The culture of medical education and the ethos of the health care industry are built on the principle that the patient comes first. Since the time of Hippocrates, this has been a natural and automatic statement in any conversation about medical professionals.

But “the patient comes first” is a double-edged sword.

Of course the patient comes first — when you’re with the patient. However, without an off switch, there is no ability to recharge, refresh and prepare oneself to go back in day after day and do it all again. There must be some time when the provider — be it a doctor, nurse, medical assistant, CEO or anyone who draws a health care paycheck — puts themselves and their family first or burnout is an inevitable result.

This external focus of attention in health care is dramatically magnified by an industry-wide mantra known as the Triple Aim. Years ago, when the cost-quality gap in U.S. health care was first noticed, the Triple Aim was adopted as a method to improve the ROI on health care dollars.

The Triple Aim mandates leadership focus on only three areas: cost, quality and population health.

Over the last two decades, the only reliable result of a Triple Aim focus in health care has been the modern epidemic of physician burnout. The Triple Aim produces a massive blind spot for all health care leaders. It completely ignores the people who provide the patient care: the physicians and staff. Burnout is the direct result.

There have been scattered victories in containing cost and improving quality and population health, but the physicians have suffered greatly in the process. Previous studies have shown over 50% of U.S. physicians suffer from at least one symptom of burnout on any given office day. Physician suicide rates are double the normal population for men and women. I could keep going here, but you get the idea.

It is the perfect storm: