key: cord-0699807-gpuoyrcu authors: Gaeta, Theodore J. title: Need for a holistic approach to reducing burnout and promoting well‐being date: 2020-06-09 journal: J Am Coll Emerg Physicians Open DOI: 10.1002/emp2.12111 sha: 572e7b8eefb8a15450c55ee9167095392c11054f doc_id: 699807 cord_uid: gpuoyrcu nan can benefit from strategies that enhance well-being and develop resilience. However, this is a form of psychological myopia. Although wellness programs and mindfulness training are practical and seem achievable, our challenge is to identify and address the underlying problems in health care that fuel that stress. There is clearly much to be done in the development of resources to mitigate burnout, improve wellness, and develop resilience. Baugh et al 5 describe how emergency department (ED) burnout may be caused by a "mismatch" between the worker and the workplace in 1 or more of 6 domains: workload, control, reward, community, fairness, and values. This article serves as a call to action for the development of a system-based approach to ED burnout and provides valuable strategies that may be applied by ED leadership who are looking to reduce the risk of physician burnout. As the authors mention, physician burnout is a complex and multifactorial issue. In the mid-1970s, a group of researchers began to seriously consider the complex and often diffi- Previous work shows that emergency physicians have higher-thanaverage rates of burnout. Physician burnout negatively affects not only physicians but also their colleagues and patients. It has been associated with perceptions of providing suboptimal patient care, lack of empathy, perceived and self-reported medical errors, poor job satisfaction, and lack of professionalism. 9 It also affects health care organizations and our health care system as a whole, because physicians choose to cut back clinically, retire early or leave clinical practice for other careers. Addressing factors associated with burnout will require a shared commitment from both health care organizations and individual physicians. In the book, Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, the authors state "Rather than searching out systems issues, it may be tempting to think of the inherent stresses of practice, the traits and characteristics of physicians, mental health issues, and the effects of the culture of medicine as being the culprits. However, the widespread nature of burnout today indicates that clinicians with burnout are not 'weak links' but rather 'canaries in the coal mine.'" 10 This book provides valuable lessons to be learned and applied by organizations that want to do something to reduce the risk of physician burnout. It delves into root causes and offers practical solutions that apply to all specialties. Although it may be true that fixing the underlying systemic and workplace issues is a more formidable task than providing individualbased support, physician burnout requires both solutions. Addressing burnout requires a more holistic approach. The COVID-19 pandemic has brought to light our resolve and resilience as a specialty. Now, more than ever, we must work together to develop a pathway for restoring the joy and passion back to the practice of emergency medicine. Solutions to address emergency physician burnout involve a shared Assessment of physician wellbeing, part two: Beyond burnout Assessment of physician wellbeing, part one: Burnout and other negative states Prevention of burnout: new percpectives Understanding the burnout experience: recent research and its implications for psychiatry Beyond the Maslach Burnout inventory: Addressing emergency medicine Burnout with Maslach's full theory The measurement of experienced burnout Burnout syndrome among emergency department staff: prevalence and associated factors Trends and factors associated with physician burnout at a multispecialty academic faculty practice organization High prevalence of burnout among US emergency medicine residents: Results from the 2017 National Emergency Medicine Wellness Survey Workplace drivers of burnout for physicians commitment from both the individual physician and their institutional