Canadian doctors are burnt out, finds study

It will come as no surprise to many, but doctors are burnt out. A new study says that a significant proportion of doctors are burned out at work —but in a way that doesn’t necessarily fit the typical pattern.

Physician burnout is a real problem in Canada. The Canadian Medical Association has stated that among residents, the burnout rate could be as high as 50 per cent. A recent survey by the Saskatchewan Medical Association found that one in every two specialists say they’re at risk of burnout as well as two out of every three general practitioners.

The long hours and physical exhaustion of working in a hospital setting are just part of the problem, as today’s doctors face issues unlike those of previous generations. Increasingly complex diagnoses, involved treatment procedures, heavier workloads and new legal and financial concerns are all adding to the stresses of the profession. A 2001 study of physicians in Massachusetts, for example, found that overall job satisfaction had significantly declined between 1986 and 1997.

And burnout has serious consequences for both the physician personally and for patients. Physicians with burnout have a higher risk of suicide, for example, and are more likely to deliver poorer patient care, both psychologically and medically, as stressed-out doctors are both more irritable and more apt to make mistakes.

To that end, researchers at the University of Western Ontario in London and the Queen Elizabeth Hospital in Charlottetown, PEI, surveyed 55 physicians (both specialists and primary care physicians) at the Queen Elizabeth Hospital, using the Maslach Burnout Inventory (MBI), a well-known questionnaire which gauges burnout via its three main elements: emotional exhaustion, depersonalization and a lack of feeling of professional accomplishment or efficacy.

Researchers found that in comparison with data on other occupational groups (the military, clerical staff, technologists, nurses, etc.) who have been rated using the MBI measure, the physicians had higher emotional exhaustion than the average across the range of occupations as well as higher cynicism and depersonalization than found in other occupations. Yet, on the professional efficacy and sense of accomplishment marker, the physicians scored a “moderate” level, in line with the average across other occupations.

The researchers see the discrepancy as significant, as it points to the unique burnout framework faced by many physicians: one in which emotional exhaustion and cynicism are likely to be in play to a greater extent than a lack of feeling of professional accomplishment.

The results showed, for example, that in responding to the statement, “I feel burned out from my work,” 83.3 per cent of physicians said they experienced burnout at least once, 64.8 per cent at least a few times a year and 44.4 per cent a few times per month or more. Yet concerning the claim, “In my opinion, I am good at my job,” a full 83.0 per cent said that they felt professionally competent at least a few times a week and 52.8 per cent said they felt that way every day.

“This suggests that improving professional medical skills (and thus a sense of efficiency) alone cannot prevent physicians from burnout,” say the study’s authors. “An implementation of other preventive strategies such as those based on mindfulness or on cognitive behaviour therapy (CBT) is necessary.”

The research is published in the Asian Journal of Psychiatry.