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Burnout in Physicians

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Five stages of disillusionment: - enthusiasm -stagnation -frustration -apathy -intervention ... with sickness and death. Coping behavior. working harder ... – PowerPoint PPT presentation

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Title: Burnout in Physicians


1
Burnout in Physicians
  • Hakan YAMAN, MD, MS

2
  • Dr. Hakan YAMAN is Assistant Professor in Sports
    Medicine at Süleyman Demirel University, Medical
    School, Isparta,Turkey.
  • He has finished a residency in Family medicine
    and has a master of science degree in sports
    sciences.
  • Since his residency he is involved in the study
    of burnout of health professionals.
  • He has published and presented several papers on
    burnout in physicians working in Turkey.

3
Learning Objectives
  • To understand the concept of burnout
  • To describe sources of stress
  • To determine coping behavior
  • To understand possible interventions

4
Performance Objectives
  • Understand the importance of burnout in
    physicians
  • Be aware of symptoms of burnout
  • Be able to determine sources of stress
  • Be aware of intervention approaches

5
Introduction
  • Practice of medicine is stressful
  • Physicians must interact with intense emotional
    aspects of life
  • Physicians are called on to cope and adapt with
    stress charecteristic of their job

6
Introduction-2
  • Burnout in physicians has many important
    implications for -persons experiencing it.
    -recipients of health care.
  • Knowledge on how stress and burnout develops is
    important.
  • This understanding will help how to prevent
    burnout.

7
The Concept of Burnout
  • Burnout is a reaction to chronic, job-related
    stress.
  • A literal collapse of the human spirit (Storlie
    1979).
  • The loss of concern for the people with whom one
    is working(Maslach 1976).
  • psychological withdrawal from work in response
    to excessive stress and dissatisfaction
    (Cherniss 1980).

8
The Concept of Burnout-2
  • Degrees of burnout
  • - first degree failure to keep up and gradual
    loss of reality
  • -second degree accelerated physical and
    emotional deterioration
  • -third degree major physical and psychological
    breakdown

9
The Concept of Burnout-3
  • Five stages of disillusionment
  • - enthusiasm
  • -stagnation
  • -frustration
  • -apathy
  • -intervention

10
The Concept of Burnout-4
  • Three stage transactional model of burnout
  • -Stage 1 demands exceeding emotional resources
  • -Stage 2 attempts to balance between demands and
    resources
  • -Stage 3 maladaptive coping mechanisms develop

11
Three stage transactional model of burnoutStage
3-Burnout
  • Maladaptive coping mechanisms
  • Responses
  • Physical Emotional
  • Adaptive coping mechanisms
  • balance restored
  • responses resolved

12
Sources of Stress
  • House officers syndrome
  • - long training hours
  • - excessive work loads
  • - sleep deprivation
  • - changing work conditions
  • - peer competition
  • - self denial

13
Sources of Stress-2
  • Senior Physician find new stresses waiting for
    them
  • - work faster and longer hours
  • - mountains of paper work and threat of
    malpractice suits
  • - economic security prove elusive

14
Sources of Stress-3
  • - difficulties to keep up to date
  • - challenge to explain and defend work
  • - daily confrontation with sickness and death

15
Coping behavior
  • working harder and longer
  • sense of entitlement
  • belief on immunity to difficulties
  • failure of self recognition of mental problems

16
Coping behavior-2
  • alienating family members and friends- three
    explanations
  • - anger and frustration are vented to family and
    friends
  • - unability to share troublesome experiences
  • -family and friends are another source of demand

17
Coping behavior-3
  • Avoiding to be with family
  • - Physician Dawdler
  • - Electronic Physician
  • - Out-of-town Academician

18
Intervention
  • Initiation of programs to alert physicians to
    stresses
  • Re-evaluation and restructuring medical training
  • Offering programs and conferences dealing with
    burnout

19
Intervention-2
  • Learning of new adaptive coping mechanisms
  • - self-assesment and determination of stressors
  • - specification of life priorities
  • - sharing and expressing feelings

20
Intervention-3
  • Aleviating stres at work
  • - focusing on positive aspects and small success
  • - setting daily and weekly goals
  • - breaks and variation in daily schedule
  • - utilizing a team approach

21
Conclusion
  • Burnout among physician is a serious problem,
    with a risk for suicide.
  • Programs and conferences are needed to alert
    physician against burnout.
  • Medical training should be re-evaluated and
    restructured to prevent burnout.
  • Physicians suffering of burnout need to learn new
    adaptive coping mechanisms.

22
References
  • 1. Deckard GJ, Hicks LL, Hamory BH. The
    occurrence and distribution of burnout among
    infectious disease physicians. JID1992165224-8.
  • 2. Schneider J. Self-care Challenges and rewards
    for hospice professionals. Hopice J
    19873121-146.
  • 3. Fawzy FI, Fawzy NW, Pasnau RO. Burnout in
    health professions. In Judd, Burrows, Lipsid,
    eds. Handbook on general hospital psychiatry.
    1991.p.119-130.
  • 4. Storlie FJ. Burnout The elaboration of a
    concept. Am J Nurs. 1979122108-2111.
  • 5. Maslach C. Burned-out. Hum Behav 1976516-22.
  • 6. Cherniss C. Staff burnoutJob stress in the
    human services. Beverly Hills SagePubl.1980.
  • 7. Simendinger EA, Moore TF. Organizational
    burnout in Health care facilitesStrategies for
    prevention and change. RockvilleAspen Syst
    Co.1985.
  • 8. Edelwich J,BrodskyA. Burned-outStages of
    disillusion ment in the helping profession.
    NewYork Human Sciences Press.1980.
  • 9. Small G. House officer stress
    syndrome.Psychsomatics 1981 22 860-864.
  • 10. Martin CA, Julian RA. Causes of stress and
    burnout in physicians caring for the chronically
    ill. Hospice j 19873121-147.
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