work/life
PM burnout
Burnout among GPs has received a lot of attention in the last couple of years. NIKKI WITHERS
investigates whether practice managers
are suffering the same
symptoms and what the main causes of stress are in the profession
T
he signs and symptoms can be subtle at fi rst, but as burnout creeps up on you, the consequences can be devastating. Job burnout has long been recognised as a problem that leaves once- enthusiastic professionals feeling drained, cynical and ineffective. It was fi rst discussed in the mid-1970s, and the portrait painted then hasn’t really changed since. The key characteristics of burnout are overwhelming exhaustion, feelings of frustration, anger, and cynicism, and a sense of ineffectiveness and failure. Although some people may quit their job as a result of burnout, others will stay on, only doing the bare minimum rather than their very best. This decline in the quality of work and in both physical and psychological health can be very costly – not just for the individual, but for everyone affected by that person, for example practice staff and patients in the case of practice managers. Burnout and other stress-related
illnesses among medical professionals have received increasing attention over the last few years, and have been described across many branches of medical practice. For example, a survey of over 500 British GPs published in BMJ Open last year revealed high levels of burnout in the profession. Nearly 50% reported high levels of emotional exhaustion, 42% reported depersonalisation and 34% reported low levels of personal accomplishment. These fi ndings were backed up by a Pulse survey of over 1,800 GPs that found that almost half are classifi ed as being at a ‘very high risk’ of developing burnout.
WHAT IS BURNOUT?
According to American psychologist Christina Maslach, job burnout is a ‘prolonged response to chronic emotional and interpersonal stressors on the job’. She defi nes three components of burnout: emotional exhaustion, depersonalisation
and a reduced sense of personal accomplishment, and has used these to develop the Maslach Burnout Inventory, which is widely used as a clinical tool to measure the condition.
There are many causes of burnout, but some people are more prone to develop burnout syndromes than others. For example, individuals with obsessive, compulsive, conscientious and committed personality characteristics – often common traits among doctors and those in the medical profession – have been found to be particularly vulnerable. Another common cause of burnout is an
increase in workload – something of particular relevance to practice managers since the recent NHS reforms. Practice managers are currently required to complete even more paperwork, work longer hours and ensure their staff are meeting the ever-increasing expectations of demanding patients. Combine this with under-valued relationships and increasing imbalances in work and home life, and it is not surprising that many practice managers are feeling the pressure. But is practice manager burnout something that is being recognised – and the question is who would report the problem – or is it something that is being hidden behind a net curtain? Teresa Webb, practice manager at Abbey Medical Practice, says that she would be surprised if most practice managers were not suffering from some level of burnout. “This is due to the many and varied demands on our time,” she says. “Not only is primary care now monitored by eight separate organisations, but the evidence required by them is extensive and arduous.”
Levels of stress are rising and it is becoming harder to manage the day- to-day pressures
OVERWHELMED, OVERWORKED Somerset LMC deputy medical secretary Dr Barry Moyse has been shocked by the number of calls the LMC has received from practice managers, and the numbers taking sick leave or even resigning: “Practice managers are overwhelmed by workload, specifi cally by being the single point of contact for multiple agencies and trying to get information to practices and then having to distil and disseminate it within the practice.” He says this has been made worse by the NHS reforms, which mean the NHS England area teams are more remote and less informed about the local situation. Nick Nurden, business manager at The Ridge Medical Practice, agrees, citing the
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