A Focus on Wellness; Keynote Speaker Tait Shananfelt, MD, Shared Causes of Occupational Burnout & Pearls to Prevent It

CHICAGO—Rheumatologists have a role in combating their risk of burnout, said Tait Shanafelt, MD, hematologist/oncologist and the Jeanie and Stew Ritchie Professor at Stanford University, Palo Alto, Calif., during the Opening Session of ACR Convergence 2025.

Dr. Tait Shanafelt

Dr. Shanafelt is also the chief wellness officer at Stanford Medicine and a well-known thought leader in the area of physician burnout. He has published more than 575 peer-reviewed papers and commentaries.

During his presentation, Dr. Shanafelt detailed factors that contribute to occupational burnout among physicians and what organizations and individual clinicians can do to lower their risk of burnout.

He shared the experience of his mother, who recently died and was in hospice care during the last weeks of her life.

“End-of-life care is obviously an area very familiar to me as an oncologist. And yet I experienced it in a very different and personal way in that time as the hospice nurses and physicians supported our family,” Dr. Shanafelt said. This illustrates why system approaches to preventing burnout are so important.

A 12-year longitudinal study on burnout in the U.S. physician workforce led by Dr. Shanafelt and published in 2025 found that 45.2% of physicians reported at least one symptom of burnout in 2023, which was lower than 2021, but still in line with earlier findings from 2011 (45.5%; but 62.8% during the COVID-19 pandemic). The 2023 study results were based on a survey with more than 7,600 physician participants and a probability-based sample of the U.S. working population. In the study, physicians were at a higher risk for burnout than other U.S. workers and less likely to be satisfied with their work–life integration.¹ 

Dr. Tait Shanafelt, with ACR President Dr. Carol Langford

Burnout Contributors

As Dr. Shanafelt outlined some of the major factors associated with burnout, he also acknowledged that the audience was likely well aware of those factors because they live it day to day.

Decreased time with patients, extra work with electronic health records (EHR), increased regulatory issues and more clinical demands all frequently contribute to burnout, Dr. Shanafelt said.

Isolation is also a factor. It’s something Dr. Shanafelt began spotlighting in 2018, long before the COVID-19 pandemic amplified the issue further. “We’ve all gotten busier seeing more patients and spending more time documenting in the EHR, which has translated into rubbing elbows with our colleagues less,” he said.

Another contributing factor to burnout is the double-edged sword of common physician traits. Example: Most physicians are thorough, committed to their patients and recognize the responsibility that comes with patient trust. These are important qualities that make us good physicians, he said, but they also often make it hard to set boundaries or take time off. This makes it harder for us to relax and  allocate time for family.

Some signs of burnout include losing the sense that you’re making a difference at work, seeing your patients or co-workers in a less-than-human way (also called depersonalization) and emotional exhaustion.

Although it’s common for everyone to experience those feelings, when they occur too frequently and to too severe a degree they indicate burnout, which can undermine professional efficacy. Occupational burnout is common among physicians and other healthcare workers and is also frequently experienced by those whose work involves intense contact with people, such as teachers, social workers and police officers, he said.

Facing professional burnout can become a big issue because of how it affects a person’s life professionally and personally, Dr. Shanafelt said. It can strain relationships and increase the risk for alcohol use and depression. Professionally, it can raise the risk of turnover, sub-optimal patient experience and medical errors.

Pearls to Address Burnout

Dr. Tait Shanafelt at ACR Convergence 2025

While some have suggested that physicians and other clinicians need to be tougher or more resilient, that’s the wrong answer. Physicians are already incredibly resilient, Dr. Shanafelt explained.

“The current healthcare delivery system is burning out [some of] the most resilient human beings on planet Earth. We won’t resilience our way out of this,” he said.

Dr. Shanafelt spent the majority of this time focused on what healthcare organizations need to do to address this issue. Steps included:

1. Start at the top. Dr. Shanafelt indicated that leader behavior is a key driver of the professional fulfillment of the physicians they lead. Effective leaders create a shared sense of purpose within for team members, engage team members to identify and prioritize opportunities for improvement, and empower them to put those that are possible into practive.
2. At the organizational level, find changes to make daily work less burdensome. He gave a surgical example. “If your ORs are taking too long to turn around, and the anesthesiologist, surgeon and nursing OR team are all going home late and missing dinner, the solution is not to teach the surgeon to meditate between cases. It’s to get the operating room turned around more efficiently,” he said. If many initiatives are needed to make workflow more efficient, start with one actionable step and then build out from there.
3. Consider using ambient AI note taking. Given the evidence that EHR documentation burden is one major contributor to burnout, it is important organizations address this issue. Ambient AI note taking during an appointment may not address all of this burden, but eight studies published in the past 12 months suggest it can make a major impact.  Although EHR timestamps suggest the time savings is modest (20 minutes per four hours of seeing patients) the reductions in cognitive load and burnout are large.²

“In my own practice when I use this, I find I’m able to pay attention to the patient. I don’t worry about tracking every detail of what they’re telling me,” he explained.

