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Letters to the Editor

Improving Wellness by Improving Autonomy Through Physician Leadership Development

Khan, Talal W. MD, MBA

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doi: 10.1097/ACM.0000000000001739
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To the Editor:

Physician dissatisfaction1 and burnout2 are on the rise. Burnout amongst health care professionals leads not only to a decrease in patient satisfaction3 but also to a rise in suboptimal care.4 When it comes to issues affecting the mental health of students, residents, and physicians, the Commentary by Slavin and Chibnall5 encourages us to find the why and change the how. Most of us went into medicine to help people. Our medical education system is set up to develop excellent clinicians, yet the realities of our health care system force fresh graduates to contend with an ever-growing regulatory burden, an electronic health record system that does not live up to our expectations, and the business side of medicine often adjudicated by nonclinicians. Loss of autonomy has been found to be one of the leading causes of physician burnout, and addressing this loss may help to improve wellness among learners and physicians.

To counteract the loss of autonomy, a number of organizations have incorporated various physician development and leadership programs within their institutions. We are proponents of incorporating basic leadership principles at the medical school, resident, and early- to midcareer faculty level. The basics should include an understanding of the financial foundations of our health care system; the evolution of payment systems from fee-for-service to value based; the physician’s role in creating value; negotiation and conflict management; leading and managing a team; becoming an authentic leader; and an awareness of self and the environment.

We are already facing a physician shortage. With more physicians second-guessing their career choice,1 we owe it to future generations to reinvigorate the noble profession of medicine.

Talal W. Khan, MD, MBA
Associate professor and chair, Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, Kansas; [email protected]; ORCID:


1. Kane L, Peckham C. Medscape Physician Compensation Report 2014. Published April 15, 2014. Accessed March 21, 2017.
2. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work–life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:13771385.
3. Argentero P, Dell’Olivo B, Ferretti MS. Staff burnout and patient satisfaction with the quality of dialysis care. Am J Kidney Dis. 2008;51:8092.
4. Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg. 2010;251:9951000.
5. Slavin SJ, Chibnall JT. Finding the why, changing the how: Improving the mental health of medical students, residents, and physicians. Acad Med. 2016;91:11941196.
Copyright © 2017 by the Association of American Medical Colleges