Vital signs - the phenomenon of physician burnout

Physicians are healers. Far and wide their profession is revered, their status impeccable. It seems contradictory, even wrong, that today's doctors may be the one group of professionals most in need of urgent care. Yet that's exactly the startling finding that University of Lethbridge professor Dr. Bob Boudreau uncovered through his research on the subject of burnout. As it happens, doctors are more at risk for professional burnout than any of the dozens of other occupations that Boudreau and his research team have examined.

Boudreau has been studying occupational stress for more than two decades. His 1985 dissertation was a theoretical paper on the critical development and directions within the field of stress and burnout. He furthered his investigation on the subject while on exchange at Hokkai-Gakuen University in Sapporo in 1988.

Dr. Bob Boudreau examines professional burnout and how doctors seem to be more at risk.

"Our early research surveys on Japanese workers led to further research opportunities on occupational health and burnout levels of workers in Canada, the United States, Belarus, New Zealand and Australia. The study of global burnout has continued to attract attention and grow in interest and importance over the years," Boudreau says.

In the last several years, Boudreau has focused his studies on stress levels and burnout in specific occupations. In 2002, he connected with Taber physician Dr. Rob Wedel to kick-start research on doctors. As fate would have it, Robin Robertson from the Alberta Medical Association overheard their conversation, and quickly thereafter it was decided that the study was something that would be conducted provincewide.

Boudreau developed a survey aimed at examining the prevalence and severity of burnout in Alberta physicians using a series of demographic questions and four measurements of burnout. More than 1,100 doctors
participated in the provincial study, and less than a year later, Boudreau was asked by the Canadian Medical Association to conduct a similar survey nationally.

What Boudreau was surprised to discover was that out of all the occupations he'd examined, doctors were by far at the highest risk for professional burnout. In fact, almost half of the physicians who participated in the study were in what Boudreau categorizes as advanced stages of the condition.

"It doesn't seem to matter whether they are specialists or GPs. Doctors as a group are worse off than other professionals when it comes to burnout. There are a lot of cracks in the health-care system and physicians are suffering in a whole host of different ways."

Boudreau believes the incidence of physician burnout in Canada can be attributed to many factors, not the least of which is the pressure that comes with being responsible for the well-being of hundreds of patients. Tie that in with an over-taxed health-care system rife with shortages, plus the day-to-day pressures of running a busy practice and you have the perfect prescription for professional exhaustion.

"We need to continue to develop a better diagnostic set of measures so we can gain a greater understanding into this complex problem," says Boudreau. "Once we figure out what it is, we will be in the best position to try to manage burnout and many of its related workplace cousins such as increased job conflict, poor performance, helplessness, higher absenteeism, lateness and poor health."

New avenues for Boudreau's research include the development of a bibliography of burnout, which will be a compilation of approximately 13,000 previously researched references on the subject put together in a user-friendly format that other researchers and students around the globe can use. With a background in industrial psychology, Boudreau aims to further his work on professional burnout in an effort to better the working environments of not only physicians, but professionals across the board.

"The strategy is to find the cracks in each occupation we study and develop the tools and strategies people need to cope with their own professional situations," he says.

Future endeavours for Boudreau include a meta-analysis on published physician burnout surveys, and a study of the effects of burnout in relation to the assessment and management of fatigue in chronic illness, conducted with an interdisciplinary team of researchers from across Alberta.