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Understanding what leaders can do to facilitate healthcare workers’ feeling valued: improving our knowledge of the strongest burnout mitigator
  1. Martin Stillman1,2,
  2. Erin E Sullivan3,4,
  3. Kriti Prasad5,
  4. Christine Sinsky6,
  5. Jordyn Deubel3,
  6. Jill O Jin7,
  7. Roger Brown8,
  8. Nancy Nankivil6,
  9. Mark Linzer1,2
  1. 1Department of Medicine, Hennepin Healthcare System, Minneapolis, Minnesota, USA
  2. 2Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
  3. 3Sawyer School of Business, Suffolk University, Boston, Massachusetts, USA
  4. 4Harvard Medical School, Boston, Massachusetts, USA
  5. 5Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
  6. 6American Medical Association, Chicago, Illinois, USA
  7. 7Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  8. 8School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
  1. Correspondence to Dr Martin Stillman, Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA; martin.stillman{at}


Aim Feeling valued is a striking mitigator of burnout yet how to facilitate healthcare workers (HCWs) feeling valued has not been adequately studied. This study discovered factors relating to HCWs feeling valued so leaders can mitigate burnout and retain their workforce.

Method The Coping with COVID-19 survey, initiated in March 2020 by the American Medical Association, was distributed to 208 US healthcare organisations. Of the respondents, 37 685 physicians, advanced practice clinicians, nurses, and other clinical staff answered questions that assessed burnout, intent to leave and whether they felt valued.

Quantitative analysis looked at odds of burnout and intent to leave among the highest versus lowest feeling valued (FV) groups. Open-ended comments provided by 5559 respondents with high or low sense of FV were analysed to understand aspects of work life that contributed to FV.

Results Of 37 685 respondents, 45% felt valued; HCWs who felt highly valued had 8.3 times lower odds of burnout and 10.2 lower odds of intent to leave than those who did not feel valued at all. Qualitative data identified six themes associated with FV: (1) physical safety, (2) compensation and pandemic-related finances, (3) transparent and frequent communication, (4) effective teamwork, (5) empathetic and respectful leaders, and (6) organisational support.

Conclusion This US study demonstrates that FV correlates with burnout and intent to leave, yet only 45% of HCWs feel valued. Six themes link to interventions leaders can follow to facilitate HCWs FV and potentially reduce burnout and increase retention for a challenged healthcare workforce.

  • value
  • support
  • management
  • effectiveness
  • engagement

Data availability statement

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  • Contributors All authors had substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work. RB completed the statistical quantitative analysis and MS, EES, KP, ML and JD completed the qualitative analysis. MS, EES, KP, CS, JOJ, RB, NN and ML contributed to drafting the work or revising it critically for important intellectual content. MS is responsible for the overall content as guarantor.

  • Funding This study was funded by the American Medical Association (AMA).

  • Disclaimer The opinions expressed in this article are those of the authors and should not be interpreted as American Medical Association policy.

  • Competing interests MS receives support for research and writing on burnout understanding and prevention through his place of employment (Hennepin Healthcare) by the American Medical Association and Optum Office for Provider Advancement (OPA). ML is supported through his place of employment (Hennepin Healthcare) by the American Medical Association, American College of Physicians, Optum Office for Provider Advancement (OPA), Essentia Health Systems, Gillette Children’s Hospital, Institute for Healthcare Improvement, California AHEC system and American Board of Internal Medicine Foundation for burnout prevention projects. NN and CS are employed by the American Medical Association. JOJ is a senior physician advisor at the American Medical Association. RB was paid as a consultant by the AMA for his work on this project.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.