As part of our reading group, for the past week, we have had some interesting
discussions and readings on the theme of “Burnout”
Issues of burnout in medical professionals-Doctors, paramedics, nurses,
managers in health set-ups came out.
Key features of Burnout
There is a difference between Burnout and middle-age crises, depression
though there may be overlap.(many smiles..)
An interesting article on this theme which will be discussed further in
our group -BMC Medicine 2004, 2:29 doi:10.1186/1741-7015-2-29-
lists the following components
Emotional exhaustion: Reduced energy and job enthusiasm;
emotional and cognitive distancing from the job.
Depersonalisation: Cynicism; lack of engagement and distancing from patients;
treatment of patients as inanimate, unfeeling objects.
Personal accomplishment: A sense of efficacy and effectiveness; of involvement,
commitment and engagement; of capacity to innovate, change and improve.
The different components of a health care system
While the obvious focus can be on doctors, as is the target group of the above mentioned
article, there is a scope of broadening the forum by including Nursing, paramedical,
managerial persons. On asking their concerns, the following points came through
A radiographer- He pointed out how the routine puts him off, and now he
has been doing the same thing for almost a decade
It does become a bit difficult, especially at the end of a long day
when an overbearing person comes with the backing of management
to push things down the throat of a tired technician
Nursing– They just give us orders, not giving us the respect which is due to
a person who is involved in patient care.
“Just give me the pethidine” one senior doctor says in a harsh tone
Managers– In health care industry, we are dealing with people.
These are not commodities, and hence complex human issues are involved
The delivery is done by experienced medical professionals who
have their own base. It is difficult and frustrating to balance these
factors, while also meeting certain targets and parameters set up
by the “Board of Directors” . We are caught in between powerful
professionals with their years of experience (and egos) and powerful
finance board directors
– – –
Hopefully this forum will evolve to start a more fruitful discussion on issues concerning
Burnout and how to check it.
Prashant Bhatt's notes 
I think that burnout occurs in all the professions, but of course, it may be expected to a greater degree in the medical profession, where most of your clients are suffering and dependent on you, and the very empathy that one would wish for, is a heavy burden for those who must relate to person after person, when so many are in pain or fearful.
Interesting comments-To this I will like to add the issue of empathy is complex. In a recent meeting of a forum in Malta a psychologist laid down the ways of hearing out the issues of patients and relatives without giving any advice or judgement, just to let them vent their feelings as they encounter the health care system.
For a EU country at least they are discussing this.
In Libya I see many persons caught in the web of Private and Public healthcare systems.
How does one balance Empathy with the issue of giving professional advice..the very word “Doctor” sometimes is a limitation.
Empathy is a beautiful word, and a great guide.
Medicine is as much an “art” as science; on the issue of empathy and “hearing out” patients problems, one should keep in mind the “rambling” historian (as we call it in UK) who will not mind / be aware of taking an hour to explain his / her problem or worries – this is hardly cunducive to the conduct of a clinic, especially a busy one; therefore, it is an art form to interrupt in a non-insulting way to get the useful and relevant information;
dealing with the physical, mental and emotional problems of the highly individual and complex human beings requires constant attention, awareness and application; having to do this precision job in a repetitive manner may be the reason for relatively early burn-out in medics; it is akin to repetitive strain injury! (Pashmina weavers from Kashmir come to mind)
A further dimension is added by the time / financial / target pressures from management which may explain why medics and their managers behold each other with jaundice in their eyes…
Thanks for the insights.
That reminds me of the 8 stages of psycho-social developments of Erik Erikson…maybe a topic which we will dissect after this month of dissecting Burnout gets “over”
Regarding “rehabilitation”…the hope that none of us requires it..brings many smiles
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very interesting facts which usually going on my mind (signals) got word frame here !! thanks sir
Will discuss in detail when we meet
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