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Physician stress and burnout is a serious and common concern in healthcare, with over half of physicians in the USA meeting at least one criterion for burnout. The paper aims to discuss these issues.

A review on current state of physician stress and burnout research, from 2008 to 2016, was undertaken. A subsequent perspective paper was shaped around these reviews.

Findings reveal research strength in prevalence and incidence with opportunities for stronger intervention studies. While descriptive studies on causes and consequences of physician burnout are available, studies on interventions and prevention of physician burnout are lacking. Future research on physician stress and burnout should incorporate intervention studies and take care to avoid limitations found in current research. Accountability and prevention of physician burnout is the responsibility of the healthcare industry as a whole, and organizational strategies must be emphasized in future research.

The value of this research comes in the original comprehensive review, international inclusion and succinct summary of physician burnout research and strategies.

As one of the five major dimensions of service quality, empathy has been and continues to be regarded as a requirement for a successful service encounter. This paper focuses on the highly customer-centric service industry of health care. The purpose of this paper is to shed light on the potential negative effects of empathy on both the physician and the patient.

Building on an in-depth review of literature and well-established service quality models, the authors propose a new model for understanding the complex role of physician empathy in the physician–patient encounter. The trait, emotional intelligence (EI), is presented as a moderator for physician empathy levels.

The Health Care Optimal Physician Empathy (HOPE) model enables further characterization and analysis of the tradeoffs between patient satisfaction and physician burnout and determining when empathy optimally works to the benefit of both the physician and the patient to maximize service quality. The HOPE model provides a systematic way to understand and determine the appropriate level of physician empathy that results in optimal outcomes for both physicians and their patients by demonstrating the tradeoffs between physician burnout and patient satisfaction.

The authors highlight the potential detrimental effects on physicians themselves, and, in turn, on service quality. The theoretical and practical implications in this paper provide insights into the development and implementation of empathy-focused interventions and best practices to optimize service quality in the physician–patient interaction. The HOPE model is the first of its kind in shedding light on the manifestation of physician empathy.

To date, relatively little evidence has been published as to what represents an effective and efficient way to improve quality of care and safety in hospitals. In addition, the initiatives that do exist are rarely designed or developed with regard to the individual and organisational factors that determine the success or failure of such initiatives. One of the challenges in linking organisational culture to quality of care is to identify the focal point at which a deficient hospital culture and inadequate organisational resources are most evident. The accumulated evidence suggests that such a point is physician burnout. This paper sets out to examine this issue.

The paper reviews the existing literature on organisational culture, burnout and quality of care in the healthcare sector. A new conceptual approach as to how organisational culture and quality of care can be more effectively linked through the physician experience of burnout is proposed.

Recommendations are provided with regard to how future research can approach quality of care from a bottom‐up organisational change perspective. In addition, the need to widen the debate beyond US and North European experiences is discussed.

The present paper represents an attempt to link organisational culture, job burnout and quality of care in a more meaningful way. A conceptual model has been provided as a way to frame and evaluate future research.

The purpose of this paper is to demonstrate burnout syndrome among internal medicine and pediatrics residents in a country that does not have the working time directive (WTD) and also to determine the risk factors and consequent impact on efficient functioning in clinical areas.

A 57-item questionnaire was given to internal medicine and pediatrics residents. Responses from 22 pediatrics and 33 internal medicine residents were evaluated.

Demographic findings, burnout scores, having hobbies, social activities and reading books unrelated to medicine were similar between the two groups. Six pediatrics residents (27.3 per cent) and 11 (33.3 per cent) internal medicine residents met the criteria for clinically significant burnout. Personal accomplishment scores and reading books unrelated to medicine were found to be related to burnout.

Burnout is a syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal accomplishment. It is important to document burnout in countries where WTDs are not implemented. Further studies might demonstrate burnout's effect on patient safety, service quality and physician's performance.

The association of calling with burnout is not well understood. This study investigates how calling influences burnout and what the roles of social worth and career stage are in this relation. Drawing from the Conservation of Resources Theory, we expect that calling may be negatively associated with burnout through increased social worth and that career stage moderates these relationships.

Based on a sample of 566 healthcare professionals, we conducted regression analyses with bootstrapping procedures to test the proposed hypotheses.

The findings show that social worth mediates the negative relation between calling and burnout. Additionally, the positive relation between calling and social worth was more pronounced for late-career employees; yet, the negative relation between social worth and burnout was stronger for early-career employees.

The findings suggest that searching and pursuing a professional calling is beneficial for individuals. Additionally, social worth is crucial in this relation and could be used to actively prevent burnout.

