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Full-Text Articles in Medicine and Health Sciences

Burnout Triggers In The Novice Registered Nurse, Sharon K. Nguyen Jan 2024

Burnout Triggers In The Novice Registered Nurse, Sharon K. Nguyen

Doctoral Dissertations and Projects

Nurse burnout has been strongly associated with decreased patient satisfaction and reduced retention rates in the novice registered nurse. This phenomenon is exacerbating the already rising global nursing shortage. A strong correlation is established between novice registered nurses who endure repeated or multiple triggers, such as unsafe staffing ratios, inadequate preceptorship, and ineffective leadership to those who succumb to burnout. Burnout is a significant problem in the United States, impacting how healthcare is perceived by the public. In 2019 there were more than six million nurses, making up the largest segment of the healthcare population and directly affecting the safety …


Mindfulness Based Interventions To Reduce Burnout And Ptsd Symptoms In Critical Care Nursing, Kelly A. Pellegrino, Libby M. Colley, Carly R. Fazendin, Emma R. Parrotta, Mollie Johnson Jan 2024

Mindfulness Based Interventions To Reduce Burnout And Ptsd Symptoms In Critical Care Nursing, Kelly A. Pellegrino, Libby M. Colley, Carly R. Fazendin, Emma R. Parrotta, Mollie Johnson

Non-Thesis Student Work

Within the medical field, nursing is a career that can be very taxing on both one’s physical and mental wellbeing, especially in regards to critical care. The life-threatening situations and strenuous work that critical care nurses are met with everyday make them especially susceptible to struggling with burnout, compassion fatigue, and PTSD-like symptoms. This not only puts their own safety at risk, but the safety of their patients as well. This raises the question: In critical care nursing, does the utilization of mindfulness based interventions, compared to no intervention, aid in the reduction of nursing burnout and PTSD symptoms? In …


Burnout For General Surgeons, Luke Edwards, Lindsay Mckelvey Jan 2024

Burnout For General Surgeons, Luke Edwards, Lindsay Mckelvey

Theses, Dissertations and Capstones

Introduction: In the healthcare sector, burnout among surgeons has emerged as a critical issue, impacting both the well-being of medical professionals and the quality outcomes of patient care. Research has consistently shown that long hours, high workloads, demanding results, and mental fatigue make physicians more vulnerable to experiencing burnout than others. Studies have revealed alarming statistical rates, with a significant percentage of surgeons reporting physical exhaustion and mental health repercussions. This trend is further enhanced by the demanding nature of the medical environment, where work-related stress and burnout have become common concerns.

Purpose of the Study: The negative effects of …


An Integrative Somatic Art Therapy Approach: Emdr & Body-Based Practices For Traumatic Stress, Alexis Sorbara Jan 2024

An Integrative Somatic Art Therapy Approach: Emdr & Body-Based Practices For Traumatic Stress, Alexis Sorbara

Art Therapy | Doctoral Dissertations

This research project used a mixed method, within subject design to explore how trauma-informed somatic art therapy and Eye Movement Desensitization Reprocessing (EMDR) therapy impacts symptoms of trauma and burnout. There is limited qualitative research on integrating art therapy with EMDR in a group setting. Art therapy can act as a container, or safe holding environment (Winnicott, 1971) for the limitations of EMDR therapy. This research addressed the implications of integrating art therapy and EMDR therapy as a trauma treatment for healthcare professionals. This research study followed the eight phases of EMDR treatment, using a combination of resourcing, a series …


Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson Jan 2024

Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson

Theses & Dissertations

Background:

Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.

