Primary care burnout and populist discontent.

Physician burnout receives much attention in healthcare circles because it poses serious threats to clinicians, staff, and patients. The forces leading to detachment and depersonalization among primary care physicians are similar to the factors responsible for populist movements more broadly-the perception of a rigged system favoring a managerial elite, disregarding the values and welfare of those who must play by the rules. The disconnect between systems initiatives and the burdens and uncertainty they create for primary care clinicians contributes to physicians' loss of confidence, expressed as resistance to organized medical specialty and regulatory structures, as well as migrations of medical students and practicing physicians away from the prevailing primary care service model. A failure among healthcare leaders to recognize the link between the root causes of burnout and populism will result in further exacerbation of an already existent primary care crisis.