Burnout

Definitions from WHO
Burnout is a psychological syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:3,4
  • Overwhelming exhaustion,
  • Feelings of cynicism and detachment from the job; and
  • Sense of ineffectiveness and lack of accomplishment.
Burnout “refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”3

Burnout

Prevalence of burnout9
As is the case in many other countries, burnout is highly prevalent among health care practitioners in Hong Kong. According to a recent survey, the prevalences of burnout (measured by the Copenhagen Burnout Inventory) among local residents in-training or doctors within 10 years of their specialist registration (n=514) were:
72.6%

Personal burnout

70.6%

Work-related burnout

55.4%

Client-related burnout

A considerable level of depression and dissatisfaction was found to be associated with burnout among young doctors.

Burnout

Symptoms of burnout10
  • Reduced effectiveness and productivity
  • Cynicism
  • Absenteeism, presenteeism, workaholism
  • Lacking motivation
  • Heightened levels of frustration, negativity
  • Unable to see anything positive or be creative
  • Lack of emotion / becoming dispassionate
  • Disengaged
  • Feelings of hopelessness and helplessness
  • Possible dual diagnosis of depression
  • Life may not seem worth living

If you notice yourself experiencing these descriptions, please seek help as soon as possible as recovery from burnout would benefit greatly from early intervention.

Learn more about self-care tips and support that you may seek in the later chapters.

Burnout

Factors of burnout
Main factors causing burnout11
Nature of the profession
  • Practising clinical medicine involves a combination of great responsibility and little control.
  • A degree of stress is inevitable especially when you are seeing patients who are hurt, sick, scared, and dying on a day-to-day basis.
Stress from your personal life
  • Lacking life balancing as you are expected to ignore personal, emotional, and spiritual needs to unhealthy levels.
  • Conflicts with your family members and financial pressures.
Stress from your workplace
  • Job demands, professional liabilities and policy issues.
  • Interpersonal clashes and leadership issues.
Character traits
  • Being a workaholic, superhero, perfectionist, and “lone ranger”.
  • Believing “patients come first” even when you are not with patients.
  • Never showing weakness.

Burnout

Impacts of burnout
Neurobiological impacts12
  • The prefrontal cortex (PFC) has extensive connections with cortical and subcortical brain areas that provide top-down control over thought, attention, action, and emotion when we feel rested, interested, and in control.
  • The higher cognitive functions of the PFC (highlighted in green) are impaired by fatigue or uncontrollable stress (grey), posing potential ramifications to clinical practice.
  • Impaired PFC self-regulation may explain a number of challenges associated with occupational burnout, such as reduced motivation, unprofessional behaviour, decreased compassion, and suboptimal communication with patients.