________________________________________________________________________ Burnout in Physicians
Work Environment Factors Burnout is more likely when an individual’s experience (actual or perceived) does not match one or more situational factors in a work environment [9]. Among the mismatches that most commonly lead to burnout in any work environment are [9]: • Work overload: Limitations in terms of staff, time, and other resources • Lack of control: Unable to perform job functions the way an individual believes is the “right” way • Insufficient reward: Absence of acknowledgment of an individual’s contributions in the work environment and lack of opportunities to advance • Absence of community: Poor working relationships, absence of adequate supervisory or peer support, poor leadership style • Lack of fairness: Inequality in workload, salary, or other signs of professional respect • Conflict in values: Disagreement between job requirements and an individual’s personal principles Personal Risk Factors Demographic variables have been studied in relation to burnout, and several have been found to influence the risk of burnout, alone or in combination, including [6]:
FIVE STAGES OF BURNOUT
Enter the Field Energy, Enthusiasm, Idealism
Work-related stress Job dissatisfaction Mismatch between nature of job and nature of individual
Stage 1: Disappointment and Fatigue Mental and physical exhaustion Emotional distance from others Setback in personal priorities
Stage 2: Frustration and Indifference Cynicism Strained personal relationships
• Age • Sex • Family status
Stage 3: Sense of Powerlessness and Professional Failure Decreased competency and caring Alienation of colleagues and others Emotional coping
• Educational status • Personality traits
Burnout is less prevalent among older individuals because they tend to be more stable and have a more balanced perspective on life [6]. In addition, the increased rate of burnout among younger individuals is a function of a “survival of the fittest” concept. Burnout usually occurs early in one’s career (in the first one to five years), and many young, burned-out individuals leave the profession; as a result, the remaining individuals in an occupation are the “survivors” [6]. Across most work settings, levels of burnout have been some- what consistent among men and women. One meta-analysis demonstrated similar overall rates of burnout among men and women, but there were differences between the sexes with regard to burnout components, with slightly higher levels of emotional exhaustion among women and somewhat higher levels of depersonalization among men [10]. Differences in burnout among male and female physicians will be discussed later in this course. Family status also seems to play an important role in burnout; rates of burnout are higher among single workers and workers with no children than among married workers and those with children [6]. The emotional resources provided by a family are thought to be the reason for this difference.
Stage 4: Isolation and Apathy Feeling of personal failure Isolation Absenteeism Breakdown in personal relationships
Stage 5: Burnout Emotional exhaustion Depersonalization No sense of personal accomplishment Contemplation of leaving job
Source: [20]
Figure 1
68
MDPA2326
Powered by FlippingBook