Clinician Resilience and Well-being - National Academy of Medicine

Clinician well-being is essential for safe, high-quality patient care.

However, clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. Among the most telling of statistics, more than 50 percent of U.S. physicians report significant symptoms. Burnout is a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work.

Clinician burnout can have serious, wide-ranging consequences, from reduced job performance and high turnover rates to—in the most extreme cases—medical error and clinician suicide. On the other hand, clinician well-being supports improved patient-clinician relationships, a high-functioning care team, and an engaged and effective workforce. In other words, when we invest in clinician well-being, everyone wins.

Supporting clinician well-being requires sustained attention and action at organizational, state, and national levels, as well as investment in research and information-sharing to advance evidence-based solutions.

Browse or click below to learn more about the Action Collaborative.

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In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-Being and Resilience, a network of more than 60 organizations committed to reversing trends in clinician burnout. The Collaborative has three goals:

Raise the visibility of clinician anxiety, burnout, depression, stress, and suicide
Improve baseline understanding of challenges to clinician well-being
Advance evidence-based, multidisciplinary solutions to improve patient care by caring for the caregiver.

The Action Collaborative is composed of five working groups that will meet over the course of four years to identify evidence-based strategies to improve clinician well-being at both the individual and systems levels. Products and activities of these five working groups include an online knowledge hub, a series of NAM Perspectives discussion papers, and an all-encompassing conceptual model that reflects the domains affecting clinician well-being.

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Action Collaborative Leadership
Victor Dzau, chair
Darrell Kirch, co-chair
Thomas Nasca, co-chair

Action Collaborative Staff

Charlee Alexander, Program Officer
Ivory Clarke, Associate Program Officer
Marc Meisnere, Associate Program Officer
Mariana Zindel, Research Associate
Imani Rickerby, Senior Program Assistant
Kyra Cappelucci, Communications Officer
Sharyl Nass, Board Director

Action Collaborative Working Groups
Please click here to view members of our five working groups.

New NAM Perspectives from the Action Collaborative on Clinician Well-Being

Three new NAM Perspectives have recently been authored by members of the Action Collaborative on Clinician Well-Being and Resilience:

Expressions of Clinician Well-Being

The National Academy of Medicine recently called on artists of all skills and abilities to explore what clinician burnout, clinician well-being, and clinician resilience looks, feels and sounds like to people across the country. 100 pieces of artwork were selected by a panel of reviewers to be displayed in a digital gallery. Explore the digital art gallery >>

Clinician Well-Being Knowledge Hub is Live!

The Action Collaborative on Clinician Well-Being and Resilience is proud to announce the launch of the Clinician Well-Being Knowledge Hub, a comprehensive resource repository for those seeking to promote clinician well-being at their organizations and in their personal lives. Visit the knowledge hub>>

Help us share the knowledge hub by clicking here.

National Call for Commitment Statements – Over 190 Received!

Over 190 organizations have formally committed to promoting clinician well-being and combating burnout. Read the statements >>

The National Academy of Medicine is still looking for additional organizations to commit, with us, to supporting clinician well-being. Consider sharing your organization’s commitment to improving clinician well-being and reducing clinician burnout by submitting a commitment statement and becoming a network organization of the Action Collaborative on Clinician Well-Being and Resilience. To submit a commitment statement, please click here.

Establishing Clinician Well-Being as a National Priority, Meeting 5 | May 28-29, 2019

The Action Collaborative will host a public meeting on May 28-29, 2019 in Chicago, IL. In-person attendance is now at capacity. Please join us via live webcast. Register >>

Establishing Clinician Well-Being as a National Priority, Meeting 4 | October 4-5, 2018

The Action Collaborative hosted a closed working meeting on October 4-5, 2018 in Washington, DC. Event page >>

Establishing Clinician Well-Being as a National Priority, Meeting 3 | May 2, 2018

The third meeting of the Action Collaborative on Clinician Well-Being and Resilience was held in Washington, DC on May 2, 2018. Watch video recordings of the meeting, download presenter slides, and explore additional resources>>

View all events>>

Clinician Well-Being Knowledge Hub

The Clinician Well-Being Knowledge Hub is a comprehensive resource repository for those seeking to promote clinician well-being at their organizations and in their personal lives. The repository contains peer-reviewed research, personal stories, toolkits, presentations, blog posts and other resources that health system administrators and clinicians can use to build a better system that helps clinicians thrive.

Visit the Knowledge Hub

Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care

The US health care system is rapidly changing in an effort to deliver better care, improve health, and lower costs while providing care for an aging population with high rates of chronic disease and co-morbidities. Among the changes affecting clinical practice are new payment and delivery approaches, electronic health records, patient portals, and publicly reported quality metrics—all of which change the landscape of how care is provided, documented, and reimbursed. Navigating these changes are health care professionals (HCPs), whose daily work is critical to the success of health care improvement. Unfortunately, as a result of these changes and resulting added pressures, many HCPs are burned out, a syndrome characterized by a high degree of emotional exhaustion and high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.

