Professional burnout of doctors: Causes, consequences and prevention at individual, organizational and systemic levels (scientific and practical review)

Introduction. One of the urgent issues of modern healthcare is the professional burnout of doctors. It has been proven to affect the sustainability of healthcare, the quality and safety of medical care, staff turnover, and economic aspects.

Aim. To summarize international and Russian data on the prevalence, determinants, and consequences of physician burnout, as well as to formulate applied prevention recommendations.

Materials and methods. A narrative review has been prepared with elements of systematization based on searches in PubMed/ Medline, Scopus, Cochrane Library, eLIBRARY.RU, documents of the Ministry of Health of the Russian Federation and relevant organizations. Priority: publications of the last 10 years (emphasis on 5 years), meta-analyses, large cross-sectional studies, national reports, validated burnout measurement tools (MBI and alternatives). Inclusion criteria: studies among doctors of clinical specialties describing prevalence, risk factors, determinants, and interventions. Exclusion criteria: uncensored opinions without data, irrelevant populations, opaque samples.

Results. Physician burnout has a multifactorial nature and significant variability in prevalence, depending on the measurement methodology and the context of the healthcare system. The most persistent determinants include resource overload and scarcity, administrative and digital workload, reduced autonomy, conflict of values, and an insecure organizational culture. The most evidence – based approaches to prevention are organizational and systemic changes, since individual interventions have a moderate effect and do not compensate for structural deficits. The context of reforms and managerial transformations over the past 30 years, the COVID-19 pandemic, staff shortages, and the imbalance between key performance indicators and clinical autonomy are critically important for Russia.

Conclusion. Burnout prevention requires a shift from “individualizing the problem” to managing working conditions and system resources. Combined strategies are promising for the Russian Federation: workload rationing, reducing bureaucracy, supporting primary care and young professionals, developing a team model, confidential psychological assistance programs, and “smart digitalization” as a tool to reduce routine rather than increase it.

1. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 4th ed. Menlo Park, CA: Mind Garden; 2018. 76 p. Available at: https://www.mindgarden.com/maslach-burnout-inventory/685-mbi-manual.html.

2. Haslam A, Olivier T, Tuia J, Prasad V. Systematic Review and Meta-Analysis of Randomized Trials Testing Interventions to Decrease Physician Burnout. Am J Med. 2024;137(3):243–253.e13. https://doi.org/10.1016/j.amjmed.2023.10.028.

3. Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Wang H et al. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2023. Mayo Clin Proc. 2025;100(7):1142–1158. https://doi.org/10.1016/j.mayocp.2024.01.034.

4. Kalani SD, Azadfallah P, Oreyzi H, Adibi P. Interventions for Physician Burnout: A Systematic Review of Systematic Reviews. J Healthc Leadersh. 2018;10:1–12. https://doi.org/10.2147/JHL.S170709.

5. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X

6. Khalfin RA, Smolnikova PS, Stolkova AS Burnout among health care workers: a pressing problem for health care management. National Health Care (Russia). 2023;4(2):40–46. (In Russ.) https://doi.org/10.47093/2713-069X.2023.4.2.40-46.

7. Kazanfarova MA, Veldanova MV, Prirodnova OF, Ardashirova NS, Zhulina YS, Chistyakova SYu. Digital competencies in medical practice: results of a survey of 18 000 physicians and nurses on the continuous medical and pharmaceutical education portal. Medical Doctor and Information Technology. 2024;(2):52–67. (In Russ.) https://doi.org/10.25881/18110193_2024_2_52.

8. Seliverstov PV, Kryukov EV, Grinevich VB. Practical implementation of artificial intelligence technologies during preventive medical examination. Meditsinskiy Sovet. 2025;19(13):282–288. (In Russ.) https://doi.org/10.21518/ms2025-322.

9. Kobyakova OS, Levko AN, Bakhteeva AV, Chernov DY, Malkova AA, Chigrina VP et al. Occupational burnout of doctors: characteristics of generations. Medical Journal of the Russian Federation. 2021;27(3):205–216. (In Russ.) https://doi.org/10.17816/0869-2106-2021-27-3-205-216.

10. Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA. Prevalence of Burnout Among Physicians: A Systematic Review. JAMA. 2018;320(11):1131–1150. https://doi.org/10.1001/jama.2018.12777.

11. Talbot SG, Dean W. Physicians aren’t ‘burning out.’ They’re suffering from moral injury. STAT News; 2018. Available at: https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury.

