Professional Burnout

Health professionals caring for seriously ill/dying patients and their families are frequently exposed to distressing emotional situations and profound suffering. Lack of attention to health providers’ stress responses to this suffering can lead to burnout, which has consequences for the provider and his/her interpersonal relationships. This Fast Fact will describe burnout and its risk factors, and review essential research regarding health professionals and burnout. Additional Fast Facts will address symptoms, consequences, avoidance and assessment of burnout.

Common features (adapted from Maslach, 1982)

A predominance of mental or emotional exhaustion, fatigue, and depression
The symptoms are more mental and behavioral than physical
The symptoms are work-related
Burnout manifests in persons with no previous history of psychopathology
Decreased effectiveness and work performance result from negative attitudes and behaviors

Situational Risk Factors

Physician Worklife Study: 2326 US physicians identified via AMA masterfile responded to 38-item mailed questionnaire developed and validated for this study. Predictors of stress were:

Demands of solo practice, long work hours, time pressure, and complex patient
Lack of control over schedules, pace of work, and interruptions
Lack of support for work/life balance from colleagues and/or spouse
Isolation due to gender or cultural differences

Hospital consultants in the U.K.: 882 gastroenterologists, radiologists, surgeons, and oncologists responded to 12-item General Health Questionnaire and Maslach Burnout Inventory. Sources of stress were:

Work overload and its effect on home life
Feeling poorly managed and resourced
Managerial responsibility
Dealing with patients’ suffering

Individual Risk Factors

At risk earlier in career
Lack of Life-partner
Attribution of achievement to chance or others rather than one’s own abilities
Passive, defensive approach to stress
Lack of involvement in daily activities
Lack of sense of control over events
Not open to change

Author: Linda Blust , MD
References: Girdin DA, Everly GS, Dusek DE. Controlling Stress and Tension, Allyn & Bacon, Needham Heights MA, 1996. Linzer M, et al. Physician stress: results from the physician worklife study. Stress and Health 2002; 18: 37-42. Linzer M, et al. Predicting and Preventing Physician Burnout: Results from the United States and the Netherlands. The American Journal of Medicine. 2001; 111: 170-175. Maslach C. Burnout: The Cost of Caring. Englewood Cliffs, NJ; Prentice-Hall; 1982. Maslach C, Schaufeli WB, Leiter MP. Job Burnout. Annual Review of Psychology. 2001;52: 397-422. Ramirez AJ et al. Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet 1996;347: 724-728. Ramirez AJ, et al. Changes in mental health of UK hospital consultants since the mid-1990s. Lancet 2005; 366: 742-744. Schaufeli WB, Maslach C, Marek T, eds. 1993. Professional Burnout: Recent Developments in Theory and Research. Washington, DE: Taylor & Francis.