Physician burnout is a significant challenge in the healthcare system in Nigeria. In the practicality of life, it is hard to fathom that physician burnout has not been the main focus of some establishments.
I know she tries to forget most times, just like some of her colleagues do. Behind her pair of perfectly round glasses and blue nose mask, her lips quiver with unvoiced words; her eyes moisten with unexpressed emotions. Thoughts of working so hard only to part with nothing by month end have become her reality.
It’s been three full months without salary. Not only does she have to deal with the fact that the only social activity she is a part of, has been that created within these white walls, but also has to condone the brash arrogance of nagging patients and their relatives. She bites hard on her tongue, preventing the cussword from escaping her throat. That would be totally unprofessional, a gross misconduct as regards the ‘noble’ profession.
They say Internal medicine see the worst cases. Have they been to General surgery 3? Dr CeCe wouldn’t wish to be in the Burns and Plastic unit ever again because she’s had it rough. Rotating different units as a house officer, this particular one seems to have lasted more than six months even though she’s barely two weeks into the posting. She has lost count of the number of surgeries she has assisted with because they are endless!
Every day, she gets home absolutely exhausted with her head threatening to split in two at the slightest sound from her neighbour next door. She shrugs off her clothes tiredly, races to the bathroom and sinks into her remedy – a tub of warm water. That is the only solace to a seemingly never-ending cycle of being overworked.
Do you ever get so tired and demotivated just as you’re in the process of carrying out a task? It is not strange to experience a decline in enthusiasm at some point in your life (whether in business or career) after putting in work for long hours anticipating the ‘big outcomes’ of a given project. What follows is the feeling of despair, fatigue and frustration. This is the point where you take a break because you definitely are burned-out.
The Oxford Dictionary defines Burnout as a state of poor health and complete exhaustion through overwork. According to the World Health Organisation, Burnout is “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”
The term “burnout” was first used in 1974 by Maslach to describe the exhaustion observed in people in healing professions though it is now widely employed in the occupational context and not used to describe experiences in other areas of life.
Burnout in the field of medicine has become a national epidemic, affecting a greater number of physicians (over one-third), and yet physicians, and institutions remain ill equipped to combat it. The need to address physician burnout is ethical and morally vital because it is of great importance in healthcare delivery. This is because physician burnout has a direct or indirect impact on the way patients are treated or cared for. Needless to say, an exhausted physician cannot operate in his or her optimal capacity.
Physician burnout is characterized by emotional fatigue, depersonalization, and a dwindled sense of accomplishment that occurs following a response to one’s environment. Some of the significant factors contributing to physician burnout include: work overload, lack of cooperation from a patient, insufficient reward for their labour, deterioration of patient’s health despite the physician’s efforts, and a misalignment between the physician’s values and that of the care facility. All these can thus result in career dissatisfaction, depression and even suicide if care is not taken.
As physician burnout progresses, work performance is greatly affected at the expense of patient care, precipitating to diminished quality of care, reduced patient satisfaction, decreased productivity and increased medical discrepancies.
Mitigating physician burnout requires the collective effort of the hospitals, departments and also the physicians themselves because such fatigue and exhaustion cannot be combated by only one party. Monumental change is the result of the joint efforts and the responsibility of effective organizational leadership (in this case the Chief Medical Director, Consultants and Residents) in preventing physician burnout.
Hospitals should ensure that the ratio of physician to patient is reasonable by making sure to employ more capable hands that would cater for the ever-increasing number of patients. Not having enough qualified doctors on grounds makes the few available doctors laddened with the burden of caring for more number of patients than they should. This results to one of the leading causes of physician burnout and fatigue.
Hospitals should also create an environment that fosters psychological safety, ranging from support in addressing moral distress, quick response to concerns regarding unprofessional conduct, and access to mental health services/therapies for every physician at least once in a month. For house officers and “junior” doctors who are still learning the ropes, shame-based learning, such as verbal abuse, mocking, exclusion, public embarrassment and intimidation by senior colleagues is not conducive to learning.
Hospitals can incorporate telehealth and telemedicine services into their system of care delivery to curb physician burnout. This is where health-technology solutions like KompleteCare comes in. By having your hospital and care facilities registered on KompleteCare, your doctors can consult patients at their own scheduled time. This will not only reduce the overcrowding in your facility but will also help you cater more effectively to patients who may not necessarily require an in-person visit to your hospital or clinic. Reducing the crowd of patients to be attended to physically can go a longer way in aiding the mitigation of physician burnout in your care facility.
Healthy competition among individual doctors plays a significant role in combating physician burnout. Healthcare organizations should clearly articulate their mission and values so that leadership can model and embody these values, using them to direct decision-making. These include prioritizing patient care over profit and trusting physicians to act in the patient’s best interests. Acknowledgment of physicians’ accomplishments, awards for diligence, and alignment of individual talents to specific needs can help to foster a culture of mutual appreciation, esteem and teamwork.
Flexibility to work-hour distribution and resumption times gives physicians better control over their schedule. A time-banking system should also be incorporated so that extra time rendered in service can be properly accounted for/rewarded. This can encourage a work culture of flexibility and collaboration thereby reducing physician burnout.
Peer-to-peer mentorship should also be encouraged among medical students and medical officers in order to build camaraderie and mitigate physician burnout. Mentorship has also been demonstrated to build professional relationships, promote professional development and increase job satisfaction.
The largest threat to healthcare today is physician burnout, which is frequently the result of ongoing physician shortages and negative financial constraints.
