We were intrigued by the article titled “U.S. Attending Anesthesiologist Burnout in the Postpandemic Era”  by Afonso et al. This piece delves into the factors contributing to the high prevalence of burnout among U.S. attending anesthesiologists, revealing a significant association between perceived support at work and the risk of burnout and burnout syndrome. As physicians on the front line of patient care, we find ourselves navigating a labyrinth of challenges, chief among them the erosion of autonomy and the shifting perception of medicine from a calling to merely a job. 

Autonomy, once the cornerstone of medical practice, now faces siege from numerous external forces. The modern healthcare landscape increasingly encroaches upon our autonomy, relegating us to the role of mere cogs in a bureaucratic machine more interested in financial gain than patient well-being. In the revered halls of medical schools, aspiring physicians are instilled with a sense of purpose—a calling to serve humanity. However, the harsh realities of modern healthcare have dulled that idealism. The Areas of Worklife Model identifies six key dimensions of the work environment (workload, control, reward, community, fairness, and values) that significantly influence individuals’ engagement with their work.This model emphasizes the importance of aligning these aspects with employees’ needs and expectations to foster a positive work experience. Research, such as that referenced by the authors, consistently underscores the detrimental impact of perceived lack of control on burnout, highlighting the critical role of autonomy in mitigating workplace stress and dissatisfaction.

The estimated cost of burnout is astronomically expensive for healthcare organizations, amounting to more than $4 billion each year due to increased staff turnover and reduced work hours. While this represents a potent motivator to invest in in burnout mitigation efforts, the cost of attrition puts these numbers into perspective: replacing a physician is estimated to cost two to three times that physician’s yearly salary. As hospitals and leaders strategize ways to combat burnout, they must prioritize efforts to restore the perception of medicine as a calling rather than merely a job. The work of Teresa Amabile and Steven Kramer describes the Progress Principle: “Of all the things that can boost inner work life, the most important is making progress in meaningful work.”  The importance of progress is foundational, yet few leaders grasp how to harness it successfully to enhance positive emotion, perception, and motivation. Implementing the Progress Principle demands a unified endeavor to remove inhibitors (actions that fail to support) and toxins (undermining events) that hinder the path of physicians. Healthcare institutions must prioritize reinstating physician autonomy to cultivate environments that nurture professional development and promote clinical care, instead of increasing profit margins and reducing cost.

As we confront the specter of burnout within our profession of anesthesiology, let us heed the timeless wisdom of the Progress Principle. Together, we can embark on a journey fueled by the pursuit of progress toward a brighter, more compassionate future for ourselves and, importantly, for those we serve.