Physician Burnout Part 1: Preventing Burnout

I am a doctor, a GP.

I have worked in the NHS for over 20 years.

I have always loved my job. Then, stress and anxiety completely crippled me. I no longer enjoyed working as a GP. In fact, I dreaded it. I was exhausted and burnt out.

I am not alone in this. Over the last 2-3 years especially, more and more doctors and health professionals are become increasingly fed-up, frustrated, unhappy and stressed. Many are becoming are becoming ill, physically and/or mentally. Many are leaving the profession, emigrating or retiring early.

As David Zigmund notes, in his letter to the BMJ in February this year, “GPs demoralisation is due to our loss of human connection”:

“From the 1990s each successive government has increased GPs’ ‘must do’  lists: myriad QOFs, goals and targets, audits, appraisals, inspections, prescribed care pathways … and then competitive commissioning of services. Each of these ‘must do’ tasks may be well intended by planners but subtracts from the autonomous headspace and heartspace of practitioners.”

Added to this more recently, is the worry for all doctors in the rising number of complaints, GMC enquiries, litigation and even criminal proceedings. This, on top of the mounting workload and the fragmented social networks within our organisations, just adds to the stress, anxiety and sense of paranoia perceived by so many of us.

There is clearly an urgent need to tackle this crisis as more and more people are struggling emotionally and as pressures and demands increase exponentially.

The government are now investing vast sums in a national GP Health Service, which is being rolled out this January. I welcome this – having rapid access to a confidential service locally would perhaps have helped me earlier on or got me back to clinical work sooner. I really hope that this will help many others now struggling.

However, I believe that we should be focussing our attention more on what we can do to prevent getting to this position in the first place.

 

So how can we prevent burnout?

Many things won’t be changeable, so it is not worth wasting our energy on these. As individuals or as small teams, we need to focus on the changes that might make a difference. Small changes in the right places can be completely transformative.

I like Dr Dike Drummond’s model for preventing burnout. He uses a “Burnout Prevention Matrix” looking at four key areas:

  • Reducing our stress at work, i.e. setting firm boundaries
  • Reducing our stress at home, i.e. being organised and having systems in place
  • Increasing our ability to re-charge at work, i.e. seeking social support, taking a pause
  • Increasing our ability to re-charge at home, i.e. activities that you enjoy and that energise you, relaxation strategies such as meditation, yoga

 

General practice for me has always required a lot of my energy as I have always given it 100%. Before having kids, I could always re-charge this energy at home. As we grew our family, I lost not only the ability to re-charge, but needed to give more and more of my energy to home life.

When I look at this matrix, it seems clear why I bypassed prevention!

Using it now, however, has enabled me to consider what changes I need to make going forward to enable me to learn to thrive at work, not just survive.

I will be writing a series of posts, each looking at one of these aspects. The next one will look at ways that we can reduce our stress at work.

 


Medical Exam Prep would like to thank Dr. Kate Little for contributing this post.

Dr. Kate Little is the founder of physicianburnout.co.uk, a resource for doctors that are feeling fed-up, stressed, anxious, depressed or burnt-out.

Kate has worked as a GP in the NHS for the last 16 years in a variety of roles – partner, salaried & locum. She has also worked in medical education as a GP trainer and facilitator, and as a GP appraiser.