Psych · Professional — doctor health, burnout and impairment
Doctor health, burnout and impairment
Also known as Physician burnout · Doctor wellbeing · Occupational burnout · Physician impairment · Physician health programme · Junior doctor mental health · Presenteeism · Moral injury in medicine · Maslach burnout
Exam-exhaustive fellowship reference on doctor health, Maslach three-dimension burnout, ICD-11 occupational framing, epidemiology and suicide risk, differential from depression and substance use, assessment, organisation- vs individual-directed interventions, impairment and mandatory reporting principles, physician health programmes, trainee risks, stigma and help-seeking, and regional doctor-health systems. FRANZCP-primary, globally tagged.
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Red flags
- Colleague intoxicated or cognitively unsafe at work — remove from duties; patient safety first
- Suicidal ideation in a doctor after complaint, error, or regulatory threat — treat as psychiatric emergency
- Labelling major depression or substance use disorder as 'just burnout' and missing treatment
- Loyalty to a colleague outranking public protection when impairment thresholds are met
- Resilience workshops as the only organisational response to system drivers
- Inventing AHPRA/GMC section numbers as if universal law
Meet the doctor
A third-year registrar is on her fourth set of nights this term. She has started calling the ward "the queue". Last week she wrote a discharge summary for a patient she could not later recall. She has stopped going to handover early, because that was where people talked.[1][3][13]
Her consultant thinks she needs a holiday. Her partner thinks she is depressed. She thinks she is failing.[7][11]
The examiner's question is not "is this burnout?" It is "what would you miss if you accepted that answer?" That is the whole topic.[7][11]
References18ShowHide
- [1]Maslach C, Schaufeli WB, Leiter MP Job burnout Annu Rev Psychol, 2001.PMID 11148311
- [2]West CP, Dyrbye LN, Erwin PJ, Shanafelt TD Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis Lancet, 2016.PMID 27692469
- [3]West CP, Dyrbye LN, Shanafelt TD Physician burnout: contributors, consequences and solutions J Intern Med, 2018.PMID 29505159
- [4]Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of Burnout Among Physicians: A Systematic Review JAMA, 2018.PMID 30326495
- [5]Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population Arch Intern Med, 2012.PMID 22911330
- [6]Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014 Mayo Clin Proc, 2015.PMID 26653297
- [7]Mata DA, Ramos MA, Bansal N, et al. Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis JAMA, 2015.PMID 26647259
- [8]Panagioti M, Panagopoulou E, Bower P, et al. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis JAMA Intern Med, 2017.PMID 27918798
- [9]Schernhammer ES, Colditz GA Suicide rates among physicians: a quantitative and gender assessment (meta-analysis) Am J Psychiatry, 2004.PMID 15569903
- [10]Dutheil F, Aubert C, Pereira B, et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis PLoS One, 2019.PMID 31830138
- [11]Brooks SK, Gerada C, Chalder T Review of literature on the mental health of doctors: are specialist services needed? BMC Med, 2011.PMID 21275504
- [12]Bismark MM, Mathews B, Morris JM, et al. Views on mandatory reporting of impaired health practitioners by their treating practitioners: a qualitative study from Australia BMJ Open, 2016.PMID 27993902
- [13]Petrie K, Crawford J, LaMontagne AD, et al. Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey BMJ Open, 2020.PMID 31964674
- [14]Harvey SB, Modini M, Joyce S, et al. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems Occup Environ Med, 2017.PMID 28108676
- [15]Dyrbye L, Shanafelt T A narrative review on burnout experienced by medical students and residents Med Educ, 2016.PMID 26695473
- [16]Tawfik DS, Profit J, Morgenthaler TI, et al. Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors Mayo Clin Proc, 2018.PMID 30001832
- [17]Petrie K, Crawford J, Shand F, Harvey SB Workplace stress, common mental disorder and suicidal ideation in junior doctors Intern Med J, 2021.PMID 33135841
- [18]Petrie K, Joyce S, Tan L, et al. A framework to create more mentally healthy workplaces: A viewpoint Aust N Z J Psychiatry, 2018.PMID 28835112