By Essie Bester

The incidents of burnout among doctors are increasing at an alarming rate – and this was already the case before the Covid-19 pandemic. Solidarity’s Professional Guild for Health Practitioners investigated this alarming fact.

In a recent overseas study it was found that 42% of American doctors suffer from burnout. In South Africa it is difficult to determine the precise numbers of burnout among professionals. However, data from the health care sector indicates that the number of South African doctors who suffer burnout is similar and in many cases much worse than that of their overseas colleagues.

The general opinion is that people such as health workers, who work under pressure and with other people, run a high risk. A consultant emergency health practitioner who worked in the emergency ward of a regional hospital in Cape Town says he is used to the pressure of emergency care. He emphasises that it isn’t the stress of handling so many acute trauma cases that got to him, but the chaos he had to endure daily.

His inability to cope with this resulted in him being overwhelmed by a strong feeling of failure and shame. Like many people who are burnt out, he experienced the urge to prove himself. “I tried harder,” he says. “I started working earlier, and stayed on until late in the evening.” However, this made no difference. Eventually he decided to leave the hospital.

Research shows that one out of every three doctors are burnt out at any given office day. Experts agree that cases of doctors suffering from burnout are often not reported. According to them, it is astonishing to see how often burnout is actively ignored in health care. It has to be realised that stress and accompanying emotions aren’t a reflection on as to whether a health care worker is able to do his or her work.

The classic symptoms of burnout include emotional exhaustion, cynicism and diminished personal fulfilment. According to the World Health Organisation’s (WHO) International Classification of Diseases, people who experience burnout usually feel exhausted, but there is also a possibility that they can feel indifferent or cynical about their work. They often perform less well at work.

Long hours, increasing pressure to see more patients, heightened interference from the government and duties not aimed at patients, all contribute to doctors’ burnout.

According to Dr Richard Heron, co-chairperson of the International Occupational Medicine Society Collaborative, patients’ high expectations are also a general driver of burnout. The above-mentioned factors are exacerbated by an increasing number of patients with chronic illnesses. “There is a higher demand for services over the entire health care spectrum.”

At the same time the promise of increased access to services in the context of universal health care cover creates unavoidable expectations. “The difference between capacity and demand leads to an overloaded work force, increased waiting periods and a lower quality service than what patients expect.”

During burnout the empathetic, caring environment becomes more difficult to maintain and the probability of errors increases. Burnout therefore is not only related to the doctor’s health, but also influences the safety and wellbeing of the patient.

This furthermore leads to a heightened absence and turnover, which disrupts the organisational function, diminishes team efficiency, and a loss of institutional knowledge.

Health workers who participated in an international survey, proposed the following interventions:

• The improvement of working conditions and a decrease or change in tasks.
• Programmes for the monitoring, early diagnosis and psychosocial risk factors are essential. A career psychologist and a career nursing professional who can trace burnout in time and compile a prevention strategy could help a lot.
• By calling burnout a “career phenomenon” and to define it as a syndrome “resulting from chronic work stress that is not managed successfully,” places just as much emphasis on the workplace as on the worker, which indicates that any meaningful answer requires action on both sides of the equation.

Health workers therefore welcome the WHO’s recent reclassification of burnout as a career phenomenon rather than a medical condition. “Up to now too much emphasis was placed on the individual to address the burnout problem. We have to look at it from a health system.”

Worldwide experts are now beginning to view career burnout among health workers as a symptom of poor work conditions in the health sector and are of the opinion that assuring proper work conditions in this section needs to be made a priority.

Meanwhile health workers are being encouraged to be considerate of their own mental health. You are worth more if you take care of your own wellbeing rather than allowing yourself to fall victim to burnout.

According to the WHO, health workers have to take care of their own health with strategies to handle stress and to make sure they get enough rest and sleep between shifts. Healthy eating habits need to be maintained while also getting enough exercise and staying in regular contact with friends and family.

Sources:

Bulletin of the World Health Organization

https://www.who.int/bulletin/volumes/97/9/19-020919/en/

https://www.rooirose.co.za/is-jy-uitgebrand/

https://www.carecloud.com/continuum/preventing-medical-burnout/