients, may be stressful and produce a feeling of burnout, particularly when physicians experience time pressure or other obstacles to providing care," they wrote. "Possibly some physicians who report burnout are sufficiently resilient that although they sometimes feel burned out, they are not overwhelmed and nevertheless are able to make the effort to get good results for their patients.""


The results of the study are not completely unexpected ... are they?

I am surprised the researchers were surprised ... they are obviously academics and not physician burnout coaches.

Physicians who care, are nice people
and who feel shame and guilt
for not doing their best,
even in the most inefficient systems and on
the most understaffed work teams

They are more likely to burn out


Provide better patient care



My Greatest Fear and Unfortunate Prediction

This sloppy headline is now a cudgel in the hand of the more profit-driven Healthcare C-Suites across the country ... as if they needed any more justification to not care about the docs and staff.

I can just hear profit-driven CEO's and CFO's spouting lines like,

"We don't want those doctors too fat and happy. You remember that research Jerry, you know, the one that showed we have to keep 'em medium rare for best performance." (chuckles and shaking of heads ensue around the mahogany table on the 12th floor of the Ivory Tower)



  • What do YOU think about this finding? Are you surprised?

  • Are you concerned about leadership use of this finding like I am?



Tags: stop physician burnout