The Lancet: Physician burnout: a global crisis

12 July, 2019

The new print issue of The Lancet carries a lead editorial on physician burnout.

Citation, extracts and a comment from me below. Full text here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31573-9/fulltext

CITATION

Editorial| volume 394, issue 10193, p93, july 13, 2019

Physician burnout: a global crisis

The Lancet, Published:July 13, 2019

DOI:https://doi.org/10.1016/S0140-6736(19)31573-9

EXTRACTS

Physician burnout, defined as a work-related syndrome involving emotional exhaustion, depersonalisation, and a sense of reduced personal accomplishment... has reached global epidemic levels. Evidence shows that burnout affects more than half of practising physicians in the USA and is rising. The 2018 Survey of America's Physicians Practice Patterns and Perspectives reported that 78% of physicians had burnout, an increase of 4% since 2016. Furthermore, 80% of doctors in a British Medical Association 2019 survey were at high or very high risk of burnout, with junior doctors most at risk, followed by general practitioner partners...

There are tremendous controversies and barriers in dealing with physician burnout. Despite wide discussions and many publications, there are striking differences in the understanding of what constitutes burnout. Lisa Rotenstein and colleagues reported at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, and there was substantial variability in prevalence estimates of burnout among physicians and variation in burnout assessment and study quality...

Disturbingly, physician burnout is still a hidden but rapidly growing epidemic in LMICs, given the soaring and large demands for health-care services in these countries... physicians' sudden death and suicide due to overwork — the consequences of extreme burnout — have not been uncommon in many Asian countries.

COMMENT (NPW)

1. This issue is of personal interest to me as overwork as a junior doctor contributed to my own experience of clinical depression, leading me eventually to switch from junior doctor to medical publishing to HIFA (a silver lining).

2. The lack of evidence on physician burnout in LMICs is troubling. I would imagine that the stresses of being a doctor in an LMIC are even greater than in a HIC, through overwork, insufficient time for each patient, and - crucially - a non-empowering work environment with limited access to medicines, equipment and/or information. Can anyone describe their experience or the situation in their country?

3. The editorial focuses on 'physician burnout', but clearly this is a problem that can affect any health professional: nurses, midwives, pharmacists, allied health professionals... What do we know about burnout for non-physician cadres?

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org