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We all have a role in tackling the burnout endemic

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Burnout, recently recognised by the World Health Organisation as a syndrome brought about by chronic workplace stress, is reaching epidemic levels, writes Graham Howarth, head of medical services, at Medical Protection Society (MPS) South Africa.

Dr Howarth writes:

Medicine is a brilliant career – there are a few other professions with so many possibilities to improve people’s lives. The increasing levels of burnout I encounter as I talk to colleagues is however extremely troubling. We must not let the environment we work in reduce the sense of value that we get from being a doctor.

The World Health Organisation (WHO) recently recognised burnout as a syndrome brought about by chronic workplace stress that hasn’t been successfully managed. It is characterised by mental, physical and emotional exhaustion, cynicism, increased detachment and a decline in professional satisfaction caused by multiple factors. When doctors feel burnt out and disillusioned it is not only concerning for the doctors but for patients and the wider healthcare team. Doctors who are happy and engaged are much more likely to be compassionate and provide safer patient care.

As leaders, managers and peers we are all responsible for identifying signs of burnout in ourselves and others and in working together to develop strategies to enhance personal resilience.

Medical Protection Society (MPS) also has a role to play. As a mutual organisation, it is vital that we listen to and care for members – which is the reason why we are rolling out our burnout workshop across South Africa in 2020. The workshop is designed to review, recognise and respect the need to build individual and organisational resilience and to develop strategies for safe recovery to avoid burnout when resilience is challenged. We have also recently presented on the issue at our flagship Ethics for All event, which outlined the link between burnout and medicolegal risk, as well as how healthcare professionals can recognise the signs of burnout. But while such support is invaluable it is only a part of the solution.

We asked members about their working environment and they told us loud and clear about the impact their work has on their wellbeing. Over half (52%) are not satisfied with their work/life balance, 47% often or always start the working day feeling tired and 56% do not feel that their personal wellbeing is a priority for their superior.

New reports are published regularly showing increasing problems with doctors’ health and wellbeing and healthcare professionals leaving practice prematurely.

The causes of burnout have also been widely debated and include the growing demands and complexity of the job, a faster pace of work and tighter financial constraints. In addition, the extent to which medical aids influence clinical management is understood to have a real impact on the way doctors practise.

It goes without saying that South African doctors are faced with challenges and stress factors that are very specific to the country. But burnout is not unique to South Africa, to doctors working in the State sector or in the private sector or to any one particular specialty. It is a widespread and global phenomenon which can affect all clinicians and is high among doctors around the world. While the rates vary by country, medical specialty, practice setting, gender, and career stage, the overall evidence suggests that many doctors worldwide will experience burnout in their careers, and the rates are rising, having reached an epidemic level.

We recognise that MPS, alongside other organisations, must work to seek commitment from healthcare leaders to improve the working environment and to truly begin to tackle the endemic of burnout in healthcare. Only with organisational level interventions can the wellbeing of doctors be safeguarded. Our campaign on burnout will be launched later this year.

The Ethics for All event took place in Durban and Pretoria last week, and will be taking place in Cape Town on Thursday 17 October

MPS material

Practitioner burnout contributing to clinical errors — MPS survey

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