Physician burnout has garnered significant attention. In a PubMed search from 2020 to April 2022, more than 7000 articles were returned on it [1]. As physician burnout remains a timely topic, investigating its history, evolution, results, and solutions is relevant.

Physician burnout researchers introduce burnout as a concept simultaneously and independently recognized by Freudenberger and Maslach in the 1970s ^[2][3][4][2,3,4]. Yet Fredenberger coined the term with his 1974 publication [5] regarding his observations of volunteer service providers of alternative organizations, and Maslach states the primacy of this work in her 1976 publication [6]—the first of hers on this topic—that includes reports on physicians among other professionals. Both publications are narratives. Frendenberger references only three publications—his own—and Maslach cites none. It is unusual in academic assessments that recognition is given to narrative researchers as the founders of a topic of study [7]—making the scale and impact of their contribution all the more remarkable. An author on physician burnout who has recognized the priority of Fredenberger’s publication over that of Maslach presents the subsequent research of Maslach with Jackson for developing the most widely accepted standard for burnout assessment—the 1981 Maslach Burnout Inventory (MBI) [8]—including a Human Services Survey applicable to healthcare professionals [9]. The 2005-created [10] Copenhagen Burnout Inventory (CBI) now represents an additional esteemed method for burnout assessment [11]. With his death in 1999 [12], publications by Fredenberger on burnout did not continue into the 21st century, and the most recent work on burnout by Maslach is from 2009, written in Spanish [13]. In the last publication by Freudenberger on burnout in 1989, he notes his astonishment regarding the speed of adoption of the concept; however, physician burnout per se was still not a focus of his research. One researcher who has published significantly on all aspects of burnout in the current decade—particularly for physicians—is Rotenstein ^{[14][15][16][17][18][19]}[14,15,16,17,18,19]. Her most cited work remains the 2018 systematic review on the topic [20], which continues to stress the importance of the work of Freudenberger and Maslach in developing the concept of physician burnout.

Physician burnout is deemed a historical constant [21]; however, circumstances particular to the 1960s and early 1970s were such that physician burnout became obvious, widespread, and particularly detrimental by the mid-1970s when it was first described [6]. The ability of physicians to help patients recover from illnesses resulting from a focus on microbiological factors regarding disease following World War II, one not previously available to physicians before this focus ^[22][23][22,23], was the basis for complete patient trust in physicians [24]. This faith in physicians by patients precipitated physician self-confidence, often evolving into arrogance by the beginning of the 1960s [25]. Concomitantly, the baby boom following World War II until the mid-1960s [26] increased the proportion of young people in society, making their demographic increasingly influential in decision-making by the end of the 1960s [27]. A focus on democratic decision-making by these young people began the questioning of physician authority [25]. With this questioning came the promotion of patient-centered care [28] through the new field of bioethics, holding the physician responsible for—and demanding patients share in—their treatment decision-making [29]. The result was increasing malpractice suits against physicians, raising their insurance rates [30], and creating the evolving view that physicians should be public servants rather than small business owners [31], leading to the proletarianization of the medical profession [32]. A new view of who was appropriate as a physician came with a “brain drain” [33] and an increase in the number of women [34] and minorities [35] who gained admission to medical schools. As such, although the ability of physicians during this period to heal patients was more than ever before [36], the status of the physician became significantly reduced [37], as was the ability of the physician to gain the type of remuneration previously expected [38]. These were systematic problems [39] unsolvable by individual physicians that, by the mid-1970s, came to an apex, making physician burnout widespread and seemingly insurmountable [40].