1. Definitions of Burnout
    • Burnout Syndrome:
    • 1. state of mental and physical exhaustion caused by one's professional life
    • 2. state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding situations
    • 3. psychological symdrome in response to chronic interpersonal stressors on the job. involves a)overwhelming exhaustion,, b) feelings of cynicism, and c) detachment from the job, a sense of ineffectiveness and lack of accomplishment
    • 4. The Burnout cycle (another card)
    • 5. Model of mismatch (another card)
  2. The Burnout Cycle
    • 1. a compulsion to prove oneself
    • 2. working harder, high personal expectations
    • 3. neglecting own needs, viewed as heroic
    • 4. displacement of conflicts - source of problem not recognized, first physical symptoms appear
    • 4. revision of values - isolation, conflict avoidance, denial of basic needs
    • 5. denial of emerging problems - develop intolerance, cynicism and agression
    • 6. withdrawal - reduce social contact, numb the pain (alcohol)
    • 7. obvious behavioral changes - fearful, shiy, apathetic
    • 8. depersonalization - mechanical life, lose contact with self & others
    • 9. inner emptiness - excessive behaviors like hypersexuality or overeating
    • 10. depression - indifferent, hopeless, exhausted
    • 11. burnout syndrome - physical and mental collapse, need medical attention
  3. Model of Mismatch
    • prof burnout results from a mismatch between the person and the six domains of his or her job environment, the greater the mismatch, the greater the likelihood of burnout.
    • 1. workload
    • 2. control
    • 3. reward
    • 4. community
    • 5. fairness
    • 6. values
  4. How do you measure Professional Burnout?
    • The Maslach Burnout Inventory
    • -assesses exhaustion, cynicism, and reduced professional efficacy
  5. Amongst Phsycians, what were the reasons for job dissatisfaction?
    • -(80%) managed care system would not improve over the next five years
    • -earnings had declined over last 5 years
    • -time with patients declined over last 5 years
    • -not happy with time available for family and personal life
  6. Predictors and Risk factors for Stress and Professional Burnout
    • -lack of percieved control, long work hours, and little or no recognition for their efforts
    • -from worklife study: demands of solo practice, long work hours, time pressure, complext patients, lack of control, lack of support, isolation b/c of gender or culture
    • -another study: work overload and it's effects on home life, feeling poorly managed/resourced, managerial responsibility, dealing with patients' suffering
    • -specific individual risk factors: young & early career (subject to survival bias, where those who burn out early, quit), lack of life partner/unmarried, males at higher risk for cynicism, attribution of achievment to chance or others, passive defensive and avoidant approach to stress, vicaroius trauma, lack of involvment in daily activities, external locus of control, not open to change, poor self-esteem, neuroticism
  7. Consequences of professional burnout for organizations?
    consequences for organizations: absenteeism, productivity problems, job dissatisfaction, lower quality or care, adverse work environment, lower retention of skilled staff, poor patient care and greater patient dissatisfaction
  8. **consequences of professional burnout for the individual?
    • 1. anxiety
    • 2. sleep or eating disturbances
    • 3. physicial problems (hypertension, weakened immune system)
    • 4. depression, suicide-related ideation and behavior
    • -highest levels of ideation in 4th year, higher than other graduate programs and general public, woman 2x higher than men.
    • -symptoms left during residency only for men.
    • 5. negative cognitions about self-worth
    • 6. substance use disorders
    • - 10-15% of gen pop at some career point
    • - 7% of physicians at any one time
    • -numbers dont change for specialty, region, age, urban vs. rural, academic vs. private
    • -major risk factor for medical malpractice
    • 7. anger
    • 8. bad marriage/family situation
    • -correlation of stresses between job and home
    • -correlation of excessive work hours and marital problems
  9. physician specific factors actors associated with substance abuse?
    • 1. >pack a day
    • 2. high stress, long work hours
    • 3. Hx of multiple affairs/marriages
    • 4. Hx of multiple jobs, in multiple communities
    • 5. occupational access
    • 6. acadmenic medicine
    • 7. ER doc, anesthesiologists, psychiatry
    • 8. self-prescribing behavior
    • 9 anger
  10. Suicide in physicians
    • -higher than general population, starting in med school
    • -40% higher in men, 130% higher in women
    • -associated psychiatric disorders: depression, alcohol or drug use, bipolar, anxiety, personality disorder
  11. Role Strain*
    • -major trigger for physician suicide
    • -three areas of challenge:
    • 1. inordinate time and work demands
    • 2. huge sense of responsibility for human life and death
    • 3. inadequate and inconstistant psycological support
  12. Self-care recommendations
    • 1. develop a personal work philosophy
    • 2. budget your personal resources - get enough nutrition, sleep and exercise
    • 3. seek social support
    • 4. pleasurable activity or hobby
    • 5. stress management techniques
    • 6. psychological or psychiatric help if needed
    • -hard for drs to ask drs, fear of "crazy" word getting out
    • 7. learn from others' hardiness - get professional mentor
    • 8. set clear boundries (work levels)
    • 9. know SELF care = PATIENT care
Card Set
MP - Professional Burnout