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FAST FACT AND CONCEPT #168: Health Professional
Burnout: Part II
Author: Linda Blust , MD
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| As
described in Fast
Fact #167, burnout is a “psychological syndrome in response to chronic
interpersonal stressors on the job” (Maslach, 1982). This Fast Fact will
explore symptoms of burnout and its personal and professional consequences.
Additional Fast Facts will describe avoidance and assessment of burnout.
Symptoms of each sequential stage
of burnout
 | Stress Arousal:
anxiety, irritability, hypertension, bruxism, insomnia, palpitations,
forgetfulness, and headaches. |
| Energy Conservation:
Work tardiness, procrastination, resentment, morning fatigue, social
withdrawal, increased alcohol or caffeine consumption, and apathy.
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| Exhaustion:
Chronic sadness, depression, chronic heartburn, diarrhea, constipation,
chronic mental and physical fatigue, the desire to “drop out” of
society. |
Consequences
| Personal
 | Depletion of emotional and physical
resources |
| Negative self-image: feelings of
incompetence and lack of achievement |
| Self-neglect: 35% of Johns Hopkins’
medical graduates had no a regular source of health care |
| Questioning of previously held
spiritual beliefs |
| Neglect of family and social
obligations |
| Mental Illness: anxiety,
depression, substance abuse, suicide
| Substance Abuse: MD lifetime risk
is 10-14% |
| MD suicide rates similar to
general population for both genders |
| Relative Risk of MD suicide
versus other professionals
| Male MDs: 1.1-3.4 |
| Female MDs: 2.5-5.7
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| Female MDs complete suicide as
often as male MDs |
| Professional
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| Longer Work hours:
If I work harder, it will get better. |
| Withdrawal, absenteeism, and
reduced productivity. |
| Depersonalization: attempt to
create distance between self and patients/trainees by ignoring the
qualities that make them unique individuals.
| Loss of professional boundaries
leading to inappropriate relationships with patients/trainees. |
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| Compromised patient care. |
| 45% of University of Washington
residents who self-report burnout also report providing “suboptimal
care”. |
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References:
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Booth JV, Grossman D, Moore J, et al.
Substance Abuse Among Physicians: A Survey of Academic Anesthesiology
Programs. Anesthesia Analg 2002; 95: 1024-1030.
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Center C et al.
Confronting Depression and Suicide in Physicians: A Consensus Statement.
JAMA 2003;289: 3161-3166.
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Gross CP, et al.
Physician Heal Thyself? Regular Source of Care and Use of Preventive
Health Services Among Physicians. Archives of Internal Medicine
2000;160: 3209-3214.
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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.
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Maslach C. Burnout: The Cost of
Caring. Englewood Cliffs, NJ: Prentice-Hall, 1982.
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Maslach c, Schaufeli WB, Leiter MP.
Job Burnout. Annual Review of Psychology. 2001;52: 397-422.
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Shanafelt TD, Bradley KA, Wipf JE, Back
AL.
Burnout and Self-reported Patient Care in an Internal Medicine Residency
Program. Annals of Internal Medicine. 2002; 136: 358-367.
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 #168. Health Professional
Burnout Part II. 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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