Strategies for maintaining resilience to the burnout threat

The impact of burnout

Burnout is associated with reduced performance and job satisfaction, increased rates of illness and absenteeism, accidents, premature retirement, and even premature death. Physically, stress induces the dry mouth, dilated pupils, and release of adrenalin and noradrenalin associated with the “fight-or-flight” reaction. The degree to which the physical, emotional, and professional symptoms are manifest depends on the depth or stage of burnout present (TABLE 2). Overall, burnout is associated with an increased risk for physical illness.⁷ Economically, the impact of physician burnout (for physicians practicing in Canada) has been estimated to be $213.1 million,⁸ which includes $185.2 million due to early retirement and $27.9 million due to reduced clinical hours.

“Do I have burnout?”

We all suffer from fatigue and have stress, but do we have burnout? With so many myths surrounding stress and burnout, it is sometimes hard to know where the truth lies. Some of those myths say that:

• you can leave your troubles at home
• mental stress does not affect physical performance
• stress is only for wimps
• stress and burnout are chemical imbalances that can be treated with medications
• stress is always bad
• burnout will get better if you just give it more time.

Maslach Burnout Inventory. The effective “gold standard” for diagnosing burnout is the Maslach Burnout Inventory,⁹ which operationalizes burnout as a 3-dimensional syndrome made up of exhaustion, cynicism, and inefficacy. Other diagnostic tools have been introduced¹⁰ but have not gained the wide acceptance of the Maslach Inventory. Some authors have argued that burnout and depression represent different, closely spaced points along a spectrum and that any effort to separate them may be artificial.^11,12