Please put on your own oxygen mask before assisting others: a call to arms to battle burnout
Abstract
Burnout among healthcare workers has reached epidemic proportions. Obstetrician/Gynecologists are not exceptions. Burnout is a phenomenon that can be difficult to distinguish from other entities, but one that has far-reaching consequences that can be deleterious both to physicians and to their patients. Most worrisome are its insidious nature, its contagiousness, and its relationship to depression. To date there has been a paucity of solutions proven to effectively fight burnout, and the implementation of those that may be helpful has been fragmented. An aggressive and multi-pronged approach is warranted that focus at the individual, departmental, institutional and national levels. Potential solutions should take into account external and internal factors, as well as issues of feasibility, impact and cost. Interventions that may play a role include cognitive-behavioral therapy, enhanced communication, physician wellbeing programs, improving work conditions, and advocacy efforts.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Burnout has increasing prevalence in HCPs and imparts increasing cost to the health-care system from job turnover, impaired job performance, and exacerbation of health conditions.
“Described as an epidemic in health care,8,9 burnout has increasing prevalence in HCPs and, given its negative sequelae, imparts increasing cost to the health-care system from job turnover, impaired job performance, and exacerbation of health conditions.8”
From Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness (2019) · cites this paper as [8]
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,842 · see citing works
The Association of American Medical Colleges
ZAPFFE, F. C. (1938) · Academic Medicine · doi:10.1097/00001888-193801000-00007 · Cited by 5,527 · see citing works
Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.3199 · Cited by 3,439 · see citing works
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.08.023 · Cited by 2,885 · see citing works
Maslach, C. (1982) · Cited by 2,389 · see citing works
Burnout and self-reported patient care in an internal medicine residency program
Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-5-200203050-00008 · Cited by 2,165 · see citing works
Burnout and Medical Errors Among American Surgeons
Shanafelt, T. D., Balch, C. M., Bechamps, G., Russell, T., Dyrbye, L., Satele, D., Collicott, P., Novotny, P. J., Sloan, J., & Freischlag, J. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181bfdab3 · Cited by 2,099 · see citing works
Burnout: 35 years of research and practice.
Schaufeli, W. B., Leiter, M. P., & Maslach, C. (2009) · Career Development International · doi:10.1108/13620430910966406 · Cited by 1,964 · see citing works
Physician wellness: a missing quality indicator
Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61424-0 · Cited by 1,608 · see citing works
Burnout and Suicidal Ideation among U.S. Medical Students
Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., et al. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-149-5-200809020-00008 · Cited by 1,532 · see citing works
Figley, C. R. (1995) · Cited by 1,461 · see citing works
Deering, D. (1996) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/0279-3695-19961101-26 · Cited by 1,356 · see citing works
Nurse Burnout and Patient Satisfaction
Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004) · Medical Care · doi:10.1097/01.mlr.0000109126.50398.5a · Cited by 977 · see citing works
Changes in medical errors after implementation of a handoff program
Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., Noble, E. L., Tse, L. L., Dalal, A. K., Keohane, C. A., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmsa1405556 · Cited by 947 · see citing works
Scott, S. D., Hirschinger, L. E., Cox, K. R., McCoig, M., Brandt, J., & Hall, L. W. (2009) · BMJ Quality & Safety · doi:10.1136/qshc.2009.032870 · Cited by 904 · see citing works
Shanafelt, T. D. (2011) · Archives of Surgery · doi:10.1001/archsurg.2010.292 · Cited by 869 · see citing works
Burnout–Depression Overlap: A Review
Bianchi, R., Schonfeld, I. S., & Laurent, E. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.01.004 · Cited by 868 · see citing works
