Stress, burnout, and strategies for reducing them

OBJECTIVE To ascertain Canadian family physicians’ levels of stress and burnout and the strategies they use to reduce these problems.

DESIGN Census survey.

SETTING Kitchener-Waterloo, an urban area with a population of approximately 300 000 in southwestern Ontario.

PARTICIPANTS Family physicians.

MAIN OUTCOME MEASURES Scores on the Family Physician Stress Inventory, scores on strategies to reduce personal stress, scores on strategies to reduce stress on the job, and scores on the Maslach Burnout Inventory.

RESULTS Participation rate was 77.8% (123 of 158 surveys returned). About 42.5% of participants had high stress levels. Burnout was defined by 3 components: emotional exhaustion, depersonalization (going through the day like an “automaton”), and perceived lack of personal accomplishment. Many respondents scored high on the burnout inventory, and almost half had high levels of emotional exhaustion and depersonalization (47.9% and 46.3%, respectively). No demographic factors were associated with high scores on these components. Use of strategies to reduce personal and occupational stress was associated with lower levels of burnout. Scores on the Family Physician Stress Inventory correlated highly with scores on the Maslach Burnout Inventory.

CONCLUSION Regardless of demographic factors, family physicians are at risk of having high levels of stress and burnout. Classic burnout is related to stress brought on by factors such as too much paperwork, long waits for specialists and tests, feeling undervalued, feeling unsupported, and having to abide by rules and regulations. Common strategies for reducing personal stress included eating nutritiously and spending time with family and friends. Common strategies for reducing stress on the job included valuing relationships with patients and participating in continuing medical education. Stress and burnout are related to the desire to give up practice and are, therefore, a human resources issue for the entire health care system.