Extinguishing burnout

By Megan Bennett, Staff Writer, January 1, 2026

About five years into her practice, Lisa Swanson, MD, FAAD, began feeling the symptoms of occupational burnout.

“It’s kind of an insidious process where it’s probably been creeping up for a while, but it feels like it hits you suddenly,” explained Dr. Swanson, a pediatric dermatologist at Ada West Dermatology and St. Luke’s Boise Medical Center in Idaho.

Burnout in the workplace is often defined by three characteristics: emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Dr. Swanson cites several factors that led to her overextension. Pediatric dermatology in private practice wasn’t as common when she entered the field 15 years ago. She rarely said no to opportunities while establishing her practice, and the productivity structure tied to her compensation left her feeling like she couldn’t take time off and she “had to keep grinding away like a hamster on a wheel every day in clinic.” The adoption of electronic health records (EHR), she explained, also created more administrative tasks per patient and work hours put in from home.

“You don’t feel like going the extra mile as much anymore,” Dr. Swanson recalled. “I found that sometimes I would lose my empathy. Even though I feel like a very empathetic person, when I was deep in burnout, you get kind of calloused to it all.”

Dr. Swanson read several books on burnout, educating herself on wellness and work-life balance. She now gives presentations to other dermatologists about burnout, a pervasive issue among all medical specialties. But when it comes to treating burnout, she likened it to a chronic skin condition.

“It’s not just, ‘Oh I was burned out and now I’m all better,’” she said. “Once you’ve been burned out, it’s a condition you manage through the years.”

Burnout rages on, despite dip after COVID

According to figures from a national study of U.S. physicians led by Stanford and published in July 2025, nearly half of U.S. physicians had at least one symptom of burnout between 2023-2024 (45.2%) when assessed using standardized instruments. While this was a decline from 2021 — when burnout peaked amid the COVID-19 pandemic at 62.8% — it remains at similar levels compared to when the study investigators began collecting this information in 2011. Physicians are also 82% more likely to experience burnout compared to U.S. workers in other fields (doi: 10.1016/j.mayocp.2024.11.031).

“The pandemic did galvanize attention for some organizations that had not previously been paying attention to how critical the well-being of the workforce is for productivity,” said Tait Shanafelt, MD, the lead author on the study and a physician burnout expert. Dr. Shanafelt is a physician in Stanford Hospital’s department of medicine and Stanford Medicine’s chief wellness officer.

“For many organizations, that was a bit of a wakeup call, and they launched organization-level efforts to improve well-being for physicians and other health care workers.”

Burnout in dermatology

While dermatology has historically had higher rates of satisfaction compared to other specialties, burnout rates have increased in the last 15 years. In the 2025 Medscape Physician Mental Health and Wellbeing Report, 46% of dermatologists reported dealing with burnout, compared to 47% of physicians across specialties; the same study done in 2011 reported 31.8%. The 2025 figures were higher among millennial dermatologists (63%) and women (62%). Every career stage and setting has burnout risks, said Faiza Wasif, MPH, the Academy’s associate director of practice management.

“Dermatologists in the early stages of their careers may be more vulnerable as they navigate demanding workloads, establish new practices, or adapt to the complex realities of modern health care delivery,” she explained. “Younger physicians may also be balancing significant professional growth with personal responsibilities, which can heighten stress levels and contribute to fatigue.”

“At the same time, dermatologists in mid-career stages are not immune to burnout,” Wasif added. “Sustained administrative demands, workforce shortages, and evolving practice models can also contribute to feelings of exhaustion or frustration over time.”

Administrative burden is a common cause of burnout across all specialties, as AAD members can attest. The tasks are only growing in volume and complexity, Wasif said.

Heavy administrative loads can be especially overwhelming for dermatologists due to their high patient volume.

“Once you’ve been burnt out, it’s a condition you manage through the years.”

“If a dermatologist in an outpatient setting is seeing 30 patients a day, then it stands to reason that an additional 90-second to two-minute task is going to add 45 minutes to an hour of work a day,” said Kiran Motaparthi, MD, FAAD, professor of dermatology at the University of Florida who has studied dermatologist burnout (doi: 10.1016/j.clindermatol.2020.02.002). “None of us is capable of creating an extra hour in the day.”

“Another contributor to chronic stress is insurance regulations and the preapproval process, especially with the roadblocks the specialty can face for treatment and medication approvals,” said Diane Whitaker-Worth, MD, FAAD, a dermatologist at the University of Connecticut Health Center.

Dermatology is also one of the specialties with the most women practicing. In 2025, 56% of AAD members were women. Both in medicine and other occupations overall, women experience higher risk of burnout. A 2020 International Journal of Women’s Dermatology article pointed out that this is despite the fact that women dermatologists are more likely to work part time (doi: 10.1016/j.ijwd.2019.08.004).

