---
title: Can We Use the Pareto Principle to Stop Physician Burnout?
description: Does the Pareto principle apply to Physician Burnout - the 80-20 rule? This study shows how and why.
image: https://www.thehappymd.com/hubfs/images/2022%20Images/BLOG%20IMAGES/BurnoutVSFavorite-Pareto.jpg
---

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## **The Creative Destruction of Physician Burnout **

[![prevent doctor burnout matrix](https://hubspot-no-cache-na2-prod.s3.amazonaws.com/cta/default/263814/da1e787d-095f-4485-9d4d-9a9bc4195d86.png)](https://hubspot-cta-redirect-na2-prod.s3.amazonaws.com/cta/redirect/263814/da1e787d-095f-4485-9d4d-9a9bc4195d86)

# [Can We Use the Pareto Principle to Stop Physician Burnout?](https://www.thehappymd.com/blog/the-pareto-formula-to-stop-physician-burnout)

Posted by [Dike Drummond MD](https://www.thehappymd.com/blog/author/dike-drummond-md)

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## You know the Pareto Principle either by that name or by its more common expression: The 80:20 Rule

Turns out that the Pareto Principle applies to Physician Burnout. We even have a study to prove the point. 

Let me break down the research and potentially show you how to put Pareto to work for your own wellbeing. 

~~~~~~~~~~~~~~~~~~~~~~  
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~~~~~~~~~~~~~~~~~~~~~~

> The Pareto Principle:   
> Also known as the 80/20 rule, or the ‘law of the vital few and trivial many,’ the [Pareto Principle](https://thedecisionlab.com/reference-guide/economics/the-pareto-principle) names the general observation that 80% of effects or outcomes come from 20% of causes or inputs.
> 
> If you look around at your own general experience of life, you will often find 80% of any result is produced by 20% of the participants in generating the result.  
> - 80% of sales come from 20% of buyers  
> - 80% of the Halloween candy comes from 20% of the houses in the neighborhood  
> Once you start looking for it, you will find the Pareto principle *everywhere*.

What if the Pareto Principle applies to Physician Burnout too?

## Here's the Research

> Career Fit and Burnout Among Academic Faculty  
> Tait D. Shanafelt, MD et al   
> Arch Intern Med. 2009;169(10):990-995.   
> Download a full PDF Copy [at This Link](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415000)
> 
> 
> 
> In this study of 465 academic physicians, the research team divided their academic practice into four broad categories of professional activity:

> - Research
> - Education
> - Patient Care
> - Administration

## Then they asked four very important questions

> Q1:  "Which of these four is YOUR FAVORITE activity?"
> 
> Here is the breakdown 
> 
> - Research = 19%
> - Education = 9%
> - Patient Care = 68%
> - Administration = 3%
> 
> Q2: "How much of your time at work do you get to spend in your favorite activity, in percent?"
> 
> 
> 
> Q3: "What is your current level of burnout?" Measured using the Maslach Burnout Inventory
> 
>  
> 
> Put all of this together and you get *the Payoff Question*
> 
> Q4: "How much time does an academic physician need to spend in their favorite part of their practice to minimize burnout?" Is there a dose response and where is the break point?

~~~~~~~~~~~~~~~~~~~~  
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[The Quadruple Aim Physician Leadership Retreat](https://support.thehappymd.com/quadruple-aim-physician-leadership-retreat-2022)  
~~~~~~~~~~~~~~~~~~~~

## The Short Answer is 20%

We have seen that number before. Is this an expression of the Pareto Principle too?  
Here's the graph of their results:

## ![BurnoutVSFavorite-Pareto](https://www.thehappymd.com/hs-fs/hubfs/images/2022%20Images/BLOG%20IMAGES/BurnoutVSFavorite-Pareto.jpg?width=400&name=BurnoutVSFavorite-Pareto.jpg) Let's break it down:

> - Overall, 156 faculty members (34.0%) were burned out.  
>   Note the study date is 2009. This is before the real bite of EMR and InBox overwhelm and COVID. These burnout rates are much higher today.  
> - The most burned out were those at 5 - 10%.  
>   They get just an occasional taste of their favorite bit ... just enough to remind them this is why they chose to be an academic in the first place - and no more. Ouch!
> - Burnout bottomed out at 20% and *did not fall further with more time spent in the favorite activity. **As if the dose response curve ended at the Pareto level of 20%.*
> 
> Here are the specific findings:
> 
> - Physicians who spent at least 20% of their time in the aspect of work that was most meaningful to them had a rate of burnout *roughly half that of those* who spent less than 20% effort in the activity that was most meaningful to them.
> - The association between time spent in the most meaningful activity and burnout was strong and was the largest predictor of burnout on multivariate analysis after other factors were controlled for.

## Is this finding an expression of the Pareto Principle?

Let's go deeper:

> NOTICE: The relationship is drawn between time spent in your favorite activity and burnout. 
> 
> This study was not built to measure positive outcomes such as happiness, satisfaction, fulfillment or engagement. It's only measure is the presence or absence of burnout. 
> 
> I suppose Pareto might say this:
> 
> 20% of your practice activities have the ability to minimize burnout in the remaining 80% of your practice - if they are aligned with your favorite aspect of your job.
> 
> And this question is screaming in my head:
> 
> What if they had measured happiness, satisfaction, fulfillment and engagement instead?
> 
> Would those factors have topped out at the *20% of what I love about my practice* ratio?

## This point is very important because this study is often mis-quoted by senior leaders.

Here is how I have  heard this study interpreted by senior leaders:

> "Research shows you don't have to give doctors any more than 20% of their time on what they like about their job." 

**Now THAT is an evil twist isn't it?**

And I believe this study does show us a way forward to minimizing burnout. I do not recommend you relax at the 20% threshold. How about you shoot for 80% and see how you feel then?

## QUESTIONS FOR YOU:

> - What is your favorite part of your current job/practice?
> - How much time - in percent - do you get to spend in that activity? If you don't know, you may want to log your next couple of weeks at work to find out?.
> - What could you do to devote just a little more time and energy to what you love about your practice in the week ahead?
> - *What is your first action step*?
> - When will you take it? 

 ===================

## PLEASE LEAVE A COMMENT:

 What did you learn in this article?  
What new action will you now take?

 

 Tags: [stop physician burnout](https://www.thehappymd.com/blog/topic/stop-physician-burnout)

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