Purpose:

The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity …


Mentorships For New Graduate Nurses, Taylor Leigh Bailey Jan 2024

Mentorships For New Graduate Nurses, Taylor Leigh Bailey

Doctor of Nursing Practice Projects

New graduate registered nurses (NGRNs) represent a crucial segment of the nursing workforce, embodying the future of the profession. Thus, it is imperative that we utilize our resources, knowledge, and experiences to continuously strengthen and grow this generation of nurses. Mentorship is one key method that can be used to support NGRNs. This DNP project aimed to evaluate the effectiveness of mentorship for NGRNs within their first year of nursing practice and was implemented within an existing residency program at a Level I trauma facility. Experienced nurse volunteers received mentor education, and 40 NGRNs were individually paired with these volunteer …


Infusing Machine Learning And Computational Linguistics Into Clinical Notes, Funke V. Alabi, Onyeka Omose, Omotomilola Jegede Jan 2024

Infusing Machine Learning And Computational Linguistics Into Clinical Notes, Funke V. Alabi, Onyeka Omose, Omotomilola Jegede

Mathematics & Statistics Faculty Publications

Entering free-form text notes into Electronic Health Records (EHR) systems takes a lot of time from clinicians. A large portion of this paper work is viewed as a burden, which cuts into the amount of time doctors spend with patients and increases the risk of burnout. We will see how machine learning and computational linguistics can be infused in the processing of taking clinical notes. We are presenting a new language modeling task that predicts the content of notes conditioned on historical data from a patient's medical record, such as patient demographics, lab results, medications, and previous notes, with the …


Best Practice Recommendations For Coaching Gymnasts To Avoid Burnout And Reframe Performance Anxiety, Clare A. Mccall Jan 2024

Best Practice Recommendations For Coaching Gymnasts To Avoid Burnout And Reframe Performance Anxiety, Clare A. Mccall

Theses: Doctorates and Masters

Gymnastics is deemed a psychologically demanding sport, with associated risk factors of burnout and performance anxiety. To date, relatively little research has explored the specific goal and perfectionistic processes of gymnasts, despite these risks. This body of work identified the specific goal-related constructs and perfectionistic orientation of young athletes and examined how these associated with burnout and performance anxiety. It comprised of two studies with a mixed methods design. The first study aimed to systematically review literature investigating how goal-related constructs and perfectionism associate with burnout and performance anxiety in young athletes. This review focused on summer and winter Olympic …


A Validation Study Of The Occupational Depression Inventory In Poland And Ukraine, Krystyna Golonka, Karine O. Malysheva, Dominika Fortuna, Bożena Gulla, Serhii Lytvyn, Leon T. De Beer, Irvin Sam Schonfeld, Renzo Bianchi Jan 2024

A Validation Study Of The Occupational Depression Inventory In Poland And Ukraine, Krystyna Golonka, Karine O. Malysheva, Dominika Fortuna, Bożena Gulla, Serhii Lytvyn, Leon T. De Beer, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

This study examined the psychometric and structural properties of the Polish and Ukrainian versions of the Occupational Depression Inventory (ODI). We relied on two samples of Polish employees (NSample1 = 526, 47% female; NSample2 = 164, 64% female) and one sample of Ukrainian employees (NSample3 = 372, 73% female). In all samples, the ODI exhibited essential unidimensionality and high total-score reliability (e.g., McDonald’s omegas > 0.90). The homogeneity of the scale was strong (e.g., 0.59 ≤ scale-level Hs ≤ 0.68). The ODI’s total scores thus accurately ranked individuals on a latent occupational depression continuum. We found evidence of complete measurement invariance …


Examining The Impact And Implementation Of Protected Administrative Time On Provider Well-Being And Service Delivery Indicators Within A Multi-State Network Of Primary Care Medical Practices, Lauren Junge-Maughan Jan 2024

Examining The Impact And Implementation Of Protected Administrative Time On Provider Well-Being And Service Delivery Indicators Within A Multi-State Network Of Primary Care Medical Practices, Lauren Junge-Maughan

Electronic Theses and Dissertations

Background:

Primary care is integral to achieving high-quality health outcomes for the population and decreasing healthcare costs. However, primary care clinicians suffer from conflicting demands, impossible expectations, and burdensome processes. With burnout and mental fatigue increasing, leadership must find innovative programs to implement in their organizations. This mixed-methods research study assessed the impact of one such intervention, protected administrative time (PRAT), on improving provider well-being.

