Donald M. Berwick, MD, MPP, former Administrator of the Centers for Medicare and Medicaid Services (CMS), and colleagues put forward a Triple Aim for healthcare that includes enhancing patient experience, improving population health, and reducing costs. He now makes the case that advances toward the Triple Aim need to be protected by addressing burnout in healthcare. Others have called for a “Quadruple Aim” that adds the goal of improving the work life of healthcare providers. A Fourth Aim that returns joy to medicine is needed because burnout in healthcare erodes the Triple Aim.

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