The Quadruple Aim

I’ve heard a lot about the Triple Aim lately – the goal of:
Improving patient experience through both quality and satisfaction.
Improving population health (care)
Reducing the per capita cost of healthcare

Well, I think we should be thinking more inclusively, and for that I propose the Quadruple Aim:
Better Patient Satisfaction
Better Patient Outcomes
Better Provider Satisfaction
Reduced Cost

The difference is in structuring meeting the Triple Aim to include Provider Satisfaction. 

It is beyond the scope of this discussion, but the chatter from physicians is more negative than usual.  Granted, a lot of physicians are ‘glass half-empty’ types, but even so, the pervasive uncertainty about the future of their careers is widespread and palpable.  A number of articles about physician ‘burnout’ have been hitting the rounds lately, even from venerable sources like the New York Times. (1)  How does a profession that prides itself on hard work and a single-minded devotion to their patients go from discussion of exciting new medical cures to 50% burnout rates, even starting in medical school?  I find that difficult to understand – on a personal level, I couldn’t wait to get to work when I was in medical school on the wards – it was just so exciting and interesting!  So how did we get from there to this?

Perhaps mandating the triple aim without including physician well-being (provider satisfaction) has something to do with it?