Impact of Organizational Leadership on Physician Burnout and Satisfaction
Shanafelt, T. D., Gorringe, G., Menaker, R., Storz, K. A., Reeves, D., Buskirk, S. J., Sloan, J. A., & Swensen, S. J. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.01.012 · Cited by 723 · see citing works
Preventing occupational stress in healthcare workers
Ruotsalainen, J. H., Verbeek, J. H. A. M., Mariné, A., & Serra, C. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002892.pub5 · Cited by 627 · see citing works
Mid-Career Burnout in Generalist and Specialist Physicians
Spickard, A. (2002) · JAMA · doi:10.1001/jama.288.12.1447 · Cited by 554 · see citing works
Williams, E. S., Manwell, L. B., Konrad, T. R., & Linzer, M. (2007) · Health Care Management Review · doi:10.1097/01.hmr.0000281626.28363.59 · Cited by 517 · see citing works
Prevalence of Alcohol Use Disorders Among American Surgeons
Oreskovich, M. R. (2012) · Archives of Surgery · doi:10.1001/archsurg.2011.1481 · Cited by 505 · see citing works
Burnout contagion among intensive care nurses
Bakker, A. B., Blanc, P. M. L., & Schaufeli, W. B. (2005) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2005.03494.x · Cited by 464 · see citing works
Caring for Our Own: Deploying a Systemwide Second Victim Rapid Response Team
Scott, S. D., Hirschinger, L. E., Cox, K. R., McCoig, M., Hahn-Cover, K. E., Epperly, K. M., Phillips, E., & Hall, L. W. (2010) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(10)36038-7 · Cited by 456 · see citing works
A Multidimensional Theory of Burnout
Maslach, C. (1998) · Theories of Organizational Stress · doi:10.1093/oso/9780198522799.003.0004 · Cited by 445 · see citing works
The prevalence of substance use disorders in American physicians
Oreskovich, M. R., Shanafelt, T. D., Dyrbye, L. N., Tan, L., Sotile, W. M., Satele, D., West, C. P., Sloan, J. A., & Boone, S. L. (2015) · American Journal on Addictions · doi:10.1111/ajad.12173 · Cited by 430 · see citing works
Burton, A., Burgess, C., Dean, S., Koutsopoulou, G. Z., & Hugh‐Jones, S. (2017) · Stress and Health · doi:10.1002/smi.2673 · Cited by 412 · see citing works
Past performance and future perspectives of burnout research
Schaufeli, W. B. (2003) · SA Journal of Industrial Psychology · doi:10.4102/sajip.v29i4.127 · Cited by 309 · see citing works
A meta-analysis of observational studies identifies predictors of sickness absence
Duijts, S. F. A., Kant, I., Swaen, G. M. H., van den Brandt, P. A., & Zeegers, M. P. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.04.008 · Cited by 284 · see citing works
Predictors of nurse absenteeism in hospitals: a systematic review
Davey, M., Cummings, G. G., Newburn‐Cook, C. V., & Lo, E. (2009) · Journal of Nursing Management · doi:10.1111/j.1365-2834.2008.00958.x · Cited by 264 · see citing works
Preventing occupational stress in healthcare workers
Ruotsalainen, J. H., Verbeek, J. H. A. M., Mariné, A., & Serra, C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002892.pub3 · Cited by 220 · see citing works
Predictors and Outcomes of Burnout in Primary Care Physicians
Rabatin, J. S., Williams, E. S., Manwell, L. B., Schwartz, M. D., Brown, R., & Linzer, M. (2015) · Journal of Primary Care & Community Health · doi:10.1177/2150131915607799 · Cited by 215 · see citing works
Quality of Life During Orthopaedic Training and Academic Practice
Sargent, M. C., Sotile, W. M., Sotile, M. O., Rubash, H. E., & Barrack, R. L. (2009) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.h.00665 · Cited by 204 · see citing works
The Psychology of Fatigue: Work, Effort and Control
Hockey, R. J. (2013) · Cited by 187 · see citing works
Handbook of Occupational Health and Wellness
Gatchel, R. J., & Schultz, I. Z. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4839-6 · Cited by 151 · see citing works
Theories of Psychological Stress at Work
Dewe, P. J., O’Driscoll, M. P., & Cooper, C. L. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4839-6_2 · Cited by 147 · see citing works
Burnout and associated factors among members of the Society of Gynecologic Oncology
Rath, K. S., Huffman, L. B., Phillips, G. S., Carpenter, K. M., & Fowler, J. M. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.07.036 · Cited by 120 · see citing works
Burnout Levels and Self-Rated Health Prospectively Predict Future Long-Term Sickness Absence
