Dr Sonia

There are many factors making it hard to tackle burnout in both individuals and organisations.
Here are my top three -  they are traps into which it is easy to fall  - but forewarned is forearmed.

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1. Burnout normalising

Recently I came across a published research paper on burnout in Indian psychiatrists. It contained a phrase which grated on my very soul...

"and so burnout is not too bad in psychiatrists - at around 33%"

Compared to what? The 40-50% of US physicians? The 56% of UK dentists? The 50% of Swedish teachers? The 57% of tech employees? An asteroid hitting the earth?
Please note - percentages in each industry vary according to the research methods but these figures, from reliable sources, give an indication that in many industries - the rate of burnout is approximating to one in two.

This odd ‘normalising of burnout' needs to be firmly nipped in the bud or at the very least highlighted.... and not just for researchers.

It is quite easy to fall into the ‘burnout normalising trap’. But this phenomenon is doing no one any favours.  Researchers do it, society does it, organisations do it, whole  industries are doing it. On a personal basis people unwittingly do it to themselves... constantly readjusting their burnout thermostat as it gets worse (burnout "re-normalising") so that everything appears normal on the surface whilst the 90% of the fallout and suffering from burnout below the surface goes unseen. Until of course the burnout crisis supervenes.

How has this reset of what is acceptable regarding burnout percentages arisen?  Are the researchers working on burnout becoming so hackneyed with the high levels of burnt out people in their selected populations  (& perhaps their own burnout?) that the horror reaction to what they discover in their research has been muted and everyone else just follows like sheep? It feels as if the point has been reached where a herd immunity has developed to reports outlining frankly appalling levels of burnout.

2 Invalid reversal statements

The second  burnout trap to watch out for is ‘the reversal statement’.
It comes in throwaway paraphrases of (& is even seen in research papers) "all is not doom and gloom because 40% burnout means 60% don’t have burnout and are doing fine."

I don’t think any such conclusions are valid especially if the research has been set up to reveal / measure burnout. Simply assuming those without measurable burnout are doing fine is just not sensible especially given much of burnout lies beneath the parapet.

I feel the need to iterate and clarify (& you can quote me on these!)...

"The absence of burnout is not... wellbeing."

"No level of burnout is not too bad unless perhaps it is way less than 1%."

"Burnout & its fallout are extremely damaging  to everyone concerned and the truth is.... all burnout is unacceptable."

3 The sticking plaster remedy

The dysfunctional nature of