The word “burnout” probably calls to mind air-traffic controllers, emergency room personnel and other people who work at a rapid pace under relentless pressure. But burnout also strikes people you might not expect—like your doctor. And this could be very hazardous to your health.
Exact statistics are hard to come by, but repeated studies in the US, Canada and Europe have found symptoms of burnout in 40% to 60% of doctors. And no one is exempt—the problem affects doctors who are fresh out of medical school and old-timers…generalists and specialists…men and women.
Shocking new finding: A 2011 study published in Archives of Surgery found that one of every 16 surgeons in the US had thought about suicide in the prior year—often due to burnout. Burnout has three main characteristics…
Emotional and physical exhaustion. The stress of work and its demands on attention and energy leave the sufferer mentally drained and often physically fatigued.
Depersonalization. Those who are approaching burnout may feel detached from themselves and others. They begin to see people less as individuals and may show a lack of enthusiasm and perform their work in a more impersonal manner.
Lack of a sense of achievement. Burnout robs people of the satisfaction they need from their work. They may believe that they’re doing a poor job or that their work is less meaningful than they would like.
Why has physician burnout increased so much in recent years? Many experts believe that the rapid changes in the health-care system are largely to blame.
For example, doctors have less control over their work than they once did—a known risk factor for burnout. They may be unable to order certain tests or use treatments that they believe their patients need because an HMO or insurer has said “no.”
Pressed by managed-care systems to see more patients in less time, doctors are often working harder and faster—overwork is another risk factor for burnout—and are unable to practice medicine in the way they feel is best. The threat of malpractice lawsuits, pressure to rein in costs and more frequent Medicare/Medicaid audits also add to the stress.
Burnout doesn’t affect only the doctor, it can impact the patient as well. A 2010 study of 188 primary care physicians published in the journal Family Practice found that on days when doctors felt anxious, fatigued and stressed, they wrote more prescriptions and ordered more tests (some of them unnecessary, the researchers suggested) and spent less time talking with patients. More errors in diagnosis and treatment also have been linked to physicians who suffer from burnout than among doctors who do not, according to research.
Less easily measured, but at least as important, is the impact on the doctor-patient relationship. A common consequence of burnout is loss of empathy—the doctor’s ability to care about others, including his patients. It shows up in lapses in attention and failure to respond with displays of concern when patients express worry or distress.
This lack of feeling on the doctor’s part affects the patient’s care because a person who senses that his doctor is listening sympathetically is likely to go into more detail about symptoms and other problems such as side effects of drugs. A doctor’s apparent lack of empathy can mean this information is withheld by patients, often leading to errors in diagnosis and treatment.
The signs of burnout can be missed if you’re not looking for them—even in a longtime family doctor whom you feel you know well. Be alert for these red flags…
It’s harder to recognize burnout in a specialist you’re seeing for the first time, but just as important. You need him to be alert and fully involved when dealing with a problem that demands expert care.
Main clue: Does the specialist know who you are and why you’re there, what tests have been done and what treatments have been tried? Your regular doctor should have sent information about you along with lab and radiology results—has the specialist taken the time to look at them?
If you suspect burnout in your doctor, what should you do? There’s always the option of finding another doctor. But if it’s someone you’ve been seeing for years and know to be essentially competent and compassionate, such a switch may not be best for you or your doctor.
Ask your doctor: “How are you? Is everything OK?” You may learn that today’s inattention is due to the kind of passing stress or disruption that can affect anyone, such as a poor night’s sleep or an office crisis. Or you may get an inkling that problems run deeper.
At the very least, showing your concern will strengthen your relationship and may even encourage him to recognize that pressure and stress are taking their toll. This may well help to persuade him to do some introspection, consult with a colleague or seek needed help. If your visits continue to leave you dissatisfied, however, it may be time to look for a new doctor.