Healthcare facilities may now serve a larger patient base and manage their personnel more effectively by implementing telemedicine tactics, which also save staff members from becoming overworked.
By using virtual visits, clinics can lessen the issues brought on by a staffing deficit. With this strategy, a patient’s treatment pathway is started through telemedicine, enabling medical centers to use technology to effectively evaluate the requirements of the patient and choose the best care location.
It is crucial to understand that by enabling treatment to be given anywhere, telemedicine gives facilities greater flexibility. Because of the freedom they have in their work setting, physicians can better serve their patients, which increases provider productivity.
Giving staff and patients thorough training is essential if they are to benefit completely from telemedicine. Physicians, nurses, and other healthcare professionals ought to receive training on telemedicine software, including how to use it, integrate it into their daily operations, communicate effectively with patients during consultations, and know when to get technical support.
To lessen burnout among doctors, a variety of techniques can be employed, such as adopting staff recognition as an organizational culture, establishing computer programs for work ease, practicing yoga, and developing spiritual programs centered on meditation, collaboration, training, and strengthening interpersonal abilities.
Additionally, employers can boost employees’ self-esteem, motivation, and engagement and lower burnout by giving them access to training, educational materials, and growth advantages.
Employers can cultivate and include how a physician can establish social assistance at work. It has been shown that social support can lessen the harmful consequences of stress, even though for the majority of doctors, finding time to socialize with coworkers is a major concern.
2. How do you prevent provider burnout?
You can prevent employer burnout when you establish and uphold proper boundaries in the workplace.
Try to establish boundaries for your time and energy, because boundaries can help you avoid burnout. Being able to say “no” to taking on more work-related obligations can help you manage your private affairs.
3. What techniques do you think would help a clinician who is experiencing burnout?
There are several techniques that can help physicians to cope with burnout; nevertheless, culture, such as workplace empowerment and participation, can lessen detachment, emotional tiredness, and general burnout while also increasing a sense of purposeful work.
4. What are some evidence-based strategies you can implement to help prevent burnout and build resilience?
To help you become more resilient to stressful situations, you will have to start with little adjustments to your daily routine. Make time in your schedule for restful activities, good eating, exercise, and sleep. In fact, when you are feeling stressed, it can be highly beneficial to incorporate an exercise regimen, which for some may include yoga or meditation.
5. How do you create a burnout prevention plan?
You can create a burnout prevention plan in a way that suits your personality. Here are the steps to a burnout prevention plan:
Determine what you need. Finding your stressors, your burnout or compassion fatigue symptoms and your present coping mechanisms are the first steps. When it comes to burnout at work, the Professional Quality of Life Scale (ProQOL) is one self-assessment tool that you can use to gauge your levels of burnout, secondary traumatic stress, and compassion fulfillment.
You can also put things like your thoughts, feelings, and actions into perspective when you are under stress, fatigued, or overloaded. Evaluate questions like: What causes, signs, and effects do you associate with stress? How do you prevent or handle it? What weaknesses do you have in your self-care routine?
Establish your objectives. Setting goals for your self-care based on your own tastes and requirements is the next step. You can make your goals more precise, quantifiable, attainable, relevant, and time-bound by using the SMART approach.
One possible goal could be to dedicate ten minutes each day to mindfulness practice or to cut down on the burden by saying no to or delegating certain duties. Your objectives can also be divided into other categories of self-care, including professional, personal, social, emotional, spiritual, and physical.
Select your pursuits. Choosing tasks that suit your way of life and assist you in reaching your self-care objectives is the third phase. Exercise, meditation, interests, counseling, support groups, coaching, mentoring, studying, or taking a break are just a few of the possibilities available to you.
Additionally, you can make a self-care menu or toolbox that enumerates the things you can do when you have five minutes, thirty minutes, or an entire day at your disposal. The secret is to figure out what fulfills, balances and works for you.
Plan your time. Organizing and prioritizing your self-care tasks in your daily, weekly, and monthly calendar is the fourth stage. To arrange your time and remind yourself of your obligations to self-care, you can utilize an app, notebook, planner, or calendar.
You can also explain your demands and establish limits with others, including your family, friends, coworkers, and clients. You have the option to decline requests that don’t fit with your objectives or to bargain for greater resources, support, or flexibility. When necessary, you can also delegate or ask for assistance.
Track your development. Monitoring and assessing your self-care efforts and results is the fifth phase. You can keep track of your activities, feelings, ideas, and outcomes using a self-care checklist, log, chart, or rating scale. To evaluate your performance and influence, you can also take input from other people, such as your peers, clients, or supervisor.
You can celebrate your successes, setbacks, and lessons learned by reviewing your statistics and observations on a weekly or monthly basis.
Modify your strategy: Adapting your self-care strategy to your input and evolving situations is the last phase. To make your plans more pleasurable, efficient, or practical, you can change your objectives, activities, or timetable.
Additionally, you can test out several self-care techniques to find which ones work best for you. If you feel stuck, overburdened, or in need of more support, you can also go for expert advice or assistance. Keep in mind that taking care of yourself is a continual process that calls for your attention, desire, and effort.
6. What coping strategy is most strongly associated with burnout?
Specific emotional coping mechanisms, including substance addiction, self-blame, rejection, dissatisfaction and complaining, have been linked to increased fatigue and burnout.
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Miller, A. (2023). How telemedicine can combat clinician burnout, the biggest challenge facing the healthcare industry.
Patel, R. S., Sekhri, S., Bhimanadham, N. N., Imran, S., & Hossain, S. (2019). A review on strategies to manage physician burnout.
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