Burnout in established general practitioners The significance of supervision

摘要

The term "burnout" refers to emotional and physical exhaustion, apathy, cynicism, a reduced sense of work satisfaction and social withdrawal, which - apart from internal factors - may be caused by work overload, a lack of "control" options, i.e. self-determination, inadequate financial compensation, a breakdown of social community, absence of fairness or conflicting values. The boundary between the concepts of burnout and depression is hard to demarcate. The former originated in the field of psychoanalysis but was subsequently expanded through insights from sociology. Austrian general practitioners in the medical profession were the subject of a survey based upon the Maslach Burnout Inventory and supplementary items (Tirol, 95 respondents). More than one third (35.8%) of respondents considered themselves to be at risk for burnout, with 27.2% showing elevated values for emotional exhaustion, 3.2% for depersonalisation and 10.0%for cynicism. The average values lay outside of the range which might warrant therapeutic intervention, however. The study did not reveal any noteworthy correlations based upon either age or gender (p > 0.05).Medical professionals licensed under the national health insurance plan tended to evidence higher degrees of burnout than did professionals practicing outside this framework ("physicians of choice"), as did those practicing in smaller communities. Availment of supervision services and participation in depth-psychologically oriented Balint groups had a favourable effect on the degree of burnout (10% lower values for cynicism, p < 0.01; - 10%; 6.5% higher values for personal accomplishment, p < 0.01). The data suggest that burnout in physicians practising in Austria is an issue which merits attention and that appropriate supervision services should be made available. This article is based on an initial study report published in German in the Wiener Medizinische Wochenschrift [1]. The authors thank the WMW for their permission to publish the present expanded version of this report. The research work was carried out at the Interuniversity College Graz / Castle of Seggau, Austria within the framework of a study program focusing on group analysis [2,3].