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Burnout recognised as a medical condition for the first time
The WHO has confirmed what most health practitioners likely already know.
The research has shown the effects of burnout can include cardiovascular disease, musculoskeletal pain, depressive treatment and job dissatisfaction.
‘This is not news to most GPs.’
That is RACGP President Dr Harry Nespolon in response to the fact that, for the first time, the World Health Organization (WHO) has recognised burnout as a medical condition in its International Classification of Diseases (ICD).
‘The fact that they’ve finally given it an official title really doesn’t change the fact that burnout is a significant and real issue for GPs,’ Dr Nespolon told newsGP.
‘It’s certainly something that’s been front of mind for GPs, and people that work with them, for a long time.’
In the new classification, the WHO defines burnout as ‘a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed’. The syndrome is characterised by three dimensions:
- Feelings of energy depletion or exhaustion
- Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
- Reduced professional efficacy
According to the classification, burnout specifically refers to phenomena in the ‘occupational context and should not be applied to describe experiences in other areas of life’.
The research has shown the effects of burnout can include cardiovascular disease, musculoskeletal pain, depressive treatment and job dissatisfaction.
Dr Nespolon believes burnout is common among GPs for a number of reasons.
He said GPs expend a lot of ‘emotional energy’ each day being empathetic to patients, while also facing a ‘whole lot’ of system issues, such as when trying to admit a patient into hospital.
‘Every day is a struggle of trying to do the best for your patient,’ he said.
‘GPs are becoming more and more advocates for their patients and the system is getting harder for them to advocate on behalf of their patients … so that puts doctors at higher risk [of burnout].
‘It certainly hasn’t been helped by government policy, especially when it comes to financing. So not only do you have to see patients, but you’re worried about a whole lot of other things apart from seeing that patient in front of you.’
Burning out as a GP doesn’t just impact the doctor, Dr Nespolon said, but also their patients.
‘It’s well recognised that part of burnout is that patients don’t get the absolute best care they could possibly get, so it is a serious issue,’ he said.
‘It is a serious issue,’ RACGP President Dr Harry Nespolon said of doctors and the risk of burnout.
GP Dr Vicki Kotsirilos is well aware of the effects of burnout, having experienced it during her internship.
‘The long hours and overnight shift work fatigued me,’ she told
newsGP.
‘Also, there was some bullying experienced by some of the nursing staff. I felt burnt out by the end of the year and confused whether I was really happy with medicine.’
Dr Kotsirilos took the year off after internship. She returned to work as a hospital resident the following year, but could feel herself becoming burnt out again.
She credits joining a meditation group and partaking in regular yoga with helping her avoid further burnout.
Nowadays, Dr Kotsirilos likes to wake at 5.00 am and start each day by meditating in her garden and walking in nature. She also works part-time, takes time to meditate during her lunchbreak, eats healthily and goes to bed early.
‘This routine of self-care keeps me healthy physically and psychologically,’ she said.
Long-time GP Dr Libby Hindmarsh has never experienced burnout herself, but came ‘very close’. When she could feel herself falling down a slippery slope, she decided to ‘work hard at not reaching that point,’ so she could continue her long-term career as a GP.
For Dr Hindmarsh, weekly supervision sessions in her practice have helped her avoid this condition. She believes taking regular holidays and exercising most days has also helped.
‘My mantra is, “You cannot give to others [patients] out of an emptiness in yourself”,’ Dr Hindmarsh told
newsGP.
Associate Professor Bob Davis believes having a number of changes in his career – including working as a rural GP, doing a university-based job with private work, and now working part-time in the hospital sector – has helped him avoid burnout.
‘Speaking to some of my GP friends, I think being locked into the same job can lead to burnout,’ he told
newsGP.
‘It helps to have a focus or passion in what you do.’
Of course, taking steps to avoid burnout can be easier said than done.
‘One of the ways of dealing with it is to take some time off, but due to the financial situations a lot of GPs are finding themselves in, it makes it difficult to do that,’ Dr Nespolon said.
Dr Nespolon said the ‘catch 22’ is that GPs at greatest risk of burnout are those who have the least amount of leave, or ability to work less.
‘That’s the irony,’ he said.
Dr Nespolon hopes the WHO recognising burnout as a medical condition will lead to governmental ‘policy changes that can have significant effects on the wellbeing of our GP workforce’.
The negative health effects of burnout were explored in a systematic review of prospective studies, published in
PLOS ONE in 2017.
The review, based on well-conducted and well-reported studies, found that cardiovascular diseases, musculoskeletal pain, depressive symptoms, psychotropic and antidepressant treatment, job dissatisfaction and absenteeism are ‘consistent effects’ of burnout.
The updated WHO ICD list,
ICD-11, was drafted last year and approved on 26 May. It takes effect in January 2022.
burnout WHO World Health Organization
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