12. Grumbach K, Willard-Grace R. Health Worker Burnout and Moral Injury: Drivers, Effects, and Remedies. Annu Rev Public Health. 2025;46(1):447–465. https://doi.org/10.1146/annurev-publhealth-071823-122832.

13. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C et al. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018;178(10):1317–1331. https://doi.org/10.1001/jamainternmed.2018.3713.

14. Kuznetsova MA, Vasilyeva TP, Zudin AB, Gruzdeva OA, Kuznetsova KYu. Study of factors influencing the psychosocial and professional characteristics of general practitioners (family doctors): validation of the international questionnaire COPSOQ III (Long version). Zdravookhranenie Rossiiskoi Federatsii. 2024;68(4):315–322. (In Russ.) https://doi.org/10.47470/0044-197X-2024-68-4-315-322.

15. Smolnikova PS, Trunkova KS, Madyanova VV, Khalfin RA. The prevalence of emotional burning-out syndrome of medical workers in the Russian Federation: Systematic review and meta-analysis. Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(3):387–399. (In Russ.) https://doi.org/10.32687/0869-866x-2023-31-3-387-399.

16. Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C et al. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017;177(2):195–205. https://doi.org/10.1001/jamainternmed.2016.7674.

17. Hagqvist E, Ekberg K, Lidwall U, Nyberg A, Landstad BJ, Wilczek A et al. The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians. Chronic Stress. 2022;6. https://doi.org/10.1177/24705470221083866.

18. Matyushkina YeYA, Blinova OA, Shishkova MB. Occupational stress and burnout among healthcare professionals. Sovremennaia Zarubezhnaia Psikhologiia. 2020;9(1):29–38. (In Russ.) https://doi.org/10.17759/jmfp.2020090104.

19. Brulin E, Wilczek A, Ekberg K, Lidwall U, De Beer LT, Hadzibajramovic E et al. Predictive value of burnout complaints and depressive symptoms for medically certified sickness absence among physicians in Sweden: a 1 year follow-up observational study. BMJ Open. 2025;15(4):e090966. https://doi.org/10.1136/bmjopen-2024-090966.

20. Samofalov DA, Chigrina VP, Tyufilin DS, Chargasia LD, Kitnuk KG, Kobyakova OS, Deev IA. Professional burnout and quality of life of physicians in the Russian Federation in 2021. Social Aspects of Population Health. 2023;69(1):1. (In Russ.) Available at: http://vestnik.mednet.ru/content/view/1445/30/lang,ru.

21. Babanov SA, Ostryakova NA, Strizhakov LA, Melentyev AV, Lysova MV. Prediction and prevention of burnout syndrome in health care professionals in high epidemic risk settings. Profilakticheskaya Meditsina. 2025;28(4):51–56. (In Russ.) https://doi.org/10.17116/profmed20252804151.

22. Shaderkina VA, Krasnyak IV. Physician burnout: the hidden healthcare crisis. Results of an online survey of doctors. Russian Journal of Telemedicine and eHealth. 2022;8(4):7–20. (In Russ.) https://doi.org/10.29188/2712-9217-2022-8-4-7-20.

23. Bezymyannyy AS, Mingazova EN. The professional burnout of medical workers and its determining factors. Problemy Sotsial Noi Gigieny I Istoriia Meditsiny. 2024;32(2):180–186 (In Russ.) https://doi.org/10.24412/1561-7785-2025-4-227-235.

24. Khalfin RA, Smolnikova PS, Stolkova AS. Burnout among health care workers: a pressing problem for health care management. National Health Care (Russia). 2023;4(2):40–46. (In Russ.) https://doi.org/10.47093/2713-069X.2023.4.2.40-46.

25. Yakovlev VV. Emotional burnout of residents studying at a medical university and directions of its psychological correction. Personality in a Changing World: Health, Adaptation, Development. 2023;11(3):231–238. (In Russ.) https://doi.org/10.23888/humJ2023113231-238.

26. Pogosova NV, Isakova SS, Sokolova OY, Ausheva AK, Zhetisheva RA, Arutyunov AA. Occupational Burnout, Psychological Status and Quality of Life in Primary Care Physicians Working in Outpatient Settings. Kardiologiya. 2021;61(6):69–78. (In Russ.) https://doi.org/10.18087/cardio.2021.6.n1538.

