Patient Care as Sacred Rite: Applying Viktor Frankl's Concept of Meaning and Confucian Li to Address Physician Burnout

Among the many factors causing physician burnout is the difficulty of finding meaning in clinical work. Psychiatrist and philosopher Viktor Frankl believed that meaning, derived from experiences of self-transcendence, can help a person endure extraordinary adversity. The Confucian concept of li may offer a path to finding meaning in clinical work. Though commonly translated as "ritual" and thought of as merely a set of rules, practices, or decorum, li may be understood as any act, state of mind, or arrangement reflecting or bringing about the sacred. Practitioners of li participate in a liturgical celebration of human community and everyday life since li is not merely ritual acts performed during religious ceremonies or special occasions but encompasses the entire spectrum of interaction with humans, nature, and even material objects. Thus, everyday interactions between physicians and their patients, colleagues, and work environment, if made li, will allow physicians to participate in such a liturgical celebration, sanctify their work, and encounter the sacred. In realizing the sacred in every ordinary task, work is no longer sterile, mechanical, and temporal but living, spiritual, and holy. With li, physicians approach work with mindful, artistic, and priestly devotion and access sources of meaning from work, from one's attitude while facing challenges, and from relationships.