by adgrooms on October 30, 2019

People talk about the problem of burnout in medicine, coming from different perspectives and using different words. We thought it might be helpful to list the terminologies and associated perspectives/approaches/solutions.

The problem: Various factors in Healthcare cause people to leave medicine, suffer from a higher level of depression, and be at greater risk of suicide.


Definition: "a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress"

  • "The term “burnout” was coined in the 1970s by the American psychologist Herbert Freudenberger. He used it to describe the consequences of severe stress and high ideals in “helping” professions."
  • In a 2018 report from Medscape that surveyed more than 15,000 physicians across 29 specialties, 42 percent reported burnout.

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Definition: "an active process of becoming aware of and making choices toward a healthy and fulfilling life. Wellness is more than being free from illness, it is a dynamic process of change and growth."

  • The phrase is from alternative medicine and was initially brought to use in the US by Halbert L. Dunn, M.D. in the 1950s.
  • It is related to well-being, psychological wellness.
  • There is a general corporate use of this term across industries referring to efforts to address employee health and well being.

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Definition: "a good feeling condition of existence. A state characterized by your health, happiness, and prosperity."

  • The World Health Organisation (WHO) defines health as 'a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity' (WHO, 1948). ... 'Wellbeing' refers to a positive rather than neutral state, framing health as a positive aspiration.
  • Well-being refers to a more holistic, whole of life experience, whereas wellness refers to physical health.
  • "There is no universally accepted 'definition' of mental well-being. This is probably because mental well-being may have different connotations for different individuals, groups and cultures."

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Definition: "the experience of a meaningful life, in the happiness, sadness, and fullness of all its moments. Joy is the humbling experience of offering care, and the privilege of enabling any betterment where this is possible. Joy is knowing that what you do is worthwhile. It is connection, it is authenticity."

  • The Institute for Healthcare Improvement (IHI) has created a framework for improving “joy in work”
  • "Joy means going home at the end of the day knowing that you’ve participated in something that matters to you, and that you have asked others, including patients, what matters to them."

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Moral Injury

Definition: "an injury to an individual's moral conscience and values resulting from an act of perceived moral transgression, which produces profound emotional guilt and shame, and in some cases also a sense of betrayal, anger and profound "moral disorientation"."

  • It is a betrayal of what is morally right by someone who holds legitimate authority.
  • "Physicians (in the United States) are caught in double and triple and quadruple binds between their obligations of electronic health records, their own student loans, the requirements for patient load through the hospital and number of procedures performed – all while working towards the goal of trying to provide the best care and healing to patients possible."

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Compassion Fatigue

Definition: "also known as secondary traumatic stress (STS), is a condition characterized by a gradual lessening of compassion over time."

  • "A state experienced by those helping people or animals in distress; It is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper."
  • "Scholars who study compassion fatigue note that the condition is common among workers who work directly with victims of disasters, trauma, or illness, especially in the healthcare industry."

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Everyone sees the problem in a different way and offers a piece of the solution. This glossary of basic terms and resources are helpful to put the problems and solutions in context. This is just a start. We will be adding more terms in the future.