Burnout in Medical Professionals

What is a burnout? What are its symptoms? Is it considered a mental illness?

“Burnout” was coined in the 70s by psychologist, Herbert Freudenberger. To date there is no scientific definition for burnout. It is general description of loss of interest and motivation towards work, following a long period of excessive stress. The sufferer complains of tiredness and lethargy. He or she may feel unappreciated and may be cynical about work and colleagues.

Read about the differences between Burnout and Depression here.

Why are medical professionals more susceptible to suffering from burnout? What do you think are the factors that cause doctors to feel burnt out?

The nature of the work encountered by medical professionals make them more susceptible to burnout. Diseases go on for 24/7 and do not respect office hours. Medical professionals often have to work long hours, rotate through shifts and attend to patients on weekends. Some may continue to worry about the patients they are in charge of even during after hours. Due to the long hours and shifts, they may not have time with their family and friends, to attend to their hobbies, or to even rest.

Medical professionals also have to face crises, deaths and sicknesses all the time. The emotional aspects of the work can be daunting and draining.

Finally, little is done to address burnout in medical professionals within the fraternity. We are expected to be able to handle long work hours and traumatic experiences even as junior doctors. An inability to cope is seen as a weakness and as such medical professionals are often fearful and unwilling to speak up when stressed up or to seek help.

How could burn out affect doctors as well as their work?

As doctors get burnt out, they will start to feel easily exhausted, and start to lose interest and confidence in their work. They may become easily tired and irritable at work. Some may start having anxiety during the weekend about the start of the work week. They may find it hard to drag themselves out of bed each and every day. When the burnout worsens. these difficulties may spread to their social and family life. They may lose their temper easily with their partners, spouses or children. In extreme cases, an anxiety disorder or clinical depression may ensue.

Can you share more about your experience as a doctor? What were some of the difficulties and challenges you faced that were not so apparent to non medical workers or non-doctors?

Doctors are deemed to be in a privileged position by society. In Singapore, the medical fraternity holds it upon ourselves to have high regards to ethics and to our fiduciary duty to our patients and society. In this regard, being a doctor does not end when we leave the hospital or the clinic as one must continue observing the decorum befitting of the profession. We are also very conscious of this in our work and the obsession over being careful all the time can be very tiring.

The doctor patient relationship can also be a tricky one. The doctor-patient relationship is seen to be sacred by us. We have to be personable and approachable but at the same time maintain a boundary with patients. We have to be mindful that our treatment decisions must at the same time be for the patients’ best interest, uphold social justice and evidenced based. Many a times, a recommended treatment may not be what the patient wants and this can often result in unhappy encounters for both sides. For eg. a patient may feel that he deserve a longer medical leave but his condition does not justify it and doing so will be unfair to his company and his colleagues.

While we may work in a team in hospitals, most of the time, we have to make clinical decisions, some of which are life or death situations, independently on our own. Not all good decisions lead to good outcomes but it is still hard to shake the guilt off when outcomes are negative, even when we tried our best.

Have you or any colleagues suffer from burn out? How did you/they cope with it? How can fellow doctors or their loved ones help them?

it is not uncommon to see colleagues suffer from some form of burn out after which they may leave their job or give up some responsibilities. Personally, while I have not experience overt burn out, I have in the past become rather irritable when I am overworked.

It is therefore important for doctors to be aware that we are not infallible and to also be mindful of our psychological wellness or the lack of. Rest is the most effective remedy for burn out and having proper sleep, exercise and hobbies are important. We should ring fence our time and have a break from work, so that we have time to do so.

Doctors do get together in informal support group to rant and ventilate about work. Talking it out helps a lot. Family members and loved ones can also be emphatic, patient and provide listening ears.

When should medical professionals seek treatment for burn out problems?

Prevention is always better than cure. Having adequate rest and a proper work life balance are essential in preventing burn out and making it possible to sustain our work as doctors.

However, when a medical professional start noticing he is having symptoms of burnout and becoming less effective at work, he should start taking steps to slow down his pace. If he notice that he is starting to have excessive anxiety, prolonged low mood, difficulties with sleep and appetite, inability to discharge his duties as a doctor, or even suicidal thoughts, he should seek treatment.