27. Seliverstov PV, Bakaeva SR, Shapovalov VV, Aleshko OV. Telemedical technologies: from theory to practice. Meditsinskiy Sovet. 2022;16(23):366–372. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-23-366-372.

28. Zolotov AA, Panikarova SV. Staffing shortages in regional healthcare: Myths, Causes, Solutions. Vocational Education and Labour Market. 2025;13(1):75–94. (In Russ.) https://doi.org/10.52944/PORT.2025.60.1.005.

29. Babich AM, Minazhetdinova DI, Fedun AS, Lobacheva AS. The concept of the culture of “well-being” of employees and its implementation in russian organizations. Management of the Personnel and Intellectual Resources in Russia. 2023;(5):49–53. (In Russ.) https://doi.org/10.12737/2305-7807-2023-12-5-49-53.

30. Sukhanova EI. Moral distress as a factor in the development of professional burnout syndrome. Neonatology: News, Opinions, Training. 2025;13(2):91–94. (In Russ.) https://doi.org/10.33029/2308-2402-2025-13-2-91-94.

31. Borges do Nascimento IJ, Abdulazeem HM, Vasanthan LT, Martinez EZ, Zucoloto ML, Østengaard L et al. The global effect of digital health technologies on health workers’ competencies and health workplace: an umbrella review of systematic reviews and lexical-based and sentence-based meta-analysis. Lancet Digit Health. 2023;5(8):e534–e544. https://doi.org/10.1016/S2589-7500(23)00092-4.

32. Hodkinson A, Zhou A, Johnson J, Geraghty K, Riley R, Zhou A et al. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ. 2022;378:e070442. https://doi.org/10.1136/bmj-2022-070442.

33. Seliverstov PV. Psychology of patient adaptation to the use of artificial intelligence in screening for chronic noncommunicable diseases. Meditsinskiy Sovet. 2024;(23):266–272. (In Russ.) https://doi.org/10.21518/ms2024-551.

34. Gluschkoff K, Hakanen JJ, Elovainio M, Vänskä J, Heponiemi T. The relative importance of work-related psychosocial factors in physician burnout. Occup Med. 2022;72(1):28–33. https://doi.org/10.1093/occmed/kqab171.

35. Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol. 2019;10:284. https://doi.org/10.3389/fpsyg.2019.00284.

36. Ryan E, Kaminsky L, Deason K, Becker-Haimes EM. The relationship between physician burnout and depression, anxiety and suicidality: a systematic review. Front Public Health. 2023;11:1133484. https://doi.org/10.3389/fpubh.2023.1133484.

37. Tavella G, Hadzi-Pavlovic D, Bayes A, Jebejian A, Manicavasagar V, Walker P, Parker G. Burnout and depression: Points of convergence and divergence. J Affect Disord. 2023;339:561–570. https://doi.org/10.1016/j.jad.2023.07.095.

38. Bentulila Y, Greenberg D, Hoffman A, Steiner-Birmanns B, Shiyovich A. Physical work environment and burnout among primary care physicians in Israel. BMC Prim Care. 2024;25(1):37. https://doi.org/10.1186/s12875-024-02310-x.

39. Christiansen F, Gynning BE, Lashari A, Zuberbühler JP, Johansson G, Brulin E. Associations between job demand-control-support and high burnout risk among physicians in Sweden: a cross-sectional study. J Occup Med Toxicol. 2024;19(1):42. https://doi.org/10.1186/s12995-024-00441-6.

40. Shanafelt TD, West CP, Dyrbye LN, Trockel M, Tutty M, Wang H et al. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clin Proc. 2022;97(12):2248–2258. https://doi.org/10.1016/j.mayocp.2022.09.002.

41. Kolennikova OA. Using digital technologies by medical professionals. Population. 2022;25(3):189–199. (In Russ.) https://doi.org/10.19181/popuLation.2022.25.3.15.

42. Neplyueva GA, Solovieva AE, Krivopolenova SD, Solovyov AE, Zaitsev VV, Zvartau NE et al. Prevalence of professional burnout among practicing cardiologists in the constituent entities of the Russian Federation. Russian Journal of Cardiology. 2023;28(1S):5320. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5320.

43. Mingazov AF, Lukomskiy IS, Khabibullina LR, Khomyakov EA. Risk factors of burnout among physicians (results of public survey). Koloproktologia. 2022;21(4): 60–67. (In Russ.) https://doi.org/10.33878/2073-7556-2022-21-4-60-67.