Burnout

Burnout is a complex phenomenon, combining all the dimensions of loss of resilience: physical (neurological, immunologic), emotional (anhedonic), energetic, cognitive, psychological (depression), and spiritual (loss of meaning, life purpose).

• Burnout is a complex phenomenon which to combine all the dimensions of loss of resilience: physical (neurological, immunologic), emotional (anhedonic), energetic, cognitive, psychological (depression), and spiritual (loss of meaning, life purpose, etc). Christina Maslach and colleagues have developed a detailed metric (Maslach Burnout Inventory) to track and measure the progress of the syndrome. In Japan, burnout takes its most acute form in “sudden death”, (karoshi).
• Some medical commentators challenge whether loss of resilience has anything to do with the physician burnout, arguing that physicians and health care providers generally are trained to be remarkably resilient and the malady lies in the institution of modern medicine itself.  One writes: “At the end of the day, if you look at what has contributed to increases in physician burnout over the last decade, it’s not that we have less resilient physicians. Physicians have always worked long hours, and physicians have always had stressful, demanding jobs. It’s the loss of autonomy, the pressure to do more with less, the ever-increasing documentation requirements, RVU-, and patient satisfaction-based reimbursement, the rise in student debt, and increasing social isolation as doctor-patient relationships and relationships among colleagues suffer as a result of time constraints, uncertainty about the future, and lack of flexible work options that reflect changing physician demographics, amongst other things.”

The implication of these studies is no matter how resilient physicians become, the odds are overwhelming. They are essentially powerless.

Whatever the cause, the phenomenon of physician, nurse, and caregiver burnout in the healthcare profession has reached crisis proportions. It is estimated that 38%-60% of physicians/nurses are burned out versus 27% of the general population, and the annual cost to the healthcare industry is estimated at $ 17 billion.

Notes:

• Burnout, Stress, and Resilience
• Helping Health Care Workers Avoid Burnout
• For a critique of resilience: (But note a key sentence: “If we can re-imagine resilience training as how to grow amidst stress, then I will come.”) Why Resilience Training Isn’t the Antidote for Burnout
• At the end of the day, if you look at what has contributed to increases in physician burnout over the last decade, it’s not that we have less resilient physicians. Physicians have always worked long hours, and physicians have always had stressful, demanding jobs. It’s the loss of autonomy, the pressure to do more with less, the ever-increasing documentation requirements, RVU-, and patient satisfaction-based reimbursement, the rise in student debt, and increasing social isolation as doctor-patient relationships and relationships among colleagues suffer as a result of time constraints, uncertainty about the future, and lack of flexible work options that reflect changing physician demographics, amongst other things. Physician Burnout: Why It’s Not About Resilience 
• Task force: Physician burnout costs healthcare industry up to $17B annually
• Maslach Burnout Inventory
• Karōshi
• Employee Burnout Is a Problem with the Company, Not the Person

Next: Trauma and Resilience