Physician Burnout and the Other Reversible Diastolic Dysfunction


Is physician burnout a heart issue?

Fam Pract Manag. 2016 May-June;23(3):48.

Author disclosure: no relevant financial affiliations disclosed.

As a family physician who has experienced burnout, I appreciate the growing literature on this topic, but I have been puzzled by a gap in the dialogue. It reminds me of the intrigue I felt as a young doctor when I read about a condition called “diastolic heart failure.” I had studied congestive heart failure (CHF) but never imagined a heart could fail due to hypertrophy of the very muscle fibers that made it strong. Later, I read with incredulity about a reversible form of CHF called Takotsubo cardiomyopathy, or “broken heart syndrome.”

I posit that the burnout many doctors are suffering from is a reversible form of spiritual diastolic dysfunction.

What does spirituality have to do with wellness? Drawing from data on 30,000 individuals, researchers recently found that those who reported four to five stressors (e.g., money worries, relationship strains, or caregiving roles) were five times more likely to report poor health than those who reported fewer stressors.1 In analyzing the data, they identified three stress “magnifiers” that correlate with poor health, low productivity, and high health care costs and three stress “buffers.” The stress magnifiers were insomnia, feeling sad or anxious, and substance use. The stress buffers were peer support, exercise, and spirituality.

Although all family physicians are comfortable talking about social support and exercise, relatively few of us discuss the value of spiritual health. Why is this? Albert Einstein said the intuitive mind is a sacred gift and the rational mind a faithful servant. Bob Samples added, “It is paradoxical that in the context of modern life we have begun to worship the servant and defile the divine.2 Could it be that family physicians' roughly 25 years of formal education – much of it devoted to reason, logic, and scientific method – have resulted in “left brain” diastolic dysfunction? We now mistrust and discount the “heart,” “right brain,” or “soft str

About the Author

Dr. Osborn directed the Loma Linda University Family Medicine Residency Program and now works for QuadMed in an employer-sponsored patient-centered medical home in Pleasanton, Calif.

Author disclosure: no relevant financial affiliations disclosed.


show all references

1. Eliza Corporation, Altarum Institute. The Vulnerability Index white paper. Published 2013. Accessed March 31, 2016....

2. Samples B. The Metaphoric Mind: A Celebration of Creative Consciousness. Reading, MA: Addison-Wesley Publishing Company; 1976:26.

3. Drummond D. Physician burnout: its origin, symptoms, and five main causes. Fam Pract Manag. 2015;22(5):42–47.

4. McCord G, Gilchrist VJ, Grossman SD, et al. Discussing spirituality with patients: a rational and ethical approach. Ann Fam Med. 2004;2(4):356–361.

5. Anandarajah G, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician. 2001;63(1):81–89.

6. Maugans TA, Wadland WC. Religion and family medicine: a survey of physicians and patients. J Fam Pract. 1991;32(2):210–213.


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