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    Burnout has become a topic of importance and discussion across many different domains and industries (Melamed et al, 2006).  In 2019, the World Health Organization listed burnout as an “occupational phenomenon” in the 11threvision of the International Classification of Diseases (WHO, 2019).  They described burnout as a syndrome resulting from inadequately treated chronic stress and characterized by feelings of fatigue and cynicism associated with reduced personal and professional efficacy and sense of accomplishment.  Though they indicated it should not be applied to “experiences in other areas of life”, there is no reason that the concept of burnout would not apply outside of the workplace.  In fact, experts have discussed the idea of an imbalance between demand and recovery within any area of life (Bianchi et al, 2015; Williams, 2020).

    Within the healthcare field, the attention placed on burnout has been on healthcare providers.  In the Medscape National Physician Burnout and Suicide Report 2020: The Generational Divide, Kane (2020) reported that 42% of physicians self-reported burn out.  Manifestations included unmanaged job related stress, extreme fatigue, cynicism, detachment from workplace expectations and responsibilities, and feelings of decreased self-efficacy.  The impact of burnout extended into the personal lives and relationships of those surveyed, further revealing the severity of the problem.  There was also interference with patient interactions due to the symptoms of burnout.  Only 28% of those surveyed reported that their employer provided resources and programs to reduce stress.  Given the extreme impact described in this survey, it is reasonable to question the impact of burnout on the quality of care provided to patients by providers experiencing burnout.

    To the best of my knowledge, there has been no description of burnout from the patient (or healthcare system consumer) perspective. Given the definition of an imbalance between demands placed upon an individual and their ability to recover from that stress, it makes sense that this phenomenon could affect patients during their interactions within the healthcare system.  The feelings of fatigue, detachment, cynicism, and lack of efficacy so commonly described amongst workplace related burnout, likely also exist amongst patients.  Particularly in the setting of chronic diseases, especially those which are life threatening, there can easily become an imbalance between the stress and demands placed upon the individual and that person’s ability to recover from and manage that stress.  This creates the   circumstance for burnout to occur.  The consequences of burnout on the patient can certainly impact quality of life but may also have an effect on recovery from the very condition which led the individual to seek care in the first place.

    Fortunately, there are strategies which can help us prevent and manage burnout.  These include lifestyle choices such as proper nutrition and hydration, adequate amounts of exercise, sleep, meditation, and mindset skill training, such as optimism.  Incorporating these elements into a regular, daily practice can be a significant factor in decreasing the chance for developing burnout as well as being a part of treating burnout if it occurs.  These strategies are important for both workplace related burnout, such as with healthcare providers, and patient related burnout.  Given the negative impacts of burnout, it is essential to reduce burnout so that providers can experience improved workplace satisfaction, energy, enjoyment, and personal efficacy and patients can experience similar benefits which may allow for enhanced recovery.  To illustrate the impact of personal factors on the potential for development of burnout, Ghorpade et al (2007) demonstrated that emotional stability was protective against developing burnout.  There is also an association between burnout and depression and anxiety, however they are not one in the same condition (Koutsimani et al, 2019).

    Acknowledging the causes of burnout and implementing strategies to minimize its impact is one foundational factor to improving health and wellness for everyone.  This is a fundamental aspect of the consulting work at Darin Davidson, MD Consulting.  To learn more, please visit www.darindavidson.com/services.

    REFERENCES

     Bianchi R., Schonfeld I. S., Laurent E. (2015a). Burnout–depression overlap: a review. Clin.  Psychol. Rev. 36, 28–41.

    Ghorpade J., Lackritz J., Singh G. (2007). Burnout and personality: evidence from academia.  J. Career Assess. 15, 240–256.

    Kane L. (2020).  Medscape national physician burnout and suicide report 2020: The generational divide.  https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460?src=WNL_physrep_200222_burnout2020_rm&uac=298770FT&impID=2286827&faf=1

    Koutsimani P., Montgomery A., Georganta K. (2019).  The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis.  Front Psychol. 10: 284.

    Melamed S., Shirom A., Toker S., Berliner S., Shapira I. (2006). Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions.  Psychol. Bull. 132:327.

    Williams, F. (2020). Your 2020 Burnout recovery plan.  Outside Magazine.  https://www.outsideonline.com/2406990/burnout-recovery#close.

    World Health Organization (2019).  Burn-out an “occupational phenomenon”: International Classification of Diseases.  https://www.who.int/mental_health/evidence/burn-out/en/

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