Burnout

Burnout

The burnout section includes informative content by Dr. Haidar Al-Hakim about how to avoid burnout.

Dr. Haidar Al-hakim is a London-based ophthalmic surgeon, international speaker, charity founder, hypnotherapist and wellness coach.
When he isn’t helping the public at home and abroad to overcome problems with their physical eyesight, you can find him coaching struggling medical professionals so that they regain control of their lives and stay stable, fulfilled, and in touch with their purpose.
Find out more here.

Uploaded on 20/02/2019

What is burnout?

Dr. Haidar Al-hakim

Physician Burnout is a frightening thing. Not only because of the effect it has on us, but because of how widespread it has become. When Cardiff University studies can reveal what 60% of doctors within the UK have experienced – or are currently experiencing – mental health issues related to their career, it’s a clear sign that not only is there a problem, but that not enough is being done to tackle it.

Today, I help medical professionals lead that fight – to zero in on causes, find resolutions, and pull themselves back from the brink. But I didn’t get to where I am without a struggle of my own. In the past, I was burnt to a blackened husk – overworked, overwhelmed, and overweight, it felt like every day I was staring into the mouth of hell itself.

When I sat down to write my instructional self-help book, Physician on Fire, it took a long time to plan the format within which I should present the materials, many of which I use on a day-to-day basis with individual clients.

It’s true that we all share common pressures within this industry: extreme hours, severe workloads, overwhelming stress, bullying – all of these things run rampant amidst a worrying lack of support. Yet we put up with it. Medicine is our calling, and our drive to help others sometimes feels like the only thing keeping us moving at the end of yet another astonishingly long shift.

These problems are fed by the culture – where overworked doctors, existing solely on coffee and light snacks, are seen as the saviours of the day because they’re still around the practice much, much longer than anyone should reasonably be expected to continue to perform. Somehow, this is admired as resilience and dedication, while the secondary effects of such behaviour and attitude are brushed under the rug: the staggering drop in focus, the potential for serious misjudgments as concentration drops, and even the danger it adds to an otherwise normal drive home.

But the secondary effects are also what I’d like to talk about – because when it comes to burnout, they’re just as major an ingredient as the conditions of the workplace. These additional secondary effects are the personal traumas: what happens when burnout follows us home.

While we’re forced to share the professional circumstances that lead to burnout, our personal stories may be wildly divergent – something I had to work with when creating my coaching programme, The Spirited Breakthrough, and again with writing my book. We have different family lives, different physical makeup, different social spheres, and different attitudes to nearly every facet of personal life.

And yet, even with these differences, once burnout sets in, the results are often the same – making this particular affliction one of the most highly adaptable threats you’ll ever face. When the overwhelm, depersonalisation, lack of motivation, lack of care, lack of anything follows you home… that’s when burnout really sets in, and once it has you gripped in both the sphere of the professional and the supposed safety of the personal, it begins to pick and tear at everything that forms the core of who you are.

This reality got me thinking, and I came to understand that if we are to effectively tackle burnout and create strong, lasting change to the positive, we need to listen and understand each other’s stories. And so Physician on Fire became as much of an autobiography as it is a self-help book – revealing the personal battle behind the scenes as much as it discusses my thoughts from the industrial perspective.

That’s the revelation I hope to present to you right now: that it isn’t enough to sit quiet, try to stay strong, and bide your time as industry changes take place (or don’t, if the climbing rates of reported burnout are any indication) – we need to share our stories, open our hearts, and drag every facet of the damage burnout causes out into the light.
Because when we can all see this enemy for what it is, from every angle, we can hit back that much harder.

I hope that you find a home at Nottinghamshire LMC Wellbeing pages – a place where you can feel both part of something bigger, and inextricably yourself. Because that’s how we take burnout down: together, with empathy and understanding for the unique preferences, circumstances, and challenges that complete each of our stories.

And may your story be filled with peace, love, and light.
– Dr. Haidar Al-Hakim, The Third Eye Doctor

Recognising burnout?

Burnout is becoming increasingly common amongst GPs but can sometimes be difficult to recognise. A report from the Society of Occupational Medicine (2018) concluded that:

• ‘Doctors are at considerable risk of work-related stress, burnout and mental health problems such as depression and anxiety. The risk is greater than that of the general working population and is increasing over time in line with the growing demands and complexity of the job, a faster pace of work and diminishing resources.

• The risk of suicide, especially among general practitioners, psychiatrists and trainees, and among women, is high compared to the general population.

• General practitioners are more vulnerable to burnout (particularly emotional exhaustion), work-related stress and common mental health problems than doctors in most other specialities. This has been linked to the increased demands placed on primary care along with diminishing financial and staffing resources. ‘

Do you hate your job? Spend your weekends dreading going into work? Have you lost interest in your patients, perhaps seeing them as a nuisance? Staying later at work and running later in your surgeries? Constantly thinking about work even during time off? Spending less time with family and friends? Making mistakes and getting more complaints? Brain fog, exhaustion, isolating yourself from colleagues? Sleeping badly, neglecting yourself, drinking more alcohol, eating badly?

All of these are signs of burnout.

What causes burnout?

Research suggests there are 6 main contributors to burnout;
1. Work overload;
2. Lack of control over the work;
3. Insufficient rewards;
4. Workplace community problems, such as incivility and a lack of support among co-workers;
5. A lack of fairness, such as inequality of pay, promotions or workload;
6. A conflict between one’s personal values and the requirements of a job.

