Senior doctors’ role vital in reducing burnout among young doctors

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Researchers say senior, influential and experienced doctors should lead in protecting their younger colleagues from debilitating burnout.

The authors of a Perspective published in the Medical Journal of Australia, Flinders University Psychiatry professor and beyondblue board member Michael Baigent, and GP Dr. Ruth Baigent said establishing mentally healthy workplaces will reduce the risk of burnout.

“It is an attention-demanding tragedy when doctors’ death are attributed to their work, which, after all, is in the service of others,” the authors stated.

Words such as “epidemic”, “crisis” and “urgent need” accompany discussions of burnout and doctor suicides.

“Yet despite this bombardment, there has been no sustained approach to achieve an effective national response. Recently responding to call for action, the Victorian government launched a workplace mental health strategy and the New South Wales government held a junior doctor wellbeing forum. Some colleges and medical organisations have websites, forums, action plans, conferences and seminars on doctors’ mental health. Doctors develop mental illness for the same reasons as any other person. Yet burnout, which is a risk factor is highly prevalent in doctors,” the authors stated.

Burnout is described through three concepts: exhaustion, cynicism, and professional efficacy.

“When the doctor has symptoms severe enough to also qualify for a mental illness, they are likely to be diagnosed; burnout is regarded as an aetiological factor. If the doctor falls short of a clinical diagnosis, burnout becomes the explanation and problem,” they said.

“Although not a diagnosis, the concept of burnout nevertheless resonates. Most doctors recognize it in a colleague’s uncharacteristic irritability, drowning fatalism and loss of belief in professional identity and efficacy.”

A 2013 beyondblue mental health survey of doctors and medical students, it was reported that 32% of Australian doctors had high levels of cynicism, which two of three domains of burnout.

“The beyondblue survey found young doctors to be at greatest risk, with those aged under 30 years most likely to report burnout (high exhaustion, 48%; high cynicism, 46%),” the authors stated. “There was a steady reduction across older age bands, with 11% of doctors aged over 61 years reporting emotional exhaustion.

“Perhaps those who burn out, get out of the profession,” the authors said.

“Also, in the life cycle of the doctor, the levels of external evaluation and autonomy also change favourably with years of experience… In burnout research generally, younger age is a more consistent variable than personality in determining burnout.”

“It is too easy to blame the system and, likewise, for the system to blame the doctor. A certain amount of work-hardening and experience is necessary, but perhaps older doctors look back on their pressurized junior years through rose-coloured glasses and see it as a rite of passage.

“Is it not time for senior, influential and experienced doctors to lead action on behalf of our young apprentices?” the authors concluded.

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