Fixing a broken system: How physician leadership can restore purpose and reduce burnout

Palliative care physician and author Alen Voskanian, MD, MBA, FAAHPM, FACHE recently appeared on The Podcast by KevinMD to share an excerpt from his book, Reclaiming the Joy in Medicine: Finding Purpose, Fulfillment, and Happiness in Today’s Medical Industry. In his conversation, Alen reflected on the personal and systemic factors contributing to physician burnout and how rediscovering purpose—and becoming a leader—helped him reclaim joy in health care.

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A journey through burnout and rediscovery

Nearly 20 years ago, before burnout was a commonly used term in health care, Alen found himself overwhelmed. After completing his fellowship in HIV and AIDS, he was seeing a high volume of patients who were not only facing serious infections but also battling homelessness and substance use. Rushing through visits, Alen felt ineffective and disconnected. He lost his sense of purpose.

That turning point led him to hospice and palliative care. He became board certified and began spending meaningful time with patients during their most vulnerable moments. Often, palliative care patients are made to feel like the health care system has given up on them. Alen wanted to be the physician who stood by them, affirming that they still deserved compassionate, high-quality care.

This experience reignited Alen’s sense of purpose—a theme that anchors his book. In conversations with colleagues, he learned many physicians similarly felt adrift, disconnected from the reasons they had entered medicine. Rediscovering one’s "why" became a critical first step in healing.

Finding purpose, gaining skills, and leading change

Realizing that burnout was not a personal failing but part of a larger systemic issue, Alen sought to be part of the solution. He recognized that to truly make an impact, he needed to develop new skills beyond clinical expertise. That led him to pursue an MBA and later become a medical director. He also worked with the Center for Medicare and Medicaid Innovation as an advisor.

Alen noted that many physicians are tapped for leadership roles simply because they excel clinically. However, leadership in health care demands more than medical knowledge; it requires business acumen, communication skills, and the ability to bridge the gap between physicians and administrators. He calls such clinicians "incidental leaders"—people who are handed the reins without the tools to lead effectively.

Systemic burnout needs systemic solutions

In his interview, Alen emphasized a key shift: moving away from viewing burnout as an individual problem to recognizing its systemic roots. Too often, organizations offer mindfulness apps or yoga sessions as a cure-all. While well-intentioned, these efforts fail to address the underlying operational dysfunction.

As a practicing physician and administrator, Alen remains acutely aware of the day-to-day frustrations: under-resourced clinics, excessive in-basket messages, and chaotic workflows. These problems, he argues, must be addressed systemically. His mantra is: "Less chaos, more care."

Alen believes health care can learn from industries like aviation, where systems are designed to minimize error and promote consistency. He applies principles such as checklists, process engineering, and reliable team structures to improve clinical operations. The goal is to create systems that support, rather than sabotage, quality care.

From translator to team builder

One of Alen’s strengths as a leader is acting as a translator between physicians and administrators. Physicians care about patients; administrators care about metrics. Alen communicates in both languages, aligning goals across stakeholders.

A concrete example of this philosophy is dyad leadership—pairing a physician with an operational leader. This approach breaks down silos and empowers teams to solve problems from the front lines rather than impose top-down fixes. The result: better morale and more sustainable solutions.

Reconnecting with your “why”

For physicians seeking a way out of burnout, Alen advises revisiting the question: “Why did I go into medicine?” He cites Simon Sinek’s work on finding one’s "why" and encourages doctors to reflect on the deeper reasons behind their work.

For Alen, that purpose has evolved. Initially, it was serving patients with HIV. Then it became guiding patients and families through end-of-life care. Most recently, it has been about fixing the broken health care system—not just for himself, but for colleagues and patients alike.

His personal story underscores this evolution. During the COVID-19 pandemic, Alen’s mother passed away unexpectedly. Denied visitation due to hospital policies, his family was nearly prevented from saying goodbye. Thanks to a compassionate ICU physician, they were granted those final moments. That experience further clarified his mission: to build systems that empower clinicians to do the right thing.

Wellness starts with the basics

Alen closed the conversation with a reminder not to neglect basic wellness. Amid the chaos of health care, it is easy for clinicians to ignore their own needs. He stressed the importance of daily exercise, healthy eating, sufficient sleep, and moments of mindfulness.

For example, he uses a simple practice before every patient visit: pausing at the door, taking a deep breath, and letting go of distractions. It’s a small ritual, but one that centers him and reinforces his intention to be fully present.

He urges clinicians not to underestimate the power of basic self-care in sustaining long-term well-being. Ultimately, physicians must care for themselves if they are to care well for others.

A call to action

Alen’s message is clear: Burnout is not a personal flaw—it is a systemic failure. But clinicians are not powerless. By rediscovering purpose, gaining leadership skills, and addressing root causes, physicians can become part of the solution.