Abstract
This study examines how Industrial Relations (IR) and Human Resource Management (HRM) governance arrangements shape the structural production of doctor burnout in Vietnam’s public hospitals. Rather than conceptualising burnout solely as occupational stress or individual resilience deficit, we frame it as a sustainability governance issue emerging from fragmented institutional alignment. Drawing on the Society–Actors–Processes–Policy (SAPP) framework and qualitative interviews with 50 doctors across 23 national-level hospitals, the analysis explores how societal reform, managerial processes, and representation structures interact in practice. Findings reveal a pronounced “support gap” between intensified HRM systems and constrained IR influence. Performance-based income mechanisms, extended working hours, administrative expansion, and disciplinary penalties translate fiscal and market pressures into everyday strain, while trade unions are largely perceived as providing symbolic welfare activities with limited leverage over workload design or income regulation. This misalignment institutionalises demand intensification without equivalent enforceable protection, contributing to persistent burnout. By reframing wellbeing as a governance architecture problem rather than a psychological outcome, the study advances IR–HRM integration scholarship and contributes to sustainable and responsible business debates on decent work, institutional accountability, and system resilience (SDGs 3, 8, and 16). The paper argues that meaningful protection of professional wellbeing in volatile public service environments requires coherent alignment between representation, policy enforcement, and job design, rather than reliance on discretionary wellbeing initiatives alone.