Burnout is a phrase that has permeated conversations around strain and shortages in the physician workforce for years — but it may not fully capture what physicians are experiencing within the systems they work.
“I think it’s on the continuum,” Michael Anderson, MD, a pediatrician and co-executive director of the Physician Leadership Institute, told Becker’s. “I think there’s mild burnout, there’s significant burnout and then there’s, ‘Oh my gosh, I can’t practice what I want to practice because of some sort of obstacle or some sort of burden.’ As I looked more in the definitions, burnout is that feeling of tiredness or frustration or what have you. But to me, moral injury is the inability of a physician to truly care for his or her patient. And obviously, the long term consequence of that moral injury can be really significant.”
Other physicians have echoed similar sentiments to Becker’s. Alan Falkoff, MD, a physician with Hartford (Conn.) Healthcare Medical Group, said that burnout had become a tired buzzword that failed to describe the true challenges physicians face in their day-to-day lives.
“There is no such thing [as burnout] and it places blame or failure on the physician,” he said. “What it is, is moral injury and harm to the individual physician created by the system under which they work.”
A study published in JAMA Network Open in March evaluated the “moral distress” of 5,741 physicians and 3,501 other U.S. healthcare workers from Oct. 19, 2023, to March 5, 2024. It found that the mean moral distress score among physicians was 3.29 on a four-point scale, with 39% reporting a score of four or higher.
Additionally, 30% of physicians surveyed with a moral distress score of less than four still reported other symptoms of burnout.
The consequences could have a serious impact on a workforce facing a projected shortage of 141,160 full-time equivalent physicians in 2038, according to a December report from the Health Resources and Services Administration.
“I think people become disillusioned and leave,” Dr. Anderson said. “I think the ultimate side effect of that is somebody leaving the practice early. People may cut down on their time just because they can’t take that much injury, if you will. And then I think there’s also the quiet quitters, the physicians that are just not practicing at the top of their game because they’re beat down so much, and all of those, collectively, lead to a weaker healthcare system.”
A 2025 survey by Jackson Physician Search and MGMA, found that 45% of physicians cite leadership or administration issues as a top reason for leaving their roles — more than any other factor.
While an overall decrease in autonomy and increase in administrative burden may be the primary driver of this trend, the problem is multifaceted.
“Our care has become so complex. You know, I’m an optimist. I think most pediatricians are. It’s an incredible time to practice medicine — think of all the advances that have been made over the past 20 years. When I trained, we barely knew what DNA or RNA was. Now we have, you know, DNA therapies that are positively affecting patients,” Dr. Anderson said.
“There’s so much more research and new progress, but then there’s a lot of barriers to providing care,” he continued. “The care has become very disjointed. There are tremendous administrative burdens that physicians have to have to jump through … . And I just think this complex, crazy system that has emerged is probably, to me, the primary driver of this moral injury.”
Turning to solutions, emerging technologies such as AI scribes are showing early signs of being able to reduce some of the burden placed on physicians.
Chicago-based CommonSpirit Health, for example, began rolling out ambient documentation tools alongside other digital initiatives to streamline clinicians’ workflows in 2025 — with positive initial results.
“Indicators suggest a positive trend,” John Chelico, MD, CommonSpirit’s chief medical information officer, told Becker’s. Documentation times are being tracked, surveys show clinicians feel more effective, and many have reported that the tools allow them to spend more time with patients.
But Dr. Chelico emphasized that software alone will not fix the problem.
“Moral distress, compassion fatigue and systemic workflow pressures are more complex to resolve,” he said.
Dr. Anderson echoed a similar sentiment, emphasizing that AI tools are only as effective as the hands they’re placed in — and who decides where they’re implemented.
“These tools help patients, but also, are they making sure that the physicians have a voice in how they’re used and how they support their work as well?” he said. “I think more and more younger physicians are saying, ‘I’m not going to be employed by your institution or your medical group if you don’t have an AI scribe or something that at least makes my job have a little less drag on the aircraft.'”
Dr. Anderson is hopeful that the incoming generation of physicians will continue to advocate for solutions that benefit patients and physicians while working within the complexities and financial realities of healthcare systems in 2026.
“I’m seeing physicians who want to be a part of the solution. More and more, the physician leaders that are approaching us for coaching, mentoring, development and catalyzing their leadership journey — they want to be a part of the solution,” he said.
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