Burnout - There's a Code For That
The big news in burnout over the last few weeks came from the World Health Organization announcing that burnout now appears in the International Classification of Diseases, also known as the ICD-11, as a medical condition. This means burnout is considered a legitimate diagnosis, and in our mind, further legitimizes the term 'burnout'. Some people have recently taken issue with the term and have used "moral injury" instead, but now that burnout has a corresponding code in the ICD-11, it's further proof that it's not going anywhere.
Burnout is now diagnosed under the following criteria which appears in the section on problems related to employment or unemployment in the ICD-11: "Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."
The Mayo Clinic offers some questions to ask ourself which may indicate we're experiencing burnout, and in turn, prompt further intervention.
Have you become cynical or critical at work?
Do you drag yourself to work and have trouble getting started?
Have you become irritable or impatient with co-workers, customers or clients?
Do you lack the energy to be consistently productive?
Do you find it hard to concentrate?
Do you lack satisfaction from your achievements?
Do you feel disillusioned about your job?
Are you using food, drugs or alcohol to feel better or to simply not feel?
Have your sleep habits changed?
Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?
If you've either experienced burnout personally, or known someone who has and seen what they went through up close, you know that answering 'yes' to any of these questions doesn't do justice to what it looks like in real life. In our household, Colin's chronic exhaustion, mounting cynicism, dread walking out the door heading to work in the morning, and worsening headaches - only told part of the story. We often reflect and think - what if he didn't have his family in his corner to come home to or if he was hit with a college complaint? We shudder at the thought and feel even more motivated to be a voice in the corner of our physician colleagues and medical trainees experiencing burnout, or who teeter on the verge, or who have even come out the other side.
So, yes, there is now a code and diagnosis for burnout and we're glad. We hope this will encourage people experiencing it to look for help and support and prompt changes in the systems that are fuelling it. When it comes to physician burnout, physicians and trainees are truly "canaries in the coal mine" signalling the work/training environment is problematic. No code applied to an individual absolves the system of its involvement.
"But beware: Burnout is not born in isolation. In fact while personal traits such as perfectionism make us more prone to burnout, the root of the problem generally lies in an unsupportive, if not toxic, environment (workplace) where long hours, limited rewards, and lack of civility and respect are widespread." ~ Alessandra Pigni