Creating Intentional Professional Connections to Reduce Loneliness, Isolation, and Burnout


Pretending we have it together and can do it all on our own is the fastest way to professional isolation and burnout. Fortunately, there's a better way.

Fam Pract Manag. 2020 Sep-Oct;27(5):20-24.

Author disclosure: Dr. Greenawald created the free PeerRxMed program described in the article.

My workdays are just insane!” Thus began a recent conversation with a colleague who was struggling with some of the harsh realities of clinical practice, which have been exacerbated by the COVID-19 pandemic. He continued, “Sure, I enjoy being a physician, but lately it's felt more like a grind than a privilege. I've not shared this with anyone before, but I'm not sure I can keep this up.”

If you have ever found yourself feeling similarly, know that you are in good company. Know also that there are compelling reasons you should not be navigating these challenges alone. Intentional peer connection is a powerful way to increase our resilience and to support and encourage each other on our professional journey — not as a substitute for the support of friends and family, but as an essential ingredient recognizing there are some aspects of our professional lives that only colleagues can truly understand.

Now, I know what you're likely thinking: Peer connection won't fix the underlying problem — a broken “system.”1 That's true. System change is badly needed, but it is unlikely that we will see a fix any time soon. Therefore, making system change a criterion for our own professional well-being is sentencing ourselves to a life of professional (and personal) misery. But peer connection can help us now to deal with the emotional toll of working in a dysfunctional system, and even to thrive as we fight for a better system.


  • Because of professional socialization and scripting, and the present pace and intensity of clinical practice, physicians have limited down-time and limited opportunities to establish meaningful connections with colleagues.

  • Lack of professional connections can lead to a “soulless efficiency” and professional isolation, making it harder to care for others and deal with the emotional toll of working in a dysfunctional system.

  • Intentional peer connection is a powerful way for physicians to increase their resilience, support and encourage each other, and thrive while fighting for a better system.


We've heard the staggering numbers so often that I fear we've become numb to them. Over the course of three national studies done at three-year intervals starting in 2011, the burnout rate for family physicians has stayed consistently above 50%.2 This rate, while alarming in itself, does not even include other manifestations of professional distress, such as depression, anxiety, compassion fatigue, moral distress/injury, change fatigue, relational dysfunction, and just plain weariness. And these numbers do not capture the sense of professional disconnection and isolation that many of us are feeling as we try to navigate


Dr. Greenawald is vice chair for academic affairs and professional development at the Carilion Clinic Department of Family and Community Medicine in Roanoke, Va. He chairs the clinic's faculty vitality/professional well-being committee and is conference chair of the American Academy of Family Physicians' annual Physician Health and Well-Being Conference.

Author disclosure: Dr. Greenawald created the free PeerRxMed program described in the article.

This article is dedicated to the loving memory and legacy of colleague, friend, and former AAFP Family Physician of the Year Hughes Melton, MD, with whom I had extensive dialogue regarding the loneliness epidemic in our society at large and within the medical profession. Were he still alive, it was our intention for him to co-author this article.


show all references

1. Winner J, Knight C. Beyond burnout: addressing system-induced distress. Fam Pract Manag. 2019;26(5):4–7....

2. Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general U.S. working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681–1694.

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

4. Murthy V. Work and the loneliness epidemic. Harvard Business Review. September 2017. Accessed Aug. 20, 2020.

5. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316.

6. Bruce LDH, Wu JS, Lustig SL, Russell DW, Nemecek DA. Loneliness in the United States: a 2018 national panel survey of demographic, structural, cognitive, and behavioral characteristics. Am J Health Promot. 2019;33(8):1123–1133.

7. Achor S, Kellerman GR, Reece A, Robichaux A. America's loneliest workers, according to research. Harvard Business Review. March 19, 2018. Accessed Aug. 20, 2020.

8. Greenawald MH. How to create a culture of well-being in your practice. Fam Pract Manag. 2018;25(4):11–15.

9. Frey JJ. Professional loneliness and the loss of the doctors' dining room. Ann Fam Med. 2018;16(5):461–463.

10. Clinical practice culture: moving from surviving to thriving. AAFP. Accessed Aug. 20, 2020.

11. National Academies of Sciences, Engineering, and Medicine. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-being. The National Academies Press; 2019.


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