See our In The Surgery section for ideas on how to improve workplace wellbeing on a wider level.

Are you burning out? Take the tests

Take the BMA Burnout Questionnaire which is based on the Oldenburg Burnout Inventory (OLBI) developed by Dr. Evangelia Demerouti.

The Burnout Self Diagnostic Tool is a means to establish if you are approaching burnout or are already in it.

The statements included in the self diagnostic tool mentioned above apply to your life in general, including work and home. Don’t try picking away at them and analysing, just allow your responses to surface spontaneously and for an overall picture to emerge and answer “yes” or “no” to each.

In general, answering “yes” 35 times or more would indicate a state of serious challenge in your life. If you answered “yes” 50 or more times you are probably in burnout right now. There is no fixed score, but clearly the higher the number of “yes” answers in this case the closer you are to being in burnout. On average, answering “yes” more than 35 times would suggest that you are very close to if not actually in burnout and this is a wake up call to do something about it.

Doctors experiences of burnout

The emotional toll of being a doctor can sometimes lead to burnout. Read other doctors experiences on the BMA wellbeing page

Kate White is a GP who developed Physician Burnout after her own experiences of burnout.

Seek support

There are a number of services to support doctors facing burnout. You can view more services and support on our Mental Health section and on our Addiction wellbeing pages.

Ways to wellbeing

We neglect ourselves when we are experiencing stress and burnout. The very things we need to keep us well are the first things we stop doing – exercises, eating well hobbies and fun, spending time with family and friends, sleep – until all we have left is work. Focusing on the basics and self care is one of the most important steps in overcoming burnout and managing stress.

Look at our 5 ways to wellbeing page which guides to proven methods for managing stress and burnout including:

Self-care tools and exercises

Self-care is often neglected in burnout and is vital to wellbeing. It can be useful to make a list of 10 self-care ideas and try to do one each day. Ideas include:

  • A bubble bath
  • A 10 minute walk or exercise dvd
  • A cup of good coffee
  • Read a book
  • spend time with family
  • watch a favourite film (research shows watching a familiar favourite is more beneficial to distress than a new film)
  • mindfulness colouring books
  • jigsaw

You may even consider creating a self soothing box with some of these things in it.

Sleep

Sleepio
Sleepio is a proven digital cbt sleep program that is free to NHS employees. Get a personal sleep report and a years access to the online sleep cbt programme and app. (put in NHS as your employer when prompted.

Sleep council
The Sleep Council is an impartial, advisory organisation that raises the awareness of the importance of a good night’s sleep to your health. It offers tips and strategies for a good nights sleep including a free 30 day personalised sleep plan and sleep advice sheets for both you and your patients. https://sleepcouncil.org.uk/

Work/Life Balance

There is a work/life balance tool available which produces personalised feedback and insight into your current work/life balance and work needs from the education support partnership.

This is an interactive work life/balance tool that calculates a score for each of 6 key areas and makes suggestions for changes.

This is a resource aimed at teachers but the premise is the same for doctors. You can access it here.

The Wheel of Life
The wheel of life is a useful tool to identify areas of your lives that you would like to focus on or make changes. You can try it here.

You can alter the headings to make them more relevant to you and score each area on a scale of 1-10 according to happy and satisfied you are with each area of your life. A perfect wheel would be a full wheel whereby you are fully satisfied with each area of your life. Attached here is a number of questions for your ‘Wheel of Life’.

10 Top Tips for Being a Patient

  1. 1. Ask for help in time. Don’t wait too long.
  2. 2. Consult another doctor other than yourself. AVOID self medicating.
  3. 3. Ask the doctor to treat you as an ordinary patient (avoid the trap of clinging to the medical persona).
  4. 4. Be sure that this is a normal consultation with proper records kept etc.
  5. 5. Ask the doctor for all the information and advice that he/she usually gives someone with the same illness.
  6. 6. No shortcuts and no corridor consultations.
  7. 7. Do your best to follow the doctors advice about sick leave, diet, medication etc. If you get little or no advice, be courageous and ask for it.
  8. 8. Inform your family and friends about your condition (they may already suspect/feel something is wrong).
  9. 9. Inform your colleagues too, even if you are not on sick leave (help destroy the myth that doctors do not get sick).
  10. 10. Ask yourself why you got sick? Is there something in your lifestyle that can/should be changed?

(Credit – Health and Self Care, Inner balance for an effective life for health professionals, Presented by Dr Andrew Tressider) free to download online here.

Useful Burnout Links and Resources

The vital signs in Primary Care – A guide for GPs seeking help and advice
This is an excellent guide from Royal Medical Benevolent Fund for GPs suffering stress, burnout and mental health problems. Access it here.

Avoiding burnout: Strategies for senior physicians
Useful strategies for managing burnout in doctors is available here.

GP Online guide to the signs of burnout and advice on how to avoid it
A quick guide to the signs of burnout and advice on how to avoid it is available here.

The Practitioners Psychiatrist Support Service
The Psychiatrists’ Support Service provides free, rapid, high quality peer support by telephone to psychiatrists of all grades who may be experiencing personal or work-related difficulties. They have created a ‘Looking After Yourself’ survival guide which you can view here.