Is clinician burnout always a question of resilience, or can it be a signal that the work itself needs to change? April and Alison discuss moral injury, the promise and limits of AI scribing, and why flexibility can matter as much as pay.
They also wrestle with the question every healthcare organization must answer: how can clinicians gain more control while patients still have reliable access to care?
Dr. Alison Curfman trained for years to care for children in emergency departments. Early in her career, she had a modest goal: someday, she hoped to sleep in her own bed every night. Night shifts were difficult for her, and she worried about what fatigue could mean in a high-stakes setting.
That goal says a great deal about the expectations clinicians learn to accept. Curfman did not want to leave medicine. She wanted a way to keep practicing that she could sustain.
In the first episode of The Work Behind Care, Curfman joins April Hansen, a nurse by training and CEO of Barton Associates, to ask a harder question about clinician burnout: When a clinician is struggling, how much of the problem belongs to the person, and how much comes from the design of the job?
Curfman describes the emotional weight of caring for families whose needs extend well beyond the exam room. A parent may be unable to afford a child’s medication or navigate the system to get the care their child needs. The clinician sees what is at stake but may have little power to change the barriers around that family.
That is why Curfman questions whether burnout always captures the experience. She raises moral injury as another way to understand the distress of knowing what a patient needs while working inside a system that makes it difficult to provide it.
The distinction deserves a conversation. Mental health support is essential, especially after traumatic clinical events. Curfman and Hansen both make that clear. But a wellness offering cannot, by itself, resolve an unmanageable schedule, inadequate backup, or a workflow that adds work without giving clinicians more capacity to care. Curfman offers a pointed example from her own experience: a required presentation on burnout scheduled in the evening, taking still more time away from physicians’ families.
should giveCurfman sees promise in AI scribing. Documentation can compete with the moments when she wants to look a parent in the eye, talk with a child, and understand what is happening. A useful scribe can capture details while she stays present with the family.
She also describes the boundary she wants to preserve. A tool that helps record the encounter is different from one that starts suggesting a diagnosis or treatment plan. Technology should relieve a real burden without quietly changing who makes clinical decisions.
That contrast runs through the conversation. New tools can help. So can better staffing. Yet clinicians feel the benefit only when those changes improve the work they do each day.
has value, forCurfman eventually built a career that combines pediatric emergency shifts with entrepreneurial and advisory work. Locum tenens assignments let her continue caring for children and stay connected to frontline practice while choosing when and where she works. She can increase or reduce her clinical shifts as her life changes.
Hansen presses on the operational challenge. Emergency departments still need coverage at 2 a.m., during holidays, and when a patient needs immediate care. A schedule that works for one clinician must also fit a system that patients depend on around the clock.
Curfman offers an example of the other side of that equation: when a facility she worked with lost a large group of physicians, locum tenens clinicians helped keep its emergency department staffed. A flexible workforce can provide essential coverage when a traditional staffing model is disrupted.
There is no universal schedule that solves every clinician’s and every facility’s needs. The more useful question is where a workforce model gives clinicians room to remain in practice while giving patients dependable access to care.
to askWhether considering an employed position or a locum tenens assignment, Curfman suggests looking beyond the pay rate:
Ask how time off, holidays, and shifts are actually assigned.
Understand patient volume, additional responsibilities, available backup, and the team dynamic during a real shift.
Clarify expectations, contract terms, and what options you will have if the work differs from what was promised.
For clinicians considering locum tenens, Curfman adds a practical point:
Assignments do not always require long-distance travel. A temporary need may arise close to home.
She also encourages clinicians to understand the agency’s responsibilities, including pay and malpractice coverage, before accepting an assignment.
Her takeaway is a question worth asking about any opportunity:
What kind of life will this job require, and what kind of life could it make possible?
For healthcare leaders, Hansen offers a companion question. When clinicians ask for more flexibility, what are they telling you about the way the work is designed? One conversation with the people doing that work can reveal where the model is losing capacity it could otherwise retain.
Watch the first episode of The Work Behind Care to hear Hansen and Curfman explore the tradeoffs behind clinical careers and healthcare operations.
Watch the Episode on YouTube
