The Last Deadly Sin: Burnout

ennui: a feeling of utter weariness and discontent resulting from satiety or lack of interest

Burnout has many characteristics, including fatigue, exhaustion, inability to concentrate, depression, anxiety, insomnia, irritability, and sometimes increased use of alcohol or drugs. Probably the most distinct characteristic of burnout is a loss of interest in one's work or personal life, a feeling of "just going through the motions." For the most part, burnout in physicians does not differ from that in other professions, but physicians' reactions may be unique in some respects, in part because burnout in physicians can have devastating consequences for patients.

-Gunderson, L., Annals of Internal Medicine, July 2001

Feelings of boredom, exhaustion or disgust can infiltrate the minds of any of us who works for a living. This is not a sin. How we cope with such counterproductive feelings, though, determines whether we will thrive or wither in our job. The excerpt above is from an extremely well-written essay about physician burnout, and I recommend it to anyone interested in this phenomenom. In fact, this piece is so well written I won't add anything to it - for example, this quotation about the cause of burnout:

Self-care is not a part of the physician's professional training and typically is low on a physician's list of priorities. "Physicians deal with [other people's] personal problems all day, but they're the least likely to raise their own personal problems. They don't easily admit that they're under stress."

This quote addresses another cause of physician burnout:

A study published in Western Journal of Medicine found a correlation between burnout and a perception of loss of control. As perceived control, social supports, and resources increased, burnout decreased. The study concluded that lack of perceived control was the best predictor of burnout.

Wellness promotion is a hot topic in health care, and for good reason. A little discretion in what our diet consists of, setting limits on how much we eat and how often, a commitment to exercising, shunning tobacco products and following guidelines for health testing go a long way to keeping us well. As challenging as these goals may seem, achieving psychological and spiritual well-being is even harder in my view.

Physicians have five major categories of self-protective practices: relationships, religion or spirituality, self-care, work, and approaches to life...researchers concluded that physicians use various approaches to aim for well-being, and that these approaches are correlated with improved levels of psychological well-being.

The bottom line is that it takes work to maintain what the researchers call well-being, and doctors must continuously monitor themselves for the signs of irritation, frustration or whatever form stress comes to haunt them. A plan of action in times of danger is the second component of avoiding physician burnout.

The first is recognizing the problem before it causes damage to two victims - physician and patient.