Peterson, U., Bergström, G., Demerouti, E., Gustavsson, P. J., Åsberg, M., & Nygren, Å. (2011) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e318222b1dc · Cited by 110 · see citing works
Destructive Organizational Communication
(2010) · Routledge eBooks · doi:10.4324/9780203928554 · Cited by 108 · see citing works
(2012) · PubMed · Cited by 72 · see citing works
Team Function in Obstetrics to Reduce Errors and Improve Outcomes
Nielsen, P. E., & Mann, S. (2008) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2007.12.011 · Cited by 44 · see citing works
Burnout experienced by nurse-midwives
COLEBEAVER, R., Sharp, E. S., & Cotsonis, G. (1986) · Journal of Nurse-Midwifery · doi:10.1016/0091-2182(86)90174-6 · Cited by 42 · see citing works
Gabbe, S. G., Webb, L. E., Moore, D. E., Mandel, L. S., Melville, J., & Spickard, W. A. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.11.004 · Cited by 36 · see citing works
Kim, W. C., & Mauborgne, R. A. (2014) · PubMed · Cited by 31 · see citing works
THEORIES OF ORGANIZATIONAL STRESS
Koslowsky, M. (2008) · Routledge eBooks · doi:10.4324/9780203024102-4 · Cited by 29 · see citing works
Anewalt, P. (2009) · Home Healthcare Now · doi:10.1097/01.nhh.0000364181.02400.8c · Cited by 28 · see citing works
Block, M. S., Ehrenworth, J. F., Cuce, V. M., Ng’ang’a, N., Weinbach, J., Saber, S. B., Milic, M., Urgo, J. A., Sokoli, D., Schlesinger, M. D., et al. (2013) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(13)39028-x · Cited by 26 · see citing works
Blue ocean leadership. (cover story)
Kim, W. C., & Mauborgane, R. (2014) · Harvard business review · Cited by 17 · see citing works
Tessmer-Tuck, J. A., & Rayburn, W. F. (2015) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2015.05.004 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Yates, S. W. (2019) · The American Journal of Medicine · doi:10.1016/j.amjmed.2019.08.034 · Cited by 374 · see citing works
Mihailescu, M., & Neiterman, E. (2019) · BMC Public Health · doi:10.1186/s12889-019-7661-9 · Cited by 110 · see citing works
Braun, S. E., Kinser, P. A., & Rybarczyk, B. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/iby059 · Cited by 56 · see citing works
Bourne, T., Cock, B. D., Wynants, L., Peters, M., Audenhove, C. V., Timmerman, D., CALSTER, B. V., & Jalmbrant, M. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-017856 · Cited by 55 · see citing works
Turner, T. B., Dilley, S. E., Smith, H. J., Huh, W. K., Modesitt, S. C., Rose, S. L., Rice, L. W., Fowler, J. M., & Straughn, J. M. (2017) · Gynecologic Oncology · doi:10.1016/j.ygyno.2017.06.026 · Cited by 43 · see citing works
Doherty, J., & O’Brien, D. (2022) · Women and Birth · doi:10.1016/j.wombi.2022.02.003 · Cited by 33 · see citing works
Exploring Factors that Affect the Well-Being of Healthcare Workers
Tomo, A., & Simone, S. D. (2017) · International Journal of Business and Management · doi:10.5539/ijbm.v12n6p49 · Cited by 29 · see citing works
Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness
Braun, S. E., Kinser, P., Carrico, C. K., & Dow, A. (2019) · Global Advances In Health and Medicine · doi:10.1177/2164956118820064 · Cited by 25 · see citing works
Delany, C. M., Jones, S., Sokol, J., Gillam, L. H., & Prentice, T. M. (2021) · Journal of Bioethical Inquiry · doi:10.1007/s11673-021-10140-0 · Cited by 22 · see citing works
Rauf, A., Rook, L., Rajapakse, B. N., Lartey, J. K. S., & Almeida, S. (2024) · Stress and Health · doi:10.1002/smi.3461 · Cited by 20 · see citing works
Burnout in Nurses Working With Youth With Chronic Pain: A Pilot Intervention
Rodrigues, N. P., Cohen, L. L., McQuarrie, S. C., & Reed-Knight, B. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx132 · Cited by 18 · see citing works
Early career professionals: A challenging road
Kulkarni, K. P., Muia, J., Boulaftali, Y., Blondon, M., & Lauw, M. N. (2018) · Research and Practice in Thrombosis and Haemostasis · doi:10.1002/rth2.12070 · Cited by 12 · see citing works
Development and Initial Psychometric Testing of the Midwifery Practice Climate Scale ‐ Part 2
Thumm, E. B., Shaffer, J. A., & Meek, P. (2020) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13160 · Cited by 10 · see citing works
Providing Doctors with Trained Administrative Support Staff and Its Effect on Doctor Workload
Gollner, E., & Szabó, B. (2017) · doi:10.18690/978-961-286-087-5.11 · Cited by 7 · see citing works
