A big elephant in the burnout room

Elephant stands on thin branch of withered tree

Burnout. We talk about it a lot these days. More prevalent in doctors than other professions, it’s a global phenomena that’s relentlessly growing, year after year after year. Medscape is the latest organisation to publish a report following a large-scale study on the subject. It makes for some interesting reading. However, within all the very useful information contained there’s a great big elephant crashing about the burnout room which we need to acknowledge. Whenever we point it out and we start to talk about it, a vital part of the solution becomes impossible to ignore.

What did Medscape find?

Medscape’s report is based on 13,000 participants’ self-assessment responses. It considers the problem from a number of angles.

They explored it from a demographic perspective. Burnout is more prevalent within Emergency Medicine than Dermatology. Younger doctors are more affected than their more experienced counterparts and women more affected than men.

The majority of the most regularly cited contributing factors are about the system and circumstances. Bureaucracy is at the top. Workload and lack of autonomy or control are in there too. It’s interesting that factors related to patients themselves and the pandemic only just make it into the top 10.

Participants describe how the stress, anxiety and anger have affected their relationships. They’ve indicated how it impacts on confidence and is detrimental to patient care. Stress, anxiety and anger lead to depression and ultimately to good people being lost to the profession.

And how do doctors deal with it? Exercise comes in at number one on that list. It’s followed by taking time alone, talking to friends and sleep. And how to try and alleviate it? #1 meditation and other stress reduction techniques. #2 reduce working hours. #3 change work settings and so on.

No real surprises in any of that.

So, where’s the elephant in the room?

Well, second from top of the list of “What contributes most to your burnout” is “Lack of respect from colleagues.” 39% of participants indicated this to be the case. That’s two out of every five doctors. Yet, there’s nothing anywhere to indicate that anyone is doing anything to change that situation. Nothing about taking steps to improve team interaction and behaviour.

Mindfulness and lunchtime yoga are examples of fantastic initiatives and they can make a difference. But virtually every entry on the list of methods to deal with burnout and how to alleviate it focus on the symptoms rather than the causes.

Developing a culture of respectful professional relationships for doctors with zero tolerance on poor behaviour is a vital part the strategy for the war on burnout. Team members must be empowered and encouraged to develop the skills to constructively stand up for themselves and support colleagues who are experiencing difficulties. More senior team members must develop and utilise compassionate leadership skills. That is compassionate leadership for both the person experiencing the difficulties and for anyone who needs to change their ways.

Speaking out about what you see to be wrong, standing up for yourself and standing up for others is not easy. Learning the skills required takes dedicated time and effort. None of that seems to appear on the survey lists for tackling the burnout problem. But it has to be part of the solution.

What are you doing to address the hulking great elephant in the burnout room?

Stephen McGuire – Managing Director