Burnout is a syndrome that we often diagnose ourselves, and that some are comfortable admitting they have experienced. But do we really understand what burnout is, or what can lead to it? And what the consequences are, not only to ourselves, but to our colleagues, families, friends, clients, patients and even our profession?
Burnout
Burnout was once described as a state in which one’s capacity to function is diminished or lost as a result of depleted physical and mental resources.1 At present, burnout is a term that can be used to describe all ranges of experience, from transient and short-lived bouts of low energy to severe depression that necessitates hospitalization.1 It’s also important to recognize that everyone is likely to experience burnout differently. It can include feelings of frustration and waning enthusiasm, as well as being overwhelmed, overburdened and stuck.2
The currently used model of burnout I medical professions has three main components: emotional exhaustion, depersonalization and low personal accomplishment.3
Those who work in the helping professions, such as veterinarians and doctors, give of themselves emotionally and physically. This constant giving leads to depletion of emotional resources, resulting in emotional exhaustion, or an inability to continue giving.3 Emotional exhaustion is also the component that is the most damaging.1
Depersonalization occurs when one distances one’s self from clients or patients based on negative or cynical attitudes and feelings toward them.3 Depersonalization and emotional exhaustion often go hand in hand; decreased emotional resources can lead to cynicism and negative attitudes about patients and clients.
Lastly, reduced personal accomplishment is also a characteristic of burnout. It centers around the tendency to evaluate oneself harshly and take a negative view about one’s contribution.3
Statistics
Many of us have likely had conversations with colleagues about feeling exhausted, fed up or burned out, but how common is burnout in veterinary medicine? A 1992 study reported that 67% of female and 53% of male veterinarians demonstrated clear signs of burnout based on a self-diagnostic scale.2
More recently, a study in Australia found that veterinarians were more likely than the general population there to experience burnout.2
Contributors to Burnout
There is a wide range of what each of us as veterinarians appreciates or finds enjoyable about practice. Some consider evaluating lameness to be fun or dentistry to be rewarding, while for others, those might be significant sources of stress. At the end of the day, when the demands of the job exceed the resources that one has or the positive aspect of one’s job, then an individual is at risk for burnout.4
Some factors that increase the likelihood of work and personal demands exceeding resources are:
- heavy workload
- work-life conflict
- poor workplace support
- negative view of clients or patients
- early career veterinarians (<5 years since graduation)
- inadequacy of resources necessary to do one’s job
Consequences and Corollaries of Burnout
Little is known about the consequences of burnout in veterinary medicine. However, the impact of burnout has been well studied in human medicine, and given the similarities between the two fields, it’s likely that similar outcomes are occurring in our profession:
- decreased quality of care
- decreased patient satisfaction
- decreased patient adherence
- inappropriate prescription of medications
- decreased empathy for patients
- increased medical errors
- physical exhaustion
- problems in personal relationships (i.e., marriage and family)
- increased absenteeism
- low morale
- poor job satisfaction
- depression
- suicidal ideation and suicide 5,7
What To Do?
EFFECTIVE COMMUNICATION
Empathetic client communication: Empathy is a communication skill that revolves around striving to understand another’s experience or situation, then communicating with that person based on that understanding.10 Empathetic communication can help to decrease depersonalization4 because it involves striving to understand that person’s perspective. It also supports positive feelings of personal accomplishment.4 Good client communication can also support a strong vet/client relationship and increase client adherence to recommendations, resulting in a more rewarding experience for the veterinarian.
Strong team communication: Working with staff and colleagues can cause frustration and exhaustion. An important part of collegial relationships is to ensure that your needs and expectations are clear, and that you know and understand what others need and expect from you. Do this by having open conversations about expectations, establishing a culture of openness, and using frequent check-ins with your team.
EMBRACE AUTHENTIC EMOTIONS IN THE WORKPLACE4
It can be hard to figure out which emotions are appropriate for the workplace, and to what extent it’s acceptable to display them. That said, it’s been shown that pretending to have emotions that you don’t have can increase the experience of depersonalization and decrease personal accomplishment. Also, hiding emotions is associated with emotional exhaustion and physical symptoms of burnout.4 Whenever possible, try to be authentic and sincere, and find appropriate ways of expressing emotions that arise in the workplace.
TEAM-CENTERED CARE
Embracing a team approach to providing care to patients and working with clients can help decrease burnout. Your team brings with it a wealth of resources, which allows you to preserve yours!
REDUCE LOW-REWARD STRESSORS
If you don’t have to perform tasks you find stressful, then delegate. If you don’t like dealing with the books, consider hiring someone to do them for you! Taking control and making choices that allow you to focus on the aspects of work you enjoy will pay dividends in wellness and job satisfaction.
COUNSELING
Counseling can often be helpful in situations where one is struggling.
References
1. Boudreau, R.A.; Grieco, R.L.; Cahoon, S.L.; et al. The Pandemic from Within: Two Surveys of Physician Burnout in Canada. Can J Commun Ment Health 2006;25:71–88.
2. Hatch, P.H.; Winefield, H.R.; Christie, B.A.; et al. Workplace stress, mental health, and burnout of veterinarians in Australia. Aust Vet J 2011;89:460–468.
3. Maslach, C.; Jackson, S.E.; Leiter, MP. Maslach Burnout Inventory Manual. Third Ed. Palo Alto, CA: Consulting Psychologists Press; 1996:1–74.
4. Lee, R.T.; Lovell, B.L.; Brotheridge, C.M. Tenderness and Steadiness: Relating Job and Interpersonal Demands and Resources With Burnout and Physical Symptoms of Stress in Canadian Physicians. JAppl Soc Psychol 2010;40:2319–2342.
5. Sigsbee, B.; Bernat, J.L. Physician burnout: A neurologic crisis. Neurology 2014;83:2302–2306.
6. Shanafelt, T.D.; Bradley, K.A.; Wipf, J.E.; et al. Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program. Ann Intern Med 2006;136:358–367.
7. Shanafelt, T.; Dyrbye, L. Oncologist Burnout: Causes, Consequences, and Responses. J Clin Oncol 2012;30:1235–1241.
8. Argentero, P.; Dell’Olivo, B.; Ferretti, M.S. Staff Burnout and Patient Satisfaction With the Quality of Dialysis Care. Am J Kid Dis 2008;51:80–92.
9. Bodenheimer, T.; Sinsky, C. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann Fam Med 2014;12:573–576.
10. Silverman, J. Skills for communicating with patients. 3rd Oxford: Radcliffe Pub, 2013.
