Causes, Signs and Symptoms of Burnout

Burnout Among Doctors

• Burnout among doctors has been extensively studied and researched upon, it has been seen that it adversely affects doctors and their mental health.
• To quote Tait Shanafelt, MD “Numerous global studies involving nearly every medical and surgical specialty indicate that approximately one of every three physicians is experiencing burnout at any given time.”
• This accurately concludes that healthcare sectors are one of the major areas where burnout is experienced by people.
• The causes, signs, and symptoms of burnout are not well known. Certain signs and symptoms of burnout are considered normal reactions and they are not given enough importance, leading to higher levels of burnout in doctors.
• Ignoring the signs and symptoms of burnout leads to adverse effects and consequences like impaired quality of work, increased mistakes in practice, and resorting to substances.
• Impact of doctor burnout can turn out to be dangerous, leading to higher absenteeism, dropping the profession, and in many cases, even suicide.

There are many signs and symptoms of burnout in doctors like fatigue, irritability, frustration, and confusion, but three main signs and symptoms of burnout are:

• 1) Exhaustion: It is the lack of energy or feeling of being completely drained physically and emotionally. Doctors fear they will not be able to continue to work any further.
• 2) Depersonalization: When doctors stop caring about their patients or start thinking negatively about their job or feel emotionally unavailable, it’s called depersonalization. It can also be called compassion fatigue.
• 3) Lack of productivity/Efficacy: Doctors start to doubt the quality of their work and are scared to make errors while treating their patients. The amount of work carried out by them also decreases.

These above mentioned are three main signs of burnout. Other signs and symptoms which seem like normal behaviors but are signs and symptoms of burnout include:

• Sleeping for longer hours
• Feeling tired after doing the bare minimum at the job
• Disinterest in going to the hospital
• Making excuses or looking for reasons to avoid seeing a high-risk patient
• Frequently falling sick
• Delays in submitting reports
• Irritability and anger towards issues that are of no importance

Burnout is not a sudden onset, it does not happen overnight, it happens slowly over a period of long time and is chronic in nature. It can impact the person suddenly when triggered by a traumatic event like the failing of a big case, a lawsuit, a tragic event, or maybe even a family dispute. A big trigger can suddenly make the person feel all the signs and symptoms of burnout and they can completely lose all their energy and feel mentally drained, which is termed as burnout.

Since burnout is not an overnight trouble, there are various reasons and causes that pile up, leading to burnout in doctors. Some of the common and important causes of burnout include:

• Work factors: Doctors' nature of work, including long working hours, night duties, comprehensive documentation, dealing with serious traumatic cases, and the risk of malpractice, leave the doctor feeling overwhelmed and worked up most days. They find a loss of autonomy at work and decreased control over the work environment.
• Personal Characteristics: Doctors generally tend to have certain specific characteristics that lead to burnout. They are self-critical at most times, engage in unhealthy coping mechanisms, perfectionism, idealism, and believe they can work straight for 20-30 hours during training. All these traits eventually add up and become a leading cause of burnout in doctors.
• Organizational factors: Different organizational factors like non-supportive seniors, workload expectations, insufficient rewards, and limited or no social support may be a very important factor or cause for doctor burnout.
• Work-life balance: There is no set routine for doctors. They can be called at midnight for emergency cases or, as trainees, might be expected to work for days at a stretch without having sufficient breaks. This uncertainty and the nature of the job make it difficult for doctors to maintain work-life balance, and they don’t end up taking enough breaks from work. This becomes one of the major causes of burnout for them in the future.
• The conditioning of medical education: Every doctor goes through intense training, and over seven-plus years of training, various things are taught to them which are normalized, like “patients come first” and “never show weakness.” Their brain gets conditioned and wired, which eventually leads to burnout.

Burnout among doctors is a significant and pressing issue that can have profound implications not only for the well-being of healthcare professionals but also for the quality of patient care. As we have explored, burnout happens through signs such as exhaustion, depersonalization, and decreased productivity, often rooted in a combination of work-related stressors, personal characteristics, and organizational factors. The chronic nature of burnout means it develops gradually, driven by an accumulation of pressures and expectations placed upon doctors throughout their training and careers.

Addressing burnout requires a multifaceted approach, emphasizing the importance of recognizing early signs, fostering supportive work environments, and promoting a healthier work-life balance. Healthcare organizations must prioritize mental health and well-being, implementing systemic changes to mitigate factors contributing to burnout. By doing so, we can help safeguard the mental health of our doctors, enhance job satisfaction, and ultimately improve patient outcomes.

The journey towards addressing burnout is ongoing, but awareness, understanding, and proactive measures can pave the way for a healthier, more resilient healthcare workforce.