Burnout is a work-related syndrome that occurs in occupations where others’ needs come first, and where there are high demands, few resources and a disconnect between workers’ expectations and experiences1
Burnout is characterized by emotional exhaustion, depersonalization or feelings of detachment and cynicism toward people and work, and a reduced sense of accomplishment.1 In contrast, the absence of burnout may be an indicator of physician wellness, which translates into engagement and satisfaction with work, and a sense of thriving in physical, emotional and social health.1,2
Many physicians experience symptoms of burnout, which often begin in medical school and increase during residency training2–5
Risk factors for burnout include organizational factors such as workload and lack of autonomy, and personal factors such as female gender.1–5 Resources for physicians experiencing burnout are shown in Box 1.
Box 1: Resources for physicians, residents and medical students experiencing burnout*.
| Organization | Contact |
|---|---|
| Alberta Medical Association Physician and Family Support Program† | 877 767-4637 |
| Physician Health Program of British Columbia | 800 663-6729 |
| Doctors Manitoba Health and Wellness Program | 204 237-8320 |
| New Brunswick Medical Society Physician Health Program | 888 453-7272 |
| Newfoundland and Labrador Medical Association Physician Care Network | 877 418-2181 |
| Doctors Nova Scotia Professional Support Program | 855 275-8215 |
| Ontario Medical Association Physician Health Program | 800 851-6606 |
| Quebec Physicians Health Program | 800 387-4166 |
| Physician Support Program of Prince Edward Island | 877 418-2181 |
| Saskatchewan Medical Association Physician Health Program | 800 667-3781 |
Other resources are available through the provincial professional associations of resident physicians and the offices of learner wellness within Canadian faculties of medicine.
There are no organizations for Nunavut, the Northwest Territories or Yukon, but Alberta has an agreement with the Northwest Territories to provide some support.
Physicians with burnout experience its effects in both their professional and personal lives2–5
Burnout is associated with depression, suicidal ideation and substance abuse, as well as unprofessional behaviour, reduction in work hours and medical errors.2–5
Burnout is difficult to recognize and address in oneself and in colleagues
Few physicians who self-identify as burnt out seek outside help, and physicians are cautious about reporting distressed colleagues.2 This is in part owing to perceived stigma, denial and avoidance as coping strategies, and concerns about licensing.2
Strategies to improve physician wellness should target organizations as well as individual physicians3–5
Two recent meta-analyses show that organization-directed interventions, such as increased autonomy and scheduling changes, are associated with a moderate but substantial reduction in physician burnout.4,5 These interventions may be more effective than physician-directed ones, such as mindfulness training and stress-management techniques, although combined approaches are likely the most successful.4,5
Footnotes
CMAJ Podcasts: author interview at https://soundcloud.com/cmajpodcasts/170827-five
Competing interests: None declared.
This article has been peer reviewed.
References
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