GPs: Why Are We Burning Out?
The term ’burnout‘ is not new, but it has been applied increasingly to NHS staff, and in particular to GPs, in an attempt to better define the growing feelings of pressure and stress within the service.
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lthough it can be defined in many ways, burnout is essentially a state of emotional, physical and mental exhaustion caused by prolonged or excessive stress. It occurs when we feel overwhelmed or emotionally drained, or when we lose autonomy, and are unable to meet the demands of our job. With the increasing and persistent pressures on Primary Care over the last few years, through a combination of decreased funding and GP numbers, increased patient demand and poor cohesion as a profession, General Practice has become the latest burnout candidate. There are many websites and self-diagnosis tools available to help us test whether we might be at risk, and with up to 50% of General Practice consultations involving some kind of mental health element, GPs are only too well aware of the signs and symptoms of stress and anxiety. I don’t want to dwell here on the familiar coping strategies – getting better sleep, eating healthily, taking exercise, scheduling work breaks, and so on.
Rather, I want to argue for a more pragmatic and focused approach to dealing with burnout in Primary Care. First, there has been a gradual and subtle erosion of autonomy in Primary Care. When asked why we went into medicine, most doctors include the phrase “because I wanted to help people”.
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...it is not surprising that GPs feel a loss in autonomy and respect.
Yet most of us spend less time than we used to on patient care and more on trying to achieve mandatory targets such as Quality and Outcomes Framework (QOF) indicators, Clinical Commissioning Group (CCG) prescribing incentives, CCG monitored referral rates, Care Quality Commission (CQC) assessments, as well as local Federation and Network projects, and our own revalidation. Meeting these requirements is not only time-consuming but runs counter to the emphasis on decisionmaking and patient-centred care that doctors receive during training.
In addition, funding issues and attempts to streamline care now mean that many of the decisions made What is Burnout? by GPs are then reThe World Health Organization refers evaluated before to burnout as a syndrome conceptualised they reach as resulting from chronic workplace stress, their intended defined by three symptoms: Secondary Care destination. • Feelings of energy depletion or Screening exhaustion centres such as • Increased mental distance, or feeling the Improved negative towards your job or career Access to • Reduced professional productivity. Psychological Therapies (IAPT), evaluate GP referrals to see if they meet the requirements set locally to see a psychiatrist.
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