• Cynical and unenthusiastic? You may be suffering burnout

    Almost half1 of all Australian young doctors may be suffering from burnout according to a major mental health survey, putting themselves, their patients and their colleagues at risk. The transition from study to full-time work, with long shifts and increased responsibility, makes interns and RMOs particularly susceptible to burnout. Make sure you don’t succumb, or if you have already, take action to deal with it using our practical tips below.

    Signs of burnout include exhaustion and a loss of enthusiasm for work. You may feel overwhelmed and have a low sense of personal accomplishment.

    Symptoms of burnout

    • physical – constant exhaustion leading to poor immunity and somatic complaints; no improvement after rest and recovery; recurring aches and pains, colds and other ills; symptoms similar to those with depression such as poor sleep quality, lethargy, and a loss or increase in appetite
    • emotional – a negative outlook; detachment; loss of empathy, especially for patients and their situations; diminished motivation; sense of being defeated, trapped or helpless; possible persecutory ideas; angry inappropriate outbursts
    • behavioural – extreme negativity, callousness and cynicism; anger and cynicism towards patients, colleagues, hospital administration and family; substance abuse, such as an increased reliance on alcohol.

    There is also often an inability or reluctance to engage with work, especially when it involves interacting with patients or colleagues.

    Beyondblue’s 2013 National Mental Health Survey of Doctors and Medical Students which surveyed 12,252 doctors and 1,811 medical students, found that those under 30 have the highest level of burnout, and young doctors have a much higher level of cynicism than students. Major stressors include work/life balance, too much to do at work, increased responsibility, fear of making mistakes and long work hours.

    Personal implications

    Personal consequences arising from burnout can be significant and include relationship breakdowns, substance abuse and suicide ideation.

    Medico-legal implications

    Burnout erodes the values, dignity and spirit of a doctor and leads to low productivity, reduced levels of patient care, increased likelihood of errors and a loss of empathy – raising the risk of complaint about a doctor’s behaviour.

    Avant Medico-Legal Advisor, Professor Greg Whelan, says a major concern is that when a doctor loses their sharpness, small things get missed and the risk of a major error escalates.

    ‘Doctors facing burnout are less likely to pick-up on a patient’s body language, which increases the risk of miscommunication. A sense that a doctor is not sensitive or does not care about a patient is often at the heart of a complaint against that doctor,’ he says.

    Preventing and dealing with burnout

    Organisational change and individual education need to be integrated to prevent burnout. According to Professor Whelan, hospitals shouldn’t place undue pressure on doctors to perform with increasingly fewer resources or to their physical limits.

    ‘Hospitals have responsibilities – individual heads of services should monitor and adjust workloads to prevent burnout,’ he says.

    ‘At the same time, it is up to the individual to be professional and recognise if they are feeling overstretched. Doctors need to take personal responsibility if they could be putting patients or colleagues at risk.’

    Professor Whelan says rest is an important first step in dealing with burnout. This should include a temporary reduction in work hours followed by a structured return to work plan, negotiated with the relevant department head. Counselling through an employee assistance program and stress management training are also important.

    And keep an eye out for your colleagues – changes in a colleague’s behaviour could be an early sign of burnout.

    Help yourself to prevent burnout
     

    Personal

    • regular rest
    • eat nutritious meals
    • spend time with family
    • engage in broad interests
    • socialise with non-medical friends
    • manage stress
    • exercise regularly
     

    Professional

    • engage in professional development
    • focus on teamwork and a collegial attitude
    • value the patient–doctor relationship
    • find a mentor
    • debrief regularly
     

    Burnout self-tests

    Do you think you may be suffering burnout? Try one of these self-tests:


    You can also fill out our online Wellbeing survey to help us understand what will help you to maintain your health and wellbeing.


    References

    1. Beyondblue’s National Mental Health Survey of Doctors and Medical Students October 2013.

    Learn more

    For assistance with burnout, visit Avant’s Health and Wellbeing website or the Doctors’ Health Advisory Service in your state or territory.

    You can also access Avant’s Personal Support Program on 1300 360 364 which provides a range of support options for members who are suffering health issues, including a confidential counselling service.