Dr. Shanafelt also shared several actions individual rheumatologists can take to promote professional fulfillment in parallel with organizational improvement efforts:

1. Think about what you enjoy most professionally, and consider how you might do more of it. Is it caring for patients with a specific disease? Teaching? Mentorship? Leadership? Learning? Quality improvement? Something else? What the most meaningful aspect of your work is may be something you haven’t considered recently. For many, the last time they went through a job search was the last time they performed deep self-reflection on this topic. It’s possible that what excites you the most professionally has changed. “We can reflect on it, and then we can assess how much time we’re spending on that and what it might take [e.g., new training, skill building, seeking new opportunities] to increase it,” he said.
2. Use executive coaching. Instead of placing the focus on healthy eating or exercise, executive coaching focuses on building leadership skills and working toward professional goals. It enhances meaning in work and can foster work–life integration. The research of Dr. Shanafelt and colleagues, which has now been validated by numerous follow-up studies, finds that executive coaching can help clinicians lower their burnout risk.
3. Share your professional, sacred moments with colleagues. Think about those memorable moments in your work in which you’ve  made a deep and profound connection with someone, perhaps with a patient. You feel joy, peace or empathy. When this happens, do you usually share that moment with someone else? If not, start to do it, Dr. Shanafelt said. Evidence from the University of Michigan indicates that the mere act of discussing sacred moments with a colleague when they occur may reduce burnout.

Ultimately, both individual and systemic changes are needed to meaningfully address the challenge, Dr. Shanafelt said.

Setting the Tone

Also during the Opening Session, outgoing ACR President Carol A. Langford, MD, MHS, director of the Center for Vasculitis Care and Research in the Department of Rheumatic and Immunologic Diseases at Cleveland Clinic in Cleveland, welcomed attendees and encouraged their involvement with advocating for research funding and support.

“It is essential to rheumatology … to be able to shine brightly without the threat of being dimmed or extinguished,” Dr. Langford said.

Dr. Langford highlighted efforts from the ACR to advocate for the specialty, including more than 100 ACR, ARP and patient delegates who met with lawmakers and their staff over the past year to educate them about rheumatology.

“In these meetings, the ACR brought forward vital messages for our nation’s leaders to support National Institutes of Health funded research, preserve access to care for Medicare patients, oppose cuts to Medicaid and urge pharmacy benefit management reform to lower prescription drug costs and increase access to treatments for patients. As a result of these collective efforts, we have seen a number of successes where the voice of rheumatology has brought about change,” she said.

Dr. Langford, who’s term as ACR president finished on the last day of the meeting, urged members to become involved with advocacy efforts in 2026.

The Opening Session also included opening remarks from ARP President Adam Goode, PT, DPT, PhD, vice chair of clinical research and epidemiology in the Department of Orthopaedic Surgery and professor of orthpaedic surgery, Duke University, Durham, N.C.

Additionally, Liana Fraenkel, MD, MPH, who was ending her term as president of the Rheumatology Research Foundation, shared highlights from the foundation, which celebrates its 40th anniversary this year. Dr. Fraenkel is director of Patient Centered Population Health Research, Berkshire Health Systems, and an adjunct professor of medicine at Yale University School of Medicine in New Haven, Conn.

For details on the awards presented during the Opening Session, check out the following articles:

• 2025 ACR Awards of Distinction;
• 2025 ARP Merit Awards;
• 2025 ACR Masters; and
• 2025 ACR Distinguished Fellows.

Vanessa Caceres is a medical writer in Bradenton, Fla.

References

1. 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 2023. Mayo Clin Proc. 2025 Jul;100(7):1142–1158.
2. Olson KD, Meeker D, Troup M, et al. Use of ambient AI scribes to reduce administrative burden and professional burnout. JAMA Netw Open. 2025 Oct 1;8(10):e2534976.