ACOFP acknowledges the impact of physician suicide in recognition of National Physician Suicide Awareness Day, September 17.
During a well-attended session at the 2025 ACOFP Annual Convention, Michael Moskowitz, DO, shared how his interest in well-being and burnout grew into a comprehensive program at his institution, Catholic Health.
Until three years ago, Dr. Moskowitz practiced as a regular family physician. Around that time, he began to see the signs of burnout. “That spark I had was starting to fade,” he says.
How Burnout Affects Physicians and Patients
Some signs of burnout include:
- Emotional exhaustion: For example, going away for a week and feeling like you never went away.
- Depersonalization: For example, losing the personal touch with patients.
- Sense of low personal accomplishment.
The ways that decisions are made in the healthcare industry can contribute to burnout. Other industries with high cognitive load, like airline pilots and nuclear power workers, have more supports in place, like mandatory breaks and mandatory debriefs. The healthcare industry has comparatively few of these supports: in residency, physicians are often told to simply show up the next day and work.
Physicians are prone to several occupational hazards associated with burnout.
- 10-12% of doctors struggle with substance abuse
- 12-18% show signs of depression, and they are much less likely to seek help
- At least 400 doctors die by suicide each year, which is underreported. Given the number of patients treated by each doctor, at least one million patients a year lose their doctor due to suicide.
About 43% of physicians are showing signs of burnout. Physician burnout costs $4.6 billion in costs like poorer patient care and additional hiring due to lack of retention.
At the session, audience members shared some of their first-hand experiences with this culture. One physician went into his first job intending to set firm boundaries between work and home. When he found the workload unmanageable during the hours in his contract, he was advised by colleagues “You can always do notes at home” or “You can always work [on your day off].”
When Dr. Moskowitz recognized the signs of burnout in himself, he explored possible career pivots, including speaking to leadership at his institution. These leaders asked what he wanted to do. He answered, “I want to be the chief morale office of Catholic Health.” This idea transformed into the creation of the role of vice president of clinician resilience and well-being.
The AMA recommends establishing a chief wellness officer role, which improves the patient experience, health outcomes, staff retention, and an organization’s financial position. Despite this, only about 15% of systems have adopted this role. AMA’s Joy in Medicine Health System Recognition Program empowers health systems to address burnout, with a three-tier recognition system.
Other leading organizations who have provided recommendations on addressing burnout include the American Hospital Association and NIOSH (National Institute of Occupational Safety and Health). Dr. Moskowitz advised highlighting these recommendations to administrators who may be reluctant to implement a wellness program: “They all say we should be doing this, so if we’re not doing it, we’re differentiating from the standards of care.”
The Power of Peer Support
One of the programs Dr. Moskowitz established at his institution is the RISE (Resilience in Stressful Events) peer-support program. A multidisciplinary care group is by far the preferred way for people to receive support—in a survey, almost 70% chose it versus a manager (15%) or counselor (13%). Peer support has also proven to be very effective.
The program trains peer supporters to listen and to go into the conversation without a plan. They have implemented mandatory peer support with residents after ICU and ER rotations. Dr. Moskowitz notes that after they publicized the program, informal support became very common, even among those who may be reluctant to call the peer support network. “We get a lot of, “Hey, I know you’re a peer supporter, can I pick your brain for a second?’”
Other initiatives included grant-funded team dinners and collaborating with a consultant to record the initiative through blogs, videos, and other free resources. They also removed obstructive language in onboarding paperwork: questions like “Have you ever sought help for mental health?” and “Are you taking medications for mental health?” Questions like these lead physicians to avoid seeking treatment and support for burnout.
After the first year of Dr. Moskowitz’s program, well-bring, resilience activation, and resilience decompression all improved. Catholic saw a 17% decrease in burnout, according to a survey of 2,000 clinicians with a 40% response rate.
Dr. Moskowitz emphasized that burnout is not your fault--there is a need for systemic change. The tools we have to address burnout are effective. Dr. Moskowitz hopes that as a result of physicians banding together and measuring outcomes, leadership will listen on a nationwide level, and we can see tools like those in use at Catholic General implemented at every healthcare system in the country.
Watch the Full Session On Demand
Dr. Moskowitz’s full session, Update on Clinician Resilience and Well-Being, is now available on demand. Purchase access to the full convention or specific bundles to earn up to 38 AOA or AMA credits.
