Healthcare organizations have spent the past several years launching wellness programs, appointing chief wellness officers, and drafting well-being frameworks. The data on their results is damning.

Six in ten American physicians reported burnout symptoms in each of the last four consecutive years, according to the Physicians Foundation. That figure sat at 40% in 2018, which researchers at the time called troubling. The number has doubled since then. Meanwhile, a 2022 WittKieffer survey of 343 C-suite healthcare executives found that 74% had personally experienced burnout in the prior six months, and 79% said their organizations weren’t doing enough to address it. The infrastructure of the response has expanded; the problem has not contracted.

One explanation for the gap may be structural. Asked whether adding a dedicated wellness executive to their organizations had helped, fewer than a third of physicians said yes, according to a separate Physicians Foundation survey. “Perhaps these well-being officers still don’t have the right tools to approach the problems in their workplaces, or they don’t have the commitment of administrations above them,” Gary Price, the foundation’s president, told Chief Healthcare Executive.

Tzadok Weinberg, who oversees a network of skilled nursing facilities through Eastern Healthcare in Virginia and holds an ownership stake in Peerstar, a Pennsylvania behavioral health company, arrives at the same problem from a different direction. His view is that wellness programs underperform because of a sequencing error. Organizations focus on the patient. They should start with the leader.

The Model That Gets It Backward

Healthcare is a field that trains people to care for others at the direct expense of themselves. The professional identity of a physician, nurse, or administrator is built around service, and that identity makes self-care feel like an indulgence or a distraction. The result is a workforce running on depleted leadership, and depleted leaders who don’t model the behavior they’re nominally asking their organizations to adopt.

“You only get one body,” Weinberg has said. “You can’t trade it in, so you have to take care of yourself. I think of wellness as the foundation of a house. Without it, everything else becomes shaky.”

Research supports the logic behind that metaphor. A multicentre study of physician leadership and burnout found that physicians whose direct supervisors demonstrated strong leadership were substantially less likely to report burnout, less likely to consider leaving their positions, and more likely to report professional fulfillment. How leaders actually behave communicates what an organization values far more reliably than formal policy.

The mechanism isn’t complicated. Organizations are social environments. People calibrate what is acceptable by watching what people above them do, rather than what they say or what a policy document requires. A leader who works 70-hour weeks and never disconnects teaches the organization something, regardless of what the wellness program posters say.

What Weinberg Actually Does

Weinberg’s wellness practice is specific enough to be instructive. It doesn’t involve a daily meditation routine or a morning gratitude journal. It involves ice hockey.

Getting on the ice several times a week, he has said, “allows me to shut off all the noise and be fully present during the game.” The sport demands it. Divided attention is punished immediately. The practice isn’t coincidental. Weinberg frames it explicitly as preparation for executive output: examining everything you’re doing, figuring out how to push yourself harder, operating at peak performance. The physical practice and the professional one reinforce each other.

His wife introduced him to hot yoga against his will. He was skeptical, went anyway, and kept going. The specifics of the activities matter less than the philosophy underneath them: that caring for your body is a prerequisite to performing at the level the job demands, not a reward for performing well enough to have earned the time.

His most unconventional idea on this front is also his most personal. Weinberg observes a weekly 24-hour period of disconnection from technology, a practice he describes as “disconnect to reconnect,” drawn from religious observance. The phone rings once a week. “As someone who sees the value of this through religious observance,” he has said, “I know how powerful it is to have that forced disconnection.” He has proposed the concept as a public health intervention: if everyone had a weekly reset, the cumulative effect on mental health and relationships would be widespread. The idea sounds radical mainly because the baseline of total, continuous connectivity has come to seem normal.

The Operational Translation

The question for healthcare organizations is how these personal commitments translate into practice, particularly in an industry where margin pressure is severe enough that time off can feel like a liability.

Weinberg’s approach at his companies is to treat PTO as a matter of trust rather than arithmetic. “We don’t track PTO days,” he has said. “People take off as they need. It’s about trusting people to get their work done while taking care of themselves.” The policy is easier to implement in some organizational structures than others, and he doesn’t present it as universally scalable. But the underlying principle transfers: an organization signals its values through its policies, not its rhetoric.

The WittKieffer data points to what happens when that signal goes the wrong way. Burned-out executives in the 2022 survey were measurably less hopeful about the future of healthcare leadership, felt less productive, and reported lower determination to make an impact in their work. The downstream effects on the organizations they lead are predictable. A leader who has stopped believing in the future of the field will make different decisions about investment, hiring, and risk than one who hasn’t.

The Physicians Foundation data illustrates a related problem: the wellness apparatus that healthcare organizations have built is not reaching the people it’s intended to serve. Programs without credible modeling from leadership are experienced as bureaucratic performance. They generate participation numbers without changing behavior.

What Weinberg describes is something prior to programs: a personal commitment that becomes visible to the organization through daily behavior. Leaders who take their own health seriously, who protect disconnected time, who treat physical and mental maintenance as nonnegotiable, create permission structures that no corporate wellness initiative can replicate from the outside.

The Case for Getting the Sequence Right

Healthcare organizations have good reasons to focus on frontline workers and patients when considering wellness. The clinical need is urgent, and the research on patient outcomes is direct. But the organizations with the most sophisticated patient wellness programs are often led by executives running on four hours of sleep and years of accumulated stress.

“When you feel good physically and mentally, you show up better everywhere,” Weinberg has said, “at work, in relationships, as a parent, in creative pursuits.” The claim is modest enough to be convincing. It doesn’t require a belief in any particular wellness philosophy. It requires only the acknowledgment that humans have physical and cognitive limits, that those limits affect decision-making, and that healthcare leaders’ decisions affect patients.

Prioritizing leader wellness is the architectural choice. The house doesn’t stand without a foundation.