Defining burnout in medicine (physician burnout)

Burnout presents a bit of a conundrum for doctors. It's difficult to define yet affects nearly 1 in 2 of us (so if you don't have it, chances are, the doc sitting next to you does). It's an insidious, multidimensional syndrome that can destroy our careers. But how much do we actually know about it? In this video, from our Burnout Prevention Masterclass: Your Path to Resilience course, we look at the complex definition of burnout, how it hides in plain sight, and why this common piece of doctor wisdom is actually a surprising sign of burnout.

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According to the American Medical Association, over 44% of American doctors surveyed, are experiencing symptoms of burnout. A large Australian study found that physicians experienced more suicidal thinking than the general population. Furthermore, a study of rural physicians in British Columbia found that 50% of them suffered from burnout symptoms.

Physician burnout is a significant problem. It impacts patient care, and physician well being. I will teach you the complex definition of burnout and show examples of how it impacts clinical practice. In 1974, Freudenberger coined the term burnout. While working in a mental health clinic with patients who had substance use disorders.

He wrote about burnout and he described it as the experience of wearing out or becoming exhausted by the excessive demands on one's energy, strength, or resources. Since Freudenberger's pivotal discussion there have been many articles and books on this topic. There are a variety of definitions of burnout and it is considered a multidimensional syndrome.

One definition of burnout is described by authors, Pines and Aronson. They define burnout as a state of physical, emotional, and mental exhaustion, which is caused by long term involvement in emotionally demanding situations. As medical professionals, you are constantly engaged in emotionally demanding situations, and will continue to be throughout the duration of your career.

Burnout presents in many different ways for different people. Some of the common symptoms are fatigue, frustration, disengagement, or apathy, stress, helplessness, hopelessness, emotional exhaustion, and anger or cynicism. Another definition was created by a key researcher in the field of burnout. Dr. Christina Maslach.

She and her colleagues define it as having three primary components: emotional exhaustion, depersonalization, and a decreased sense of accomplishment. Emotional exhaustion encompasses the feeling of being overextended. One's own inner resources are used up, which can lead to feeling too tired to care. The second component is depersonalization.

This is displayed by the physician or nurse as seeing the patient as a number. They no longer see each person as unique with their own story, but feel detached from patients. They begin to lose the empathy and compassion towards patients that they once felt. The final component described by Dr. Maslach is a decreased sense of accomplishment. The job no longer provides the sense of fulfillment. The burnt out individual feels excessively self critical of their work, and feels that they're incompetent.