• Sara & Colin Taylor

Burnout Defined

Recently, JAMA published an editorial, Physician Burnout: A Serious Symptom, But of What?, and a systematic review, Prevalence of Burnout Among Physicians, raising valid questions as to how we are really defining burnout and measuring it when estimating the magnitude of the problem. Christina Maslach is a well known name associated with burnout research. In an article she co-authored with Michael Leiter in 2016, Understanding the Burnout Experience: Recent Research and Its Implications for Psychiatry, they define it as: "...a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment."

Most studies use a version of the Maslach Burnout Inventory (MBI) which was designed to assess these three dimensions of burnout. This all makes sense, however, practically speaking, most people don't rate their level of burnout on a scale, nor is there a true clinical diagnosis (as you would see in the DSM-5 for instance).

But why? We know that burnout among physicians is a risk factor for many things from mental illness, addictions and suicide; to broken relationships; to leaving medicine altogether. Yet, if we can't come to a consensus on how it's defined, some would argue that we use the term loosely without any evidence to support it. 

The statistics that we tend to use for physician burnout is a prevalence rate of over 50%. Variability exists depending on speciality, level of training and practice, age, gender, etc., but also may not always capture personal variability such as marital status, geographical location, resilience factors, etc. No matter how you look at it, it's a complex interplay of many factors.

However, short of performing the MBI on yourself or someone else, do the semantics of its definition really matter? Maybe, but when you're experiencing symptoms of burnout, you may not even be in a place psychologically to care about measurements. You may not even know that something is wrong given how insidious it can be.

The term burnout is really a warning sign. Recognizing over half of physicians are truly experiencing it, the definition is semantics if it's happening to you or someone you care about.

"Once full of passion and ideals, people suffering from burnout feel an allergy towards their work and struggle to find new horizons. Burnout is a wake-up call." ~ Alessandra Pigni, The Idealist's Survival Kit: 75 Simple Ways to Avoid Burnout

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