We thank the Editor and Dale and Old1 for commissioning and writing an interesting commentary on our research on depersonalistion as a form of burnout in GPs.
Given that we received the biggest number of completed Maslach Inventories so far reported (564 GPs, with 42% depersonalised), we agree the findings merit serious attention. Their practical suggestions, such as making time for a weekly lunch between colleagues, in our experience, work well.
We, too, are interested in the finding that females suffered less depersonalisation and agree females may have much to contribute to considering responses. However, we are cautious about this finding since, as we stated, we did not have data on part-time working. We suspect that part-time working (much more common in females) may be protective against burnout.
We think it is very helpful that Dale and Old distinguish between depersonalisation as we used it (as defined by the Maslach Inventory) and the psychiatric state they describe. Although doctors may lose insight when depersonalised, our new finding was that they still maintain a professional face, so that patients answering questionnaires, did not perceive the depersonalised doctors as being different from other doctors.
We do not agree that a degree of depersonalisation (cynical feelings towards patients) is necessary. Maintaining a safe emotional distance is a skill GPs need to learn, but not at the cost of cynicism. As they write, our results show that most GPs achieve it.
Dale and Old undervalue doctors consulting GPs for stress. The two of us who are experienced GPs (PO and DPG) have both had the privilege of being consulted by several fellow doctors over many years. Doctors as patients do indeed have special difficulties, but with clear agreements, ground rules on privacy, adequate time, and personal care with continuity. We believe valuable support and treatment can be and often is provided for consultants and GPs within general practice. Indeed, this may be the optimal setting for care.
REFERENCES
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