Physician Burnout: The Making of a Crisis.

This essay places contemporary efforts to understand and respond to the crisis of physician burnout in historical perspective, proposing that the origins of such efforts lie in nineteenth century concerns over "nervous exhaustion," well before the term "physician burnout" was coined by social scientists in the early 1970s. Only very recently, however, have physician-scholars started to bring more sophisticated tools to bear in conceptualizing the problem, moving from a "systems approach" to the most recent efforts to frame the issue as a problem of corporate culture. The essay proposes that these different approaches to physician burnout illustrate the changing self-images of the medical profession over the last century and a half. Because such self-images are embedded in normative assumptions, contextualizing physician burnout in these terms reveals the crisis to be as much social and political as professional.