© Borgis - New Medicine 4/2010, s. 169-170
*Ewa Ogłodek, Aleksander Araszkiewicz
Professional burnout among family physicians
Chair and Clinic of Psychiatry of the Nicolaus Copernicus University,
Collegium Medicum in Bydgoszcz, Poland
Head of Department: prof. Aleksander Araszkiewicz, MD, PhD
The ?burnout syndrome? (BOS) is used to describe a type of job stress specifically in those professionals who maintain a direct relationship with people who are the beneficiaries of their work, and means to be or feel burned out, exhausted, and overworked. The risk of professional burnout particularly concerns people who practise professions belonging to the so-called human services group. Professional burnout is a state of emotional and physical exhaustion caused by excessive and prolonged stress. As the stress continues, one begins to lose interest in or motivation for performing one?s job. Additionally, burnout reduces one?s productivity and energy. There are three phases of professional burnout: emotional exhaustion, depersonalization, and reduced sense of personal accomplishment. Professional burnout is often associated with incapacitation and high social, economic and individual cost, absenteeism, decrease in productivity, high turnover, increasing demand for health services, and abusive use of tranquilizers, alcohol and other drugs. Factors associated with burnout include age, marital status, how long the individual has been working as a health professional, work overload, interpersonal conflicts, conflicts between workers and their clientele, and lack of social support, of autonomy and of participation in decision-making processes. This paper discusses basic problems of professional burnout among family physicians.
Professional burnout syndrome is one of the more serious consequences of professional stress, in the literature often described as one of the possible reactions of an individual to chronic emotional stress related to working in professions where continuous contact with people is required. Professional burnout syndrome is, for a family doctor, one of the most serious results of stress (1, 2, 3).
Maslach dealt with the problem of professional burnout syndrome in the 1980s, and this concept was later supplemented by other researchers, such as Leitera, and Jackson. In the proposed model the symptoms of professional burnout syndrome have been grouped into three categories:
Emotional exhaustion ? it is the sense of emotional overload and depreciation of the possessed resources of emotions. The results of the lack of possibility to modify given stresses are pathological defensive reactions consisting in avoiding the stresses by withdrawal from contacts with patients, increasing the distance and even avoiding them;
1. The sense of alienation ? depersonalization. A person at this stage of burnout shortens contacts with patients to the necessary minimum, avoids eye contact and keeps a considerable distance in relations, with simultaneous appearance of his or her professional competences.
2. Reduced personal accomplishment is a reaction to failure in dealing with the experienced professional stress, which is associated with dissatisfaction with one?s accomplishments and leads to lowering of self-esteem and feelings of frustration (4, 5, 6).
According to the developed pattern, the course of professional burnout syndrome dynamics is as follows:
? first, as a result of a stressful job, emotional exhaustion intensifies, with psychosomatic symptoms dominant in its clinical picture: headaches, fatigue, insomnia;
? the next stage involves attempts to protect oneself against the consequences of exhaustion; the doctor applies mechanisms leading to the loss of care for those requiring help;
? the next, final stage is reduced personal accomplishment ? which reduces the quality of the performed work and extends the time of performing the undertaken tasks (7, 8, 9).
Prevention of the professional burnout syndrome in family doctors heavily burdened with a stressful job in everyday medical practice is an important element of consciously counteracting this phenomenon. Taking into account the fact that the discussed problem is of a complex nature, the actions undertaken for preventive purposes should apply to various areas of life (10, 11).
Prophylactic actions may be carried out in three dimensions, for the purpose of early detection and minimizing its presence:
1. The first level is the society; at this stage the most important actions are:
? education of the society about the professional burnout syndrome;
? improving professional education programmes for family doctors.
2. The second, directing level is based on preventive actions. These actions include:
? determination of work schedules, so that they do not exceed hourly standards provided for in the Act;
? if necessary, ensuring the possibility of rotation of personnel, based on a change of post or the type of work;
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