Dr. Whitaker-Worth, the publication’s coauthor, suggested this imbalance is likely because women often assume more off-the-clock responsibilities, including childcare and household tasks.

“People may continue to seek part-time employment rather than full-time employment or may not take on leadership roles if they don’t have the support in the home,” she said. “I don’t know that it’s going to get worse on the home side of things. I think as gender roles change over time, women are more comfortable not taking on all that stuff. But I think in the workplace, for now, it’s only going to be worse.”

Women physicians also disproportionately experience mistreatment from patients, Dr. Shanafelt said. There is research showing women will receive more patient messages compared to men with comparable positions and patient counts.

“That might be a marker of them doing a very good job building relationships with their patients, being approachable, and/or patients feeling that they can reach out with concerns,” he explained. “But it creates this extra work. I think that is a really enlightening example of something that is not easy to see.”

Burnout in the current health care landscape

For many large medical organizations, inflation and today’s declining Medicare reimbursements lead to cost reductions and a “do more with less” mindset, said Dr. Shanafelt, resulting in more clinic visits.

He and other physicians also described a more polarized society today than in recent memory, leading to angrier patients and an increasing risk of mistreatment or violence.

“There is a growing lack of patience among patients,” said William Huang, MD, MPH, FAAD, professor and vice chair for Strategic Initiatives at the University of North Carolina School of Medicine’s Department of Dermatology in Chapel Hill. Dr. Huang has studied burnout in academic dermatologists. “The ideal experience from a patient perspective is: I get checked in on time. I have almost no wait time before the doctor comes into the room. The doctor spends a significant amount of time with me. I get all my concerns addressed during a single visit. I leave and get all the medicines that I am prescribed covered completely by my insurance. The doctor responds immediately to my messages in the patient portal. Each of these can be a potential pain point during a patient encounter.”

Dr. Swanson added, “I think doctors as a whole don’t garner the respect that we used to. Everybody can get on Google and use AI, so sometimes they come in with preconceived ideas as to their diagnosis or the appropriate treatment for them. The other factor is that society is used to getting everything really fast. We can order something online today, and it’ll be at our house tomorrow if not later today. People want to be seen sooner and want improvements sooner.”

What’s at stake?

The most discussed consequences of physician burnout are deceased levels of quality care, higher risk of medical errors, and patient dissatisfaction. But there are other wider-reaching effects. For some institutions, the cost could be literal. Some studies estimate that turnover can cost upward of $1 million per doctor.

Burnout can also cause mental health decline. A 2021 JAAD study estimated that 19% of dermatologists have experienced suicidal ideation, though the causes were not specifically linked to burnout (10.1016/j.jaad.2021.04.057). However, a 2017 study published by Dr. Shanafelt and colleagues found that 40% of physicians were reluctant to seek mental health care out of concern that it would prevent them from receiving or renewing their license (doi: 10.1016/j.mayocp.2017.06.020).

“We all spent hundreds of thousands of dollars on our education and years of training to get to where we are,” said Dr. Huang. “Then, over time, let’s say we become burned out, we make more patient care errors, and we’re producing lower-quality care. If we seek care, we fear that we can get punished or stigmatized for getting help. Think about the message we are sending here.”

Burnout and doctor shortages

This phenomenon could also worsen the country’s projected physician shortages. A 2021 Association of American Medical Colleges study projects the U.S. could have an estimated shortage of 86,000 physicians by 2034.

“We have a generation of doctors right now that are going through training and are potentially thinking, ‘You know what? Maybe I don’t want to see patients for my career,’” said Dr. Huang. “‘Maybe I want to have a career in industry. Maybe I want a career as an influencer in the [medical] space.’ They may have been mentored by someone who they saw was burned out or retired early because of it. If these physicians don’t go into patient care, then our physician shortages worsen.”

Dr. Motaparthi said he’s seen colleagues seek administrative roles to lessen the burden. This isn’t inherently a bad thing — he thinks dermatologists need more representation in institutional leadership — but it can have a negative effect if leaders are too far removed from the work they oversee.

“They just can’t take it anymore and deal with the clinic and the inbox four days a week,’” Dr. Motaparthi added. “It’s too much. They say they can’t do that many surgeries a week anymore. They can’t take care of people the way they want to. They tell me, ‘I can’t teach, meet the productivity requirements, manage the inbox, and take care of my own kids. I need a day off. That’s why I’m trading a day of clinical work in for a day of meetings and emails.’”

Dr. Shanafelt also warns that shortages will be worse for institutions that don’t properly address workplace wellness.

“The competition for talent is going to become quite substantial,” said Dr. Shanafelt. “Organizations that do this well — that create more optimal work environments, lessen unnecessary burden in the work, and create a meaningful and fulfilling place to practice — are going to have an advantage recruiting and retaining talent. I think those that don’t attend to it are going to be left behind.”