The study advances our understanding of the consequences of calling for employees by explaining the underlying mechanism between calling and burnout and its importance at different career stages.

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease patients' trust and satisfaction and even endanger patients' lives. There is a need to examine the critical factors affecting the medical staff's emotional exhaustion by investigating its relationship with the patient-safety dimensions based on the safety attitudes questionnaire (SAQ).

A case study is conducted from the viewpoints of physicians and nurses to examine the relationship between emotional exhaustion and six dimensions of the SAQ from 2016 to 2020 from a regional teaching hospital in Taiwan. Linear regression with forward selection is employed. Six dimensions of the SAQ are the independent variables, whereas emotional exhaustion is the dependent variable for each year.

Stress recognition is the most important variable to influence emotional exhaustion negatively, while job satisfaction is the second important variable to affect emotional exhaustion positively from 2016 to 2020. On the contrary, working conditions do not influence emotional exhaustion in this hospital from medical staff's viewpoints.

This study uses longitudinal data to find that both stress recognition and job satisfaction consistently influence emotional exhaustion negatively and positively, respectively, in this five-year period. The third dimension to impact emotional exhaustion varies from time to time. Thus, the findings from a cross-sectional study might be limited. The authors' findings show that reducing stress recognition and enhancing job satisfaction can lead to the improvement of emotional exhaustion from medical staff's viewpoints, which should be monitored by hospital management.

The purpose of this paper is to investigate gender differences in work experiences, satisfactions and psychological health among physicians in Turkey.

Data were collected from 237 male and 194 female physicians using an anonymously completed questionnaire. Measures included personal demographic and work situation characteristics, stable individual difference factors (e.g. workaholism components, Type A behavior, optimism), job behaviors (e.g. perfectionism, hours worked), work and extra‐work satisfactions, indicators of work engagement, and psychological wellbeing.

There were few differences in personal demographic and work situation characteristics. Female physicians had less professional tenure and worked fewer hours and extra‐hours per week. Female and male physicians were similar on stable individual difference factors, job behaviors, work outcomes, extra‐work satisfactions and psychological wellbeing, with a few exceptions. Female physicians reported more work‐family conflict and more psychosomatic symptoms and tended to be absent more.

Data were collected using self‐report questionnaires raising the possibility of response set tendencies. It is also not clear to what extent these findings generalize to male and female physicians in other countries.

Despite previous studies showing considerable gender differences in the work experiences and wellbeing of female and male physicians in other countries, female and male physicians in Turkey reported generally similar job behaviors, satisfactions, quality of life and emotional wellbeing. This suggests that an emphasis on gender similarities rather than gender differences might be warranted.

Among healthcare professionals, burnout is one of the key challenges affecting organizational outcomes, employee productivity and quality of care. The knowledge of burnout and its root causes and primary contributors continues to grow yet remains limited. In many environments, an entrepreneurial orientation (EO) has been shown to dramatically improve organizational outcomes and performance. The purpose of this paper is to illustrate critical research areas at the intersection of organizational EO and employee burnout within the healthcare sector.

A conceptual model which considers how EO has the potential to provide an operational context that may negate, lessen or delay the negative effects of burnout among healthcare professionals, is advanced as a useful focal point to foster research exploring connections between organizational orientation and employee well-being.

Insights into how an opportunity-embracing EO characteristic of high-tech firms may shape how stress is experienced and address burnout when applied to healthcare organizations. A decrease in burnout stands to improve quality of care as well as the satisfaction of staff and patients alike, including a greater sense of autonomy, engagement, motivation and passion.

This research agenda proposes new insights and the need for additional research into how the manifestation of organizational EO may contribute to the field of medicine, influence burnout and enhance the well-being among healthcare professionals.

The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in transforming the present culture of healthcare to restore, refine and preserve its traditional care components.

The literature on change, organizational culture and leadership is leveraged to describe the structural interdependencies and dynamic complexity of the present healthcare system and to suggest how physicians can strengthen the care components of the healthcare culture.

When an organization’s culture does not support internal integration and external adaptation, it is the responsibility of leadership to transform it. Leaders can influence culture to strengthen the care components of the healthcare system. The centrality of professionalism in the delivery of patient services places a moral, societal and ethical responsibility on physicians to lead a revitalization of the care culture.

This paper focuses on cultural issues in healthcare and provides options and guidance for physicians as they attempt to lead and manage the context in which services are delivered.

The Competing Values Framework, the major interdependent domains and five principal mechanisms for leaders to embed and fine tune culture serve as the main tenets for describing the ongoing changes in healthcare and defining the role of the physician as leaders and advocates for the Patient Care Culture.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.