“Burnout” is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. The hospital environment can put doctors and other clinicians at high risk for burnout, especially because of busy work days, high patient load, and emotional intensity of the job. It is marked by emotional exhaustion, depersonalization (adopting an impersonal approach toward patients), loss of empathy and a lack of sense of personal accomplishment.
Doctor burnout is actually very common worldwide. Studies have shown that as many as 40-50% of doctors in the USA experience symptoms of burnout. The situation is understandably worse in Nigeria with over 75% of Nigerian doctors reporting one or more symptoms of burnout. It is also worthy of note that female doctors experience burnout more commonly that males; this may be due to added pressures of family, reproduction and gender bias.
Some causes of doctor burnout include:
Sense of Powerlessness; especially for doctors who work among populations in poor socioeconomic situations like Nigeria, the inability to do what they can to help their patients’ medical issues leads to a feeling of defeat and futility.
Keeping up with increased patient demand as well as patient load; the number of people seeking medical care has exponentially increased, without a corresponding increase in numbers of doctors. Some outpatient doctors see as many as 30 patients in a clinic day!!!!
Poor working environment; absence of basic work tools, facilities and resources to render proper patient care can lead to frustration in low socio economic countries like Nigeria.
Working too many hours, with loss of work/life balance; contributes to physician burnout and there is a correlation among hours worked and physician burnout rates.
Poor remuneration; although the practice of medicine is considered a call to service or largely “humanitarian”, when the doctor is unable to provide adequately for the family due to poor salaries, it can be a major cause of frustration and reduced self-worth.
What are the symptoms?
Physical
- Feeling tired and drained
- Lowered immunity
- Frequent headaches, back pain, muscle aches
- Change in appetite or sleep habits
- Drop in libido or impotence
Emotional
- Sense of failure and self-doubt
- Feeling helpless, trapped, and defeated
- Detachment, feeling alone in the world
- Loss of motivation
- Increasingly cynical and negative outlook
- Decreased satisfaction and sense of accomplishment
Behavioral
- Withdrawing from responsibilities and procrastinating
- Using food, drugs, or alcohol to cope
- Taking out frustrations on others (spouse, children, staff or co-workers)
- Skipping work or coming in late and leaving early
Dangers of doctor burnout
Our public health policy should address this unwholesome development as it has implications for patient safety, doctor safety and healthcare system performance as a whole. Doctor burnout is a danger to patient health as doctors with burnout are more likely to be involved in patient safety incidents, they are also more likely to deliver suboptimal care to patients owing to low professionalism and diminished empathy for patients. Many doctors experiencing burnout are also prone to clinical errors and patient mismanagement errors (this is more profound amongst surgeons). Extreme cases of burnout has led to increasing suicide rates among healthcare workers in general, and doctors in particular.
Management
As most of the symptoms of doctor burnout are the same as depression/anxiety/chronic stress states, mental health habilitation is paramount in its management. Healthcare facilities should have a health worker psychological management system in place to help provide support. Doctor communities where there can be connections with colleagues are advised. Doctors should have a sense of control over their work and schedules, with opportunities to grow and excel in their chosen specialties. Others include; community involvement opportunities, employee recognition events and information about creating flexible work schedules.