Read the discussion paper

Validated Instruments to Assess Work-Related Dimensions of Well-Being

A key organizational strategy to improving clinician well-being is to measure it, develop and implement interventions, and then re-measure it. A variety of dimensions of clinician well-being can be measured including burnout, engagement, and professional satisfaction.

Click below for a summary of established tools to measure work-related dimensions of well-being. Each tool has advantages and disadvantages and some are more appropriate for specific populations or settings.

View the Instruments

A Journey to Construct an All-Encompassing Conceptual Model of Factors Affecting Clinician Well-Being and Resilience

Why are so many clinicians experiencing burnout?

The answer is complex but a new discussion paper from the National Academy of Medicine aims to shed light on the issues contributing to of clinician burnout and well-being.

Taking a holistic view of the external, systemic, and internal factors that impact clinician well-being and burnout, the authors of this discussion paper provide a first look at a comprehensive model that highlights and illustrates the interrelated factors affecting clinician burnout on a daily basis.

Individuals and organizations can use this model to identify methods to increase well-being and decrease burnout for clinicians at any stage of their careers.

Read the discussion paper

Nurse Suicide: Breaking the Silence

Although burnout, depression, and suicide in nurses are beginning to be recognized as a significant threat to our health care system, we cannot report the rate at which nurses die by suicide because this data is not accurately tracked. We also know through first-hand accounts that nurse suicide is rarely discussed and not often addressed institutionally. In our new discussion paper, the authors share their insights and the insights of those who have been personally affected by the loss of a colleague, relative, or friend in an effort to encourage formal tracking of data on nurse suicide, as well as focus attention on this critical issue.

Read the discussion paper

Care-Centered Clinician Documentation in the Digital Environment: Solutions to Alleviate Burnout

Electronic health records are not living up to their full potential.

The authors of our most recent discussion paper attest that electronic health records (EHRs) focus on supporting billing and legal documentation, and do not assist with ongoing patient care. EHRs require data in ways that disrupt clinician workflow, and consume more than half of their workday. This discussion paper analyzes how the medical community can re-engage with EHRs so that they may become flexible and comprehensive enough to serve clinicians, patients, and insurance providers alike.

Read the discussion paper

Expressions of Clinician Well-Being

Expressions of Clinician Well-Being collects insights directly from clinicians, patients, loved ones, and organizations working to prevent burnout and promote well-being. By allowing people to creatively express their experiences with burnout, this gallery captures critical moments in the journey to well-being.

We hope this art will offer an entry point for conversations that can be difficult to have and shed light on the joys and challenges experienced by so many. We hope that the stories captured through this art will allow you to more fully understand why clinician well-being is so essential to the vitality of our health system. Clinician well-being is essential for everyone. It’s time to take care of those who take care of us.

Let’s build a better system to help clinicians thrive.

Explore the digital gallery

Implementing Optimal Team-Based Care to Reduce Clinician Burnout

Teamwork is critical for clinician well-being and better patient care. But how can we better foster team-based care so that patients and clinicians can thrive?

A new discussion paper from the National Academy of Medicine explores optimal team-based care and its role in reducing clinician burnout and achieving better patient outcomes. Authors describe key features of successful health care teams, review existing evidence that links high-functioning teams to increased well-being, and recommend strategies to overcome barriers to optimal team-based care.

Read the discussion paper

Burnout and Job and Career Satisfaction in the Physician Assistant Profession: A Review of the Literature

While much is known about the prevalence of burnout among physicians and nurses, little is known about burnout in the physician assistant (PA) profession. Approximately 50 percent of physicians and 35 percent of nurses report symptoms of burnout. Burnout is linked to increased health care costs, medical errors, and poor patient outcomes.

The PA profession emerged in the 1960s in response to workforce shortages in rural and underserved communities. The profession has evolved from one designed for primary care to one that is adaptable to broad workforce demands. PAs are now employed in almost all medical specialties, including those with physicians reporting high rates of burnout. The authors believe that this is the first paper to explore the literature that relates specifically to PA burnout and career and job satisfaction.

Read the discussion paper

A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being

Clinician well-being is crucial in ensuring a healthier future for all. But we cannot effectively combat clinician burnout without measuring its pervasiveness.

The following discussion paper investigates several measurement tools that organizations can use to assess clinician burnout and well-being. Tools vary widely and should be chosen carefully by researchers and organizational leadership. Authors provide a list of considerations and a brief overview of the tools that may be available to you.

Read the discussion paper

A Vision for a Person-Centered Health Information System

We have a health care system with robust but highly fragmented capabilities. How can we leverage technology to enhance harmonized, patient-centered care?

Realizing the full potential of patient-centered health care technology that also reduces clinician burden will require collaboration across multiple sectors, a willingness to share data, and the development of universal standards. This discussion paper describes a vision for the future, identifies existing gaps and barriers, and describes a potential roadmap to achieving a person-centered health information system.

Read the discussion paper

Additional Resources

Click here to find additional publications from the National Academies addressing clinician well-being and resilience.

We currently do not require additional formal sponsors of the collaborative, but we very much want all interested organizations to stay connected as supportive partners. You can join our efforts by becoming a Network Organization of the Action Collaborative.

Learn more about becoming a Network Organization

Thank you for your commitment to clinician well-being.