The three stages of doctor burnout and prevention tips

Burnout caused by the stresses of a doctor’s job is sadly common. Psychological stress, especially within the medical profession, has been investigated regularly since the early 80s. Using the Maslach Burnout Inventory (MBI), burnout can be viewed as a process with different stages. Typically, stress at work leads to physical and emotional exhaustion, followed by depersonalisation and a cynical attitude towards the job.

The burnout process often ends with an aversion to everything, feelings of despair and guilt. However, burnout stages may develop sequentially too, and may be a result of high demands and low resources – something we all know is common in a doctor’s daily work.

Physical and Emotional Exhaustion

The first thing that someone heading in the direction of burnout will suffer from is physical and emotional exhaustion from high levels of stress, job expectations and workloads. The environment and resources of an institution also affect emotional exhaustion. Relationships, interactions, and decision-making have also been shown to affect stress in numerous ways. The person suffering from physical and emotional exhaustion will just have nothing left to give after getting home from work, which leads onto not having anything to give at work. This can become dangerous fast, especially within doctor jobs. All in all, the emotional exhaustion aspect to burnout is very important and can be addressed through philosophy, attitude, passion, personality, and emotions from an individual and institutional perspective.

Depersonalisation

The second part of burnout is depersonalisation. This is the “psychological withdrawal from relationships and the development of a negative, cynical, and callous attitude”. People in doctors jobs are facing depersonalisation and withdrawal, which is characterised by individuals pulling away, isolating them selves, feeling a diminished sense of accomplishment and considering a departure from medicine altogether. General awareness of the mind, body, and environment can increase the ability to assess a situation, which can affect stress and help address depersonalisation.

Helplessness / Existential Crisis

At this stage, people in doctor jobs start to question what they’re doing in medicine and start to lose that original sense of accomplishment that they would have had earlier on in their career. This is the stage that doctors start to wonder if this is actually the profession for them, they have lost all the meaning and passion that is required to thrive in such a high-stress environment. This is when physicians often consider leaving medicine altogether.

The difference between working in a high-stress environment and burnout is that there is a loss of joy, meaning and a loss of commitment. Burnout is a multifaceted phenomenon, it includes work, home, personality, emotional exhaustion, depersonalisation and a lack of personal accomplishment that affects the physical, emotional, and mental wellbeing of physicians in doctor jobs.

If a person holds a more flexible and reflective attitude and understanding of the meaning of life, the less likely they will be to experience stress and burnout from emotional exhaustion. Addressing how you feel at work and at home is an important first step.

Are you at risk of burning out? Simply assessing the way you feel about your job and experiences can be a reality check. This self-assessment tool is a really good way to see where you’re standing in relation to potential burnout.

Tips to prevent burnout

Burnout prevention at an organisational level is important, but this is hard to take on as an individual, particularly if you're already feeling burnt out. An important first step is to focus on what you can control - and this starts with personal health. Like all health issues, prevention is easier than the cure, which is why burnout prevention is so important.

There are no downsides to prioritising and optimising your own physical and mental health. Healthier doctors make better doctors.

1. Do not self-treat or self-prescribe. Establish contact with a GP outside of your family and work circles. See your GP when you need to and consider regular health checks.

2. Establish a ‘buffer zone' between work and home. Schedule breaks and holidays and try to maintain your paid hours (this means not starting early and finishing late for every single shift!).

3. Schedule time for your own needs and make this a priority, not a wish list. Make time for exercise and to prepare healthy meals. Prioritise some time every week to do something you enjoy or find relaxing.

4. Use your colleagues for support. Get involved in professional support networks like a mentor programme or peer support network.

5. Recognise that your personal and professional life will be affected by work-related stress. Learn to notice the signs of excessive stress and burnout in both yourself and colleagues, and find out what you can do locally to help. Act now, not later.