Purpose:

The first aim was to evaluate the association of PRAT on the service delivery indicators of primary care clinicians’ productivity, average appointments per day, patient satisfaction (likelihood to recommend), clinician time to the next …


Using Mindfulness In Nursing Burnout. An Integrative Review., April Day Branham Dec 2023

Using Mindfulness In Nursing Burnout. An Integrative Review., April Day Branham

Doctoral Dissertations and Projects

The purpose of this integrative review is to evaluate if mindfulness is effective in decreasing nursing burnout. Nursing burnout has negatively affected the nursing profession for many years, and since the COVID-19 pandemic, it appears to be worse. Mindfulness is a practice that has been used for decades, however, it is gaining more attention in the nursing realm. Mindfulness consists of being present in a moment without judgment. It can consist of individual exercises that are completed using an instructor in person, in an application on a smartphone or computer, or yoga-based mindful activities. A preliminary literature review was completed …


Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis Dec 2023

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …


A Quality Improvement Project To Increase Awareness And Utilization Of Employee Assistance Program Services Among Healthcare Providers, Scarlet Gould Dec 2023

A Quality Improvement Project To Increase Awareness And Utilization Of Employee Assistance Program Services Among Healthcare Providers, Scarlet Gould

Doctoral Projects

Mental health distress among healthcare providers (HCP) is a common problem, yet Employee Assistance Programs (EAP) are consistently underutilized. Unmanaged workplace stress can lead to problems such as provider burnout and increased rates of turnover, which can result in decreased access to patient care. The purpose of this project was to increase awareness and utilization of EAP services by using the Plan-Do-Study-Act cycle (PDSA) for quality improvement. Nurse Practitioners at a community-based hospital were provided with a PowerPoint® presentation via email that contained information regarding the facility’s employee assistance program, mental health wellness education, as well as ways to …


Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement Dec 2023

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …


Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner Dec 2023

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …


Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner Dec 2023

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …


Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker Dec 2023

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …


Prevention And Treatment Of Nursing Burnout Through Policy, Hannah Khiev, Marina Gerard, Anastasiya Likhovodova, Hailie Lopez-Santiago Dec 2023

Prevention And Treatment Of Nursing Burnout Through Policy, Hannah Khiev, Marina Gerard, Anastasiya Likhovodova, Hailie Lopez-Santiago

NURS 320: Evidence-Based Nursing Student Presentations

Research poster created as part of Nursing 320 class. The poster looks "To research the causes of burnout, to then construct policies to combat the onset and treat those in need."


Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block Nov 2023

Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block

MSN Capstone Projects

Most people do not go to work and fear being assaulted or harassed daily. However, for emergency nurses in this county that is exactly what it has come to. Up to 96% of emergency department nurses state they have been verbally abused. This entails name calling, verbal threats, being shouted at and being sworn at. Anywhere from 25% to 60% of these nurses have had to face physical assaults while on the job. (Al-Aadi, 2020; Copeland & Henry, 2017; Grinberg, 2022; Li et al., 2019; McDermid et al., 2019). Physical assaults can include being spit on, slapped, punched, kicked, choked, …


Exploring Experiences Of Alarm Response And Alarm Fatigue Among Nurses Working In The Icu Of A Tertiary Care Hospital In Karachi, Pakistan: A Qualitative Study, Shenila Shamsuddin Nov 2023

Exploring Experiences Of Alarm Response And Alarm Fatigue Among Nurses Working In The Icu Of A Tertiary Care Hospital In Karachi, Pakistan: A Qualitative Study, Shenila Shamsuddin

Theses & Dissertations

Background: Alarm fatigue is a significant concern within the healthcare sector, marked by the excessive exposure of healthcare practitioners to clinical alarms. This prolonged exposure can result in desensitization and delay nurse’s responsiveness to vital warnings. The occurrence of inaccurate alarms intensifies desensitization, undermining confidence in alarm systems and potentially leading nurses to ignore alarms. Alarm fatigue is a prevalent issue of worldwide significance, which calls for more investigation to effectively tackle these issues and enhance understanding of alarm systems to get the best possible treatment results. However, there is a lack of study undertaken in Pakistan about the investigation …


Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos Nov 2023

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …


Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Schonfeld Nov 2023

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. Accordingly, three symptoms define the entity: (i) feelings of energy depletion or exhaustion; (ii) increased mental distance from one’s job or feelings of negativism or cynicism towards one’s job; and (iii) a sense of ineffectiveness and lack of accomplishment. We call into question the definition of burnout embodied in the Maslach Burnout Inventory and incorporated into the ICD-11. We draw stakeholders’ attention to the fact that burnout’s symptoms and etiology …


Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Sam Schonfeld Nov 2023

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. According to the ICD-11, three symptoms define the entity: feelings of exhaustion, increased mental distance from one’s job, and a sense of ineffectiveness at work, all of which correspond to the structure of the Maslach Burnout Inventory. The ICD-11 includes burnout among the factors that influence health status. This paper calls into question that conceptualization based on a number of lines of evidence. The evidence includes the following: burnout was …


Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen Oct 2023

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …


How Important Are Regular Breaks For Bedside Nursing Staff?, Gabriel Wohl Oct 2023

How Important Are Regular Breaks For Bedside Nursing Staff?, Gabriel Wohl

Nurse Residency

Background: A career in nursing can be a challenging one and a rewarding one. Nurses work directly with patients in need, in a way that their efforts have an immediate and tangible impact. Due to the nature of the work itself, nursing is also a physically, mentally, and emotionally demanding career that often leads to exhaustion, burnout, and in many cases, a departure from the profession altogether. It is well known that nurses work long hours and often receive little to no breaks. Is this lack of proper breaks a chief accessory to the overall dissatisfaction and burnout that nurses …


Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan Carlos Lopez Alvarenga, Maya Guevara Sep 2023

Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan Carlos Lopez Alvarenga, Maya Guevara

Research Symposium

Background: Adverse childhood experiences (ACEs) represent types of childhood trauma that are associated with long-term negative effects on health and wellbeing. An elevated number of ACEs can lead to depression, suicidality, alcoholism, and substance use. Factors that can protect a person from increased health risks include resilience, which is broadly defined as the ability to bounce back from adversity. Few studies have analyzed the exposure of ACEs in medical students, however, there is extensive literature on how low levels of resilience are linked to higher rates of depression, fatigue, and burnout among medical students. Little is known about the …


Life Balance, Stress, And Occupational Burnout In Occupational Therapy Assistant Students: An Exploratory Study, Olivia W. Hammond, Mba, Otr/L, Cht Sep 2023

Life Balance, Stress, And Occupational Burnout In Occupational Therapy Assistant Students: An Exploratory Study, Olivia W. Hammond, Mba, Otr/L, Cht

Post-Professional Occupational Therapy Doctorate Culminating Presentations

The United States healthcare worker burnout crisis demands immediate attention. College is critical for preparing occupational therapy assistant students (OTA) to address life balance, stress, and burnout as they transition into the workforce. However, little is known about these factors in this population. In this doctoral presentation, the primary author presents her doctoral project, which explored OTA students' life balance and its association with their perceived stress and occupational burnout across employment status, residential status, years of study, and age. A cross-sectional Qualtrics e-survey was distributed to OTA students ages 18 and older, including a demographic survey, Life Balance Inventory …


Burnout And Its Impact On Nurses And Doctors, Zahra Tharani, Abeer Musaddique, Syeda Humera Qutb Sep 2023

Burnout And Its Impact On Nurses And Doctors, Zahra Tharani, Abeer Musaddique, Syeda Humera Qutb

School of Nursing & Midwifery

No abstract provided.


Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster Sep 2023

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …


Burnout As Chronic Disease, Benjamin Doolittle Aug 2023

Burnout As Chronic Disease, Benjamin Doolittle

Journal of Wellness

Burnout is endemic. The prevalence of burnout (~50%) among healthcare providers has been stable over the past 20 years. Acknowledging variability from year to year, burnout is pervasive, with no signs of abating. Despite increased awareness of mental health issues, the rise of Chief Wellness Officers, and the expansion of Employee Assistance Programs, there has not been much improvement. We are even burned out from burnout. Survey responses are low and often do not result in action. Longitudinal intervention trials are often small and of short duration. We need a new paradigm to manage physician burnout. A chronic care management …