Nearly half of all General Practitioners (GPs) in the UK are at a very high risk of burning out and are jeopardizing their mental health, according to a PULSE survey.
PULSE is a UK medical journal that focuses on general practice (primary care).
According to the study, 72% of primary care physicians throughout the country are showing high levels of “emotional exhaustion”.
A GP (General Practitioner) is a primary care physician, a family doctor.
PULSE researchers used the validated Maslach Burnout Inventory tool and found that 43% of GPs surveyed were at a very high risk of burnout. GPs working in deprived areas and GP partners were the worst affected.
This study is the first to show clearly how high workload levels are undermining both GPs’ health and possibly patient care too.
Forty-one percent of GPs scored high for “depersonalization”, a common panic attack symptom in which sufferers have a strange feeling that they are not really in their body. Depersonalization would have a negative impact on a doctor’s relationship with patients.
GPs are having to deal with a massive increase in workload as a result of commissioning responsibility and a new imposed contract deal – and also as Jeremy Hunt, Health Secretary, prepares to give back out-of-hours care responsibility to general practice.
The survey involved 1,784 general practitioners from around the country. It was conducted on the PULSE website as well as the PULSE Live conference in May 2013. The researchers used a version of the Maslach Burnout Inventory assessment which was adapted for GPs.
Doctors were asked questions assessing three key areas that point to a high risk of burning out:
- emotional exhaustion
- low level of personal accomplishment
While 43% had high scores in all three areas, nearly all the GPs surveyed were classified at risk in at least one area.
Dr Richard Vautrey, deputy chair of the General Practitioners Committee, BMA, described the results of the survey as “hugely concerning”.
Dr. Vautrey added:
“It’s alarming that so many GPs are burnt out. The current level of work is unsustainable. I hope enough alarm bells are ringing in the Department of Health, in NHS England, Health Education England and all the devolved nations for them to say ‘we need to tackle this'”.
Chief executive of Londonwide LMCs, Dr Michelle Drage said she had never seen it so bad. She expressed alarm and concern at the levels of burnout among GPs, adding that they are causing a deterioration in general practice as a profession. “The impact of a GP being burnt out isn’t only on their own families, but on the 2,500 people they care for.”
Dr. Amy Small, a general practitioner in Lothian, said that she switched to part-time work because she was “burning out”. She said she felt as if she were drowning – getting up every day to a job she had started to hate. “I was there from 8am to 8pm and I was struggling. During consultations I would cut patients off when they were speaking. They would come in and I would see three or four yellow QOF boxes to tick. I was always hoping I didn’t generate a referral. I was curt with patients, I was always rushing, going on home visits but not delving into complex issues.”
Dr. Small continued “A patient saw me and I’d focus on the issue at hand but not go into other problems – which you should for holistic, all round care. I wasn’t sleeping properly, I felt stressed all the time. Friends would say I looked tired. Now I’ve gone part time people tell me ‘you look so much better'”.
Burnout is devastating general practice, Dr. Arup Paul, who works as a GP in Tower Hamlets, east London said. One of the consequences of burnout is depersonalization with patients. Dr. Paul, who said he used to care about patients too much, he cares about them less now.
Dr. Paul said “It affects my whole life. You go home and you find it difficult to speak to your elderly mother, because you know you’re going to get whinged at. You come home and you don’t want to speak to your partner because all you want to do is check your emails and eat.”
Steve Nowottny, editor at PULSE, said: “While there’s inevitably some degree of selection bias in this kind of survey, the sheer number of GPs who responded and the worrying stories they told suggest thousands of GPs are working themselves harder than is safe for them – or safe for patients.”
“(Health Secretary) Mr Hunt has already ratcheted up GPs’ workload with the contract imposition this year. As he prepares to shift yet another burden onto GPs, with the return of out-of-hours responsibility, he should take a long hard look at these findings and consider how much more general practice can really take.”
Burnout is affecting doctors in several fields of medicines on both sides of the Atlantic.
A Mayo Clinic-led study found that many American oncologists have experienced at least one symptom of burnout.
Study leader, Tait Shanafelt, M.D., a hematologist/oncologist, said “Oncologists work long hours, supervise the administration of highly toxic therapy, and continually observe death and suffering, so it is important to study the issues of burnout and career satisfaction.”
In another study led by Dr. Shanafelt last year involving 7,288 physicians, researchers reported in Archives of Internal Medicine that at least 45.8% of doctors in the USA had one symptom of burnout.
37.9% of those surveyed reported high emotional exhaustion, 29.4% had high depersonalization, and 12.4% felt a low sense of personal achievement. In the control group the risk of having the symptoms of burnout was 27.8%, compared to 37.9% among doctors.
Written by Christian Nordqvist