Physician Burnout: Its Origin, Symptoms, and Five Main Causes

 


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Burnout is everywhere, but you can't fight an enemy unless you recognize it.

Fam Pract Manag. 2015 Sep-Oct;22(5):42-47.

Author disclosure: Dr. Drummond is an author, speaker, and consultant on the subject of physician burnout.

© 2015 Dike Drummond, MD, CEO, TheHappyMD.com

There is an epidemic of physician burnout in the United States, and it has a pervasive negative effect on all aspects of medical care, including your career satisfaction. According to one researcher, “Numerous global studies involving nearly every medical and surgical specialty indicate that one in every three physicians is experiencing burnout at any given time.”1 The 2015 Medscape Physician Lifestyle Survey reported an even higher burnout rate – 46 percent of physicians, up from 39.8 percent in the 2013 survey.2

At your next physician staff meeting, take note of your colleagues sitting on either side of you. At least one of you is likely experiencing burnout.

Burnout is directly linked to an impressive list of undesirable consequences:38

  • Lower patient satisfaction and care quality,

  • Higher medical error rates and malpractice risk,

  • Higher physician and staff turnover,

  • Physician alcohol and drug abuse and addiction,

  • Physician suicide.

Yes, burnout can be a fatal disorder. Suicide rates for both men and women are higher in physicians than the general population and widely underreported.9

So, before we go on, let's agree that physician burnout is bad on multiple levels – bad for doctors and their families, bad for staff and patients, and bad for organizations. And burnout is everywhere, all the time.

Unfortunately, although physician burnout is incredibly common and damaging, it remains a taboo subject in the workplace. Stress management and burnout prevention are not covered in detail in medical school or residency training.

In this article, we will fill this hole in your medical education by exploring burnout's origin, cardinal symptoms, and five main causes. In future articles, we will explore multiple, field-tested burnout prevention tools to help you lower your stress level and build more life balance and a more ideal practice.

IN THE AUTHOR'S OWN WORDS

Dr. Drummond explains the concept of an energy account and its role in physician burnout.


The origin of physician burnout

Burnout originates from a disorder of energy metabolism. This is not the Kreb's cycle. It is more like “the force” in Star Wars. A common metaphor for burnout is the battery. Physicians often discuss exhaustion and burnout as a state where, “My batteries are just run down.” This battery metaphor is at odds with reality for the following reasons.

When a toy's battery runs out, what does the toy do? It stops working. When did you ever stop working – ever? The answer is likely “never” because if you had stopped working at any time during medical school,

About the Author

Dr. Drummond is a family physician, CEO of TheHappyMD.com (www.TheHappyMD.com), author of Stop Physician Burnout: What to Do When Working Harder Isn't Working, and developer of the “Burnout Proof” mobile app for physicians. He was a general session speaker at the 2014 AAFP Scientific Assembly.

Author disclosure: Dr. Drummond is an author, speaker, and consultant on the subject of physician burnout.

© 2015 Dike Drummond, MD, CEO, TheHappyMD.com

 

References

show all references

1. Shanafelt TD. Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centered care. JAMA. 2009;302(12):1338–1340....

2. Medscape Physician Lifestyle Survey 2015. http://www.medscape.com/features/slideshow/lifestyle/2015/public/overview#2. Accessed Aug. 19, 2015.

3. Shanafelt TD, West C, Zhao C, et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med. 2005;20(7):559–564.

4. Firth-Cozens J, Greenhalgh J. Doctors' perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44(7):1017–1022.

5. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358–367.

6. Williams ES, Skinner AC. Outcomes of physician job satisfaction: a narrative review, implications, and directions for future research. Health Care Manage Rev. 2003;28(2):119–139.

7. Gardiner M, Sexton R, Durbridge M, Garrard K. The role of psychological well-being in retaining rural general practitioners. Aust J Rural Health. 2005;13(3):149–155.

8. Wetterneck TB, Linzer M, McMurray J, et al. Worklife and satisfaction of general internists. Arch Intern Med. 2002;162(6):649–656.

9. Schernhammer E. Taking their own lives – the high rate of physician suicide. N Engl J Med. 2005;352(24):2473–2476.

10. Maslach C, Leiter MP. The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It. San Francisco: Jossey-Bass; 1997.

11. Houkes I, Winants Y, Twellaar M, Verdonk P. Development of burn-out over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study. BMC Public Health. 2011;11:240.

12. Dyrbye LN, Sotile W, Boone S, et al. A survey of U.S. physicians and their partners regarding the impact of work-home conflict. J Gen Intern Med. 2014;29(1):155–161.

13. Shanafelt T, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015;90(4):432–440.

14. Although Einstein is widely quoted as saying this, there is no evidence that he actually did. That does not make it any less powerful, however.


 

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