A Primer on Physician Burnout
What is burnout?
The idea of “burnout” has received considerable attention of late, but it was originally described in the 1970s in relation to exhausted and overworked “helping” professionals by American Psychologist Dr. Freudenberger. While definitions have varied, one of the most well-known was outlined by Maslach and Jackson, who described burnout as a syndrome of “emotional exhaustion, depersonalization, and reduced personal accomplishment.” Physicians that experience burnout syndrome can become highly cynical, emotionally detached, and have a feeling of professional disempowerment. We know that burnout rates are not only high among physicians, but also that they appear to be on the rise. The percentage of physicians experiencing burnout jumped from 45% to 54.4% from 2011 to 2014, according to a recent study. Emergency medicine physicians in particular appear to have the highest rates of burnout, with over 70% reporting burnout in 2014. Female physicians have been reported to have higher rates of burnout than their male peers.
What happens when physicians are burnt out?
Physicians that are burnt out do not perform as well as their peers. They make more medical errors, have lower ratings from patients, and are believed to more readily demonstrate behaviors that can suggest impaired professionalism. Additionally, physician burnout affects physicians’ personal lives, leading to higher rates of divorce, depression, suicidal ideation, and motor vehicle crashes.
What causes burnout?
While burnout is usually caused by a combination of different factors, it appears that there are several that are especially problematic. A recent Medscape survey identified the top three causes of burnout to be physicians having too many bureaucratic tasks, spending too many hours at work, feeling their income was not high enough, and facing increased computerization of their practice. There are, however, a multitude of other contributory factors at play, such as having a large workload, practicing in an unsupportive environment, and having difficulty achieving a work-life balance. Some physicians feel that burnout strikes them most deeply when they lose meaning in their work.
Several approaches have been undertaken to help tackle burnout. The use of cognitive-behavioral therapy combined with mental and physical relaxation has been shown to reduce stress in healthcare workers. Additionally, some improvement in stress levels has been demonstrated through the use of meditation, and changes in work schedule. Mindfulness training has been identified in a number of studies as being a useful modality to help reduce burnout. Helping physicians to balance their work and personal life commitments by helping them to have flexible schedules and teaching them how to set limits has also been shown to have positive outcomes.
Freudenberger, Herbert J. "Staff burn‐out." Journal of social issues 30.1 (1974): 159-165. Maslach, Christina, and Susan E. Jackson. "The measurement of experienced burnout." Journal of organizational behavior 2.2 (1981): 99-113.
Peckham, Carol. “Physician Burnout: It Just Keeps Getting Worse.” Medscape. January 26, 2015. http://www.medscape.com/viewarticle/838437_3
Shanafelt, Tait D., et al. "Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014." Mayo Clinic Proceedings. Vol. 90. No. 12. Elsevier, 2015.
“Webinar: From Burnout to Engagement: Strategies to Promote Physician Wellness and Workplace Satisfaction.” Modern Healthcare. April 14, 2015. http://www.slideshare.net/ModernHealthcare/april-2015-from-burnout-to-en...