GoodWork Paper 49: “On Fire” or “Burned Out"? Engagement and Burnout in Physicians

Author(s): Kerri Johnson

Editor(s): Howard Gardner, Series Editor

Media: Paper

Description: In addition to the existing criteria of “excellent” and “ethical,” recently the GoodWork® model was expanded to include a third “E” criterion: the work should be engaging to the employee. Engagement is an intriguing addition to the GoodWork® model because, unlike excellence and ethics, it would seem possible to have too much of a good thing. In this paper, I detail concretely how engagement fits into the GoodWork® model, looking specifically at the line between engagement and over engagement, and the implications of over engagement for producing good work. Using existing transcripts from the GoodWork® in Medicine project as well as conducting original interviews, I conducted a two-part study of engagement and over engagement in physicians. Findings from this study are grouped into themes of meaningful work, impact of patient interaction, work-life balance, burnout, and restrictions to residents‘ work hours. Drawing on a model of engagement and burnout originated by Maslach (1982), I argue that there exists a separate state of “over engagement” that is a frequent contributing variable to burnout. Finally, I propose a model of the relationships among engagement, over engagement, burnout, and professional identity that provides an alternate explanation for the route from long work hours to fatigue.