Daniel E. Shapiro, PhD, et al. The American Journal of Medicine (2019) 132:556−563

In this article, the author uses the Maslow hierarchy of needs as a template to organize physician needs starting from the most basic to intellectual and relational needs required to thrive as a professional. This approach makes it possible for teams to study needs of their members and to design interventions to prevent burnout.

Tait D. Shanafelt, MD. Mayo Clin Proc. 2021;96(10):2682-2693.

This article by a thought leader for wellness describes "Wellness 1.0" as the learning phase we are now leaving on our way to "Wellness 2.0," the action and transformation phase for wellness culture. Incredibly direct and helpful expert opinion for collaboration on institutional change.

Krall, Edward J. Clinical Medicine & Research Volume 12, Number 1-2: 6-9

An intensely personal perspective with practical insights and tips for individual physicians to build their own resistance. The author believes physicians need to take ownership of their stress and develop a healthy response through a lifetime of practice.

Zwak et al. Acad Med.2013;88:382-389.

This article seeks to identify health-promoting strategies employed by experienced physicians in order to define prototypical resilience processes and preventative actions others can take. Well organized and useful.

Trockel et al. Acad Psychiatry (2018) 42:11-24.

Shanafelt and others present a validated tool to briefly assess burnout and professional fulfillment. Unlike the Maslach Burnout Inventory, this tool is calibrated to register changes after interventions in as short a time as three weeks. Unlike the Well Being Index, this tool includes sleep impairment measures. It may be a good candidate for rapid tests of change in a medical workforce.

Shanafelt T, et al. JAMA Internal Medicine. Online September 25, 2017. E1-7.

Understanding the business case to reduce burnout and promote engagement as well as overcoming the misperception that nothing meaningful can be done are key steps for organizations to take action.

Panagioti, et al. JAMA Intern Med. 2017;177(2):195-2015

Recent intervention programs for burnout in physicians were associated with small benefits that may be boosted by adoption of organization-directed approaches. This finding provides support for the view that burnout is a problem of the whole health care organization rather than individuals.

Squires et al. Ann Thorac Surg 2017;104:1117-22.

Healthcare organizations in the United States are implementing committees and support groups in an attempt to reduce burnout among their physicians, but these efforts are typically focused on increasing resilience and wellness among participants rather than combating problematic changes in how medicine is practices in the current era. A call for a shift in the focus of these efforts toward one proposed root cause of burnout.

Jensen M et al. Canadian Fam Phys. Vol 54:May 2008 pp 722-29

While some might argue that resilience is a result of inherited personality traits, some of the factors described in this study as contributing to resilience can be learned behaviors.

This pre-publication study is the first to relate high stress in residency with higher levels of stress in practice.

Aaronson et al. Acad Psychiatry (2018) 42:469-472

Resident and fellow physicians are at higher risk for developing depression compared tot he general population, but they re also less likely to utilize mental health services. This study identifies barriers to receiving care which included lack of time, concerns about confidentiality, concerns about what others would thing, cost, and concern for the effect on one's ability to obtain licensure.

Eckleberry-Hunt, et al. J Grad Med Ed, December, 2009; 225-230

The benefits of cultural change include providing a more positive educational environment for residents and faculty, raising awareness of burnout and its symptoms, decreasing the stigma associated with burnout symptoms, enabling the development of prevention strategies.