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FAST FACT AND CONCEPT #167: Health Professional Burnout:
Part I Author: Linda Blust , MD
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Health professionals caring
for seriously ill/dying patients and their families are frequently exposed
to distressing emotional situations and profound suffering. Lack of
attention to health providers’ stress responses to this suffering can lead
to burnout, which has consequences for the provider and his/her
interpersonal relationships. This Fast Fact will describe burnout and its
risk factors, and review essential research regarding health professionals
and burnout. Additional Fast Facts will address symptoms, consequences,
avoidance and assessment of burnout.
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Definitions: Burnout is a . . .
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“Psychological syndrome in response to
chronic interpersonal stressors on the job.” (Maslach, 1982)
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“State of mental and/or physical
exhaustion caused by excessive and prolonged stress.” (Girdin, 1996)
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Common features (adapted from
Maslach, 1982)
| A predominance of mental or emotional
exhaustion, fatigue, and depression |
| The symptoms are more mental and
behavioral than physical |
| The symptoms are work-related |
| Burnout manifests in persons with no
previous history of psychopathology |
| Decreased effectiveness and work
performance result from negative attitudes and behaviors |
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| Situational Risk Factors
| Physician Worklife Study: 2326 US
physicians identified via AMA masterfile responded to 38-item mailed
questionnaire developed and validated for this study. Predictors of
stress were:
 | Demands of solo practice, long work
hours, time pressure, and complex patient |
| Lack of control over schedules,
pace of work, and interruptions |
| Lack of support for work/life
balance from colleagues and/or spouse |
| Isolation due to gender or cultural
differences |
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| Hospital consultants in the U.K.: 882
gastroenterologists, radiologists, surgeons, and oncologists responded
to 12-item General Health Questionnaire and Maslach Burnout Inventory.
Sources of stress were:
| Work overload and its effect on
home life |
| Feeling poorly managed and
resourced |
| Managerial responsibility |
| Dealing with patients’ suffering |
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Individual Risk Factors
| At risk earlier in career |
| Lack of Life-partner |
| Attribution of achievement to chance
or others rather than one’s own abilities |
| Passive, defensive approach to stress |
| Lack of involvement in daily
activities |
| Lack of sense of control over events |
| Not open to change |
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See Fast Fact # 168-170 for further
discussion of burnout
References
- Girdin DA, Everly GS, Dusek DE.
Controlling Stress and Tension, Allyn & Bacon, Needham Heights MA,
1996.
- Linzer M, et al.
Physician stress: results from the physician worklife study.
Stress and Health 2002; 18: 37-42.
- Linzer M, et al. Predicting and
Preventing Physician Burnout: Results from the United States and the
Netherlands. The American Journal of Medicine. 2001; 111:
170-175.
- Maslach C. Burnout: The Cost of
Caring. Englewood Cliffs, NJ; Prentice-Hall; 1982.
- Maslach C, Schaufeli WB, Leiter MP.
Job Burnout. Annual Review of Psychology. 2001;52: 397-422.
- Ramirez AJ et al.
Mental health of hospital consultants: the effects of stress and
satisfaction at work. Lancet 1996;347: 724-728.
- Ramirez AJ, et al.
Changes in mental health of UK hospital consultants since the mid-1990s.
Lancet 2005; 366: 742-744.
- Schaufeli WB, Maslach C, Marek T, eds.
1993. Professional Burnout: Recent Developments in Theory and
Research. Washington, DE: Taylor & Francis.
Fast Facts are edited by David E.
Weissman, MD; Palliative Care Center, Medical College of Wisconsin. For
comments/questions write to:
dweissma@mail.mcw.edu. The complete set of Fast Facts are available at
EPERC:
www.eperc.mcw.edu
Copyright/Referencing Information:
Users are free to download and distribute Fast Facts for educational
purposes only. Blust L. Fast Fact and Concept #167. Health Professional
Burnout Part 1. November 2007. End-of-Life Physician Education Resource
Center End-of-Life Palliative Education Resource Center
www.eperc.mcw.edu.
Disclaimer: Fast Facts provide educational information.
This information is not medical advice. Health care providers should
exercise their own independent clinical judgment. Some Fast Fact information
cites the use of a product in dosage, for an indication, or in a manner
other than that recommended in the product labeling. Accordingly, the
official prescribing information should be consulted before any such product
is used.
Purpose:
Self-Study Guide, Teaching
Audience(s)
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Training:
Fellows, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6,
Physicians in Practice |
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Specialty:
Anesthesiology, Emergency Medicine, Family Medicine, General Internal
Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN,
Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery |
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Non-Physician:
Nurses, Pharmacists/Clinical Pharmacists |
ACGME Competencies:
Professionalism
Keyword(s):
Miscellaneous
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