As part of GPonline's Wellbeing for GPs series Dr Jennifer Napier, a GP with a special interest in occupational medicine, has written a useful article explaining what burnout is, how it can manifest and some of the issues and challenges in general practice that are contributing to rising levels of burnout in the profession. You can read this article here.
The tips below are intended to provide a quick guide to help GPs recognise whether they are suffering from burnout and offer some advice on how to prevent burnout.
What is burnout?
In the article above, Dr Napier defines burnout as someone who is suffering from the following:
- Emotional exhaustion – feeling unable to ‘give’ any more
- Depersonalisation – not used in the normal psychiatric sense, but referring here to cynical attitudes towards patients and colleagues
- Lack of personal accomplishment – a tendency to evaluate one’s work negatively.
How to tell if you have burnout
The BMA has some useful tools for doctors to assess whether they are suffering from burnout or are alcohol dependent. You can find these here.
Seven early warning signs of burnout highlighted by the Royal Medical Benevolent Fund in its Vital Signs publication are:1
- The ‘disappearing act’: not answering calls, unexplained absences during the day; lateness; frequent sick leave.
- Low work rate: slowness in doing procedures, clerking patients, dictating letters, and making decisions; arriving early, leaving late and still not achieving a reasonable workload.
- ‘Clinic Rage’: bursts of temper; shouting matches; reacting badly to real or imagined slights.
- Rigidity: poor tolerance of ambiguity; inability to compromise; difficulty prioritising; inappropriate ‘whistle blowing’.
- 'Bypass syndrome’: junior colleagues or nurses find ways to avoid seeking the doctor’s opinion or help.
- Career problems: difficulty with exams; uncertainty about career choice; disillusionment with medicine.
- Insight failure: rejection of constructive criticism; defensiveness; counterchallenge.
Physical symptoms of burnout may include non-cardiac chest pain, palpitations, shortness of breath, bowel upset, dizziness or headaches. Those experiencing burnout may be more vulnerable to emotional eating and uncontrolled eating. Burnout can also often lead to depression.2
What to do if you are suffering from burnout
If you believe you are suffering from burnout the best advice is to talk to someone. There are a number of doctor support organisations and helplines that can provide support, including the NHS GP Health Service for GPs in England. There is a full list of support organisations here.
Tips to prevent burnout
There is plenty of advice in books and online about on how to avoid stress and burnout. The following may prove useful (some of these tips are taken from the sources listed in the reference section below):
- If you feel you are starting to suffer from burnout is there anything you can do to improve your work/life balance? Try to evaluate your options and, if possible, discuss them with an appropriate colleague.
- Eat healthily, exercise and make sure you are getting enough sleep.
- Set boundaries between your work and home life and try to leave work at work.
- Set aside time to do something that helps you unwind and that is totally unrelated to work.
- Be kind to yourself.
- Informal or formal discussions with colleagues (either in the practice or in peer support groups) about challenges that you face at work can help prevent day-to-day issues from turning into ongoing stress.
- Self-awareness: being aware and reflective and having a realistic view of what is achievable can reduce frustration.
- Mentors and formal mentoring relationships can also be helpful for some people.
- Do not ignore the early warning signs of stress – speak to colleagues, friends or family, or seek professional help from the groups above if you feel you need to.
The RCGP has produced an eLearning programme The GP Lifestyle – Wellbeing in General Practice. It aims to help GPs reflect on various aspects of their wellbeing, in a holistic, non-judgemental way and promote ideas for a more balanced and healthy lifestyle.
- Royal Medical Benevolent Society. The Vital Signs in Primary Care. A guide for GPs seeking health and advice.
- Tidy, C. Occupational Burnout. Patientinfo. Jan 2015
- RCGP's Wellbeing in General Practice eLearning module.
- BMA tools to assess whether you are burnt out or alcohol or nicotine dependent.
- Wessex LMC advice on burnout
- Royal College of Psychiatrists. On looking after yourself: a survival guide. (This is aimed at psychiatrists but the advice is useful for any doctor)