Stress and Quality of Life in Nurses Working at Different Clinical Departments
Lučanin, J. D., Arapović, M., & Lučanin, D. (2017) · doi:10.18690/978-961-286-087-5.3 · Cited by 7 · see citing works
Burnout and Work-Life Balance: A Review of Linkages and Mechanisms
Tement, S. (2017) · doi:10.18690/978-961-286-087-5.1 · Cited by 7 · see citing works
Enhancing Employees’ Performance through Organizational Care Policies in the Health Care Context
Tomo, A., & Todisco, L. (2018) · Public Administration Research · doi:10.5539/par.v7n1p5 · Cited by 8 · see citing works
Development and Initial Psychometric Testing of the Midwifery Practice Climate Scale
Thumm, E. B., & Meek, P. (2020) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13142 · Cited by 7 · see citing works
Staying in bounds: A framework for setting workplace boundaries to promote physician wellness
Herbst, R. B., Sump, C., & Riddle, S. W. (2023) · Journal of Hospital Medicine · doi:10.1002/jhm.13102 · Cited by 6 · see citing works
Caulfield, A., Plymoth, A., Nartey, Y. A., & Mölsted-Alvesson, H. (2020) · BMJ Global Health · doi:10.1136/bmjgh-2020-002334 · Cited by 5 · see citing works
Anger: an underappreciated destructive force in healthcare
Grunebaum, A. N., McLeod‐Sordjan, R., Pollet, S. L., Moreno, J., Bornstein, E., Lewis, D., Katz, A. A., Warman, A., Dudenhausen, J. W., & Chervenak, F. A. (2023) · Journal of Perinatal Medicine · doi:10.1515/jpm-2023-0099 · Cited by 4 · see citing works
Don’t forget your oxygen mask! Caring for ourselves so that we can better care for our clients
Rowley, A. (2021) · British Journal of Music Therapy · doi:10.1177/1359457521997793 · Cited by 3 · see citing works
Ang, A. A. C., & Soriano-Estrella, A. L. (2021) · Philippine Journal of Obstetrics and Gynecology · doi:10.4103/pjog.pjog_1_21 · Cited by 2 · see citing works
Getting outside of ourselves: Towards an other-oriented model of psychological health
Rosset, E., El-Jor, C., Kotsou, I., & Shankland, R. (2024) · International Journal of Wellbeing · doi:10.5502/ijw.v14i2.3561 · Cited by 2 · see citing works
Normative Perceptions and Medical Providers’ Help-Seeking Behavior in a Rural Health Setting
Terry, D. L., & Safian, G. (2023) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-023-09980-2 · Cited by 1 · see citing works
Physician Personal Well-Being and Resilience
Mastrogiannis, D. S., & Ballas, J. (2024) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2024.10.006 · Cited by 1 · see citing works
Quality of Care and Quality of Life
MINKOFF, H. L., O'Brien, J., & Berkowitz, R. L. (2024) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005681 · Cited by 1 · see citing works
Self-citationBettendorf, E. (2017) · ASA Monitor · doi:10.1097/01.asm.0001075804.30382.d9
Stress and Resources in Female and Male Physicians
Siller, H. U., Juen, B. H., & Hochleitner, M. (2017) · doi:10.18690/978-961-286-087-5.9
Toasted: Is burnout affecting otolaryngology trainee career decisions?
Abell, B. D., Fischman, V., Ramos, L., Cabrera‐Muffly, C., Getz, A. E., & Johnson, A. P. (2025) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2025.104735
Organizational Ethics in Health Care
(2018) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64113-078-320251017
Topical Haemostatic Agents In Modern Surgery: A Mechanism-Oriented Classification
Ceylan, S., Kürkçüoğlu, E., & Kandemir, T. (2026) · OSMANGAZİ JOURNAL OF MEDICINE · doi:10.20515/otd.1990954
- Authors
- Atallah, F., McCalla, S., Karakash, S., & Minkoff, H.
- Affiliations
- Maimonides Medical Center (US)
- Corresponding author
- Atallah, Fouad
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 215
- Issue
- 6
- Pages
- 731.e1-731.e6
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2514402592
- Cited by
- 37
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 14
- FWCI
- 13.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- burnout, healthcare workers, obstetricians and gynecologists, physician well-being, depression, burnout intervention, cognitive behavioral therapy, physician communication, working conditions
- MeSH terms
- Burnout, Professional, Communication, Depression, Gynecology, Health Promotion, Humans, Obstetrics, Physicians, Cognitive Behavioral Therapy, Resilience, Psychological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review