Changing the culture

In a 2021 publication, Dr. Shanafelt broke down the three phases of the “Physician Well-Being Movement” for medical institutions: the era of distress, Well-Being 1.0, and Well-Being 2.0. (doi: 10.1016/j.mayocp.2021.06.005). The 1.0 stage is primarily about acknowledging the issue, offering more individual-focused initiatives like stress reduction and resilience training. The 2.0, however, is a shift toward eliminating burnout’s root causes.

For example, if a Well-Being 1.0 strategy is to provide doctors with tips to optimize EHR technology, 2.0 would include developing team-based documentation and order entry practices, demanding better products from vendors, collaborating with vendors and regulatory bodies to reform documentation requirements, and tracking EHR to assess and address efficiency and burdens.

Most organizations are in the late phases of 1.0, Dr. Shanafelt said, but he’s seen a growing interest in their evolution. In 2025, 109 health care organizations were recognized by the AMA’s Joy in Medicine program, which celebrates those trying to systemically combat burnout. In 2019, its inaugural year, there were only 22.

“It’s still early days and there’s more to do,” said Dr. Shanafelt. “I think one of the things that is a bit of a barrier for some organizations is they’re still stuck in this mindset that making these changes will require large financial investment and they can’t advance physician well-being while simultaneously prioritizing other elements — expanding access, improving quality, reducing some elements of waste and cost expense — instead of recognizing that these are interrelated priorities.”

In the current corporate wellness movement, Dr. Motaparthi sees too much responsibility being placed on the individual rather than the larger medical system. Commonly promoted practices — like meditation, exercise, and staff bonding activities — don’t change the bigger picture, he said, referencing a 2020 JAMA Internal Medicine publication. In that two-year study of a university’s employee wellness program, participants had improved perceptions of their own well-being but no notable improvements in measurable health outcomes or in use of health services (doi: 10.1001/jamainternmed.2020.1321).

“We should pay attention to studies like that and accept the fact that the current wellness culture isn’t working. Rather than always adding, we have to backtrack and look at what we can take off of everyone’s plate so they can do their work more efficiently and provide the best care,” said Dr. Motaparthi. “We need the best at diagnosing, treating, and teaching; we don’t need the best at utilizing electronic health records.”

Dr. Swanson is encouraged by local actions. As of September 2025, 40 medical licensure boards have removed questions about mental health from medical license applications. The Idaho Medical Association, in partnership with several other local groups, created the Physician Vitality Program. The initiative offers members free and confidential appointments with mental health experts. Many hospitals have also updated their own credentialing questions in a congruent manner.

Nationwide initiatives to de-stigmatize mental health treatment for physicians include the Physician Support Line (888-409-0141) — a free, confidential resource created in 2020 for doctors and medical students — and the Dr. Lorna Breen Health Care Provider Protection Act. Signed into law in 2022 with bipartisan support, it provides federal grants for mental health programs for doctors.

“The more resources that can be devoted to giving physicians a space to talk about this and not fear penalty or retribution, the more you’re going to see physicians ask for the help they need rather than just coping and falling into deeper despair,” said Dr. Swanson.

Caring for self and one another

The Academy’s Practice Management Center offers resources designed to ease doctors’ busy work, including tools to simplify EHR documentation and prior authorization appeal letter templates for more than 70 drugs.

“All of these resources are aimed at one goal: helping members do more of what they love — caring for patients and advancing dermatology — and less of what they don’t enjoy,” Wasif said.

Personal care strategies are important to Dr. Swanson. She makes music playlists to lift her mood and tries to take unplugged vacations. In the office, she blocks off one day on her calendar each month to not see patients and uses that time to reflect and recharge. Dr. Swanson said she also makes a point to thank colleagues through notes and gift cards.

But if self-help strategies have limitations, and structural change is slow-moving, how can dermatologists help one another in the meantime?

Taking inspiration from other health care professions, Dr. Whitaker-Worth said physicians should better embrace collective advocacy to eliminate excessive oversights and create better support structures, like dividing up administrative work with non-physician staff.

“That’s the kind of support that would help so that physicians can just take care of patients, which is really what we want to do,” she said. “That’s part of the reason why I think advocacy involvement has been a tough sell because it takes time away from taking care of patients. People have to be politically minded and get out there and offer solutions for the health care systems’ problems.”

But she’s hopeful that the upcoming generation of physicians is more willing to challenge the status quo. “I think they recognize there are forces that do not have their best interest at heart, and that there’s not necessarily a need to just always say, ‘OK, that’s fine,’” said Dr. Whitaker-Worth. “They really do feel work life-balance is much more important, whereas in the old days people would just dedicate their whole lives to medicine and let their personal lives suffer. I don’t think people are willing to do that any longer.”

Additional DermWorld Resources