Musing onleadership, quality and safety, and burnout: what goes up must come down

Burnout in healthcare has been increasingly recognized over the past few decades and has recently been accepted as a recognized diagnosis by the World Health Organization. By choice, we have sought careers where unfortunately both the stakes and the chances for error are high. When a serious safety event occurs, our patients (and their families) become the first victims. Those of us in healthcare, however, can become traumatized when a poor or unanticipated adverse outcome occurs, leading to morbidity and/or mortality, and where one personally bears the responsibility. This leads to the provider becoming the "second victim (SV)". Awareness of burnout and the SV syndrome by ourselves, peers, and the institutions and organizations in which we work is paramount to our understanding of the plight of the provider and averting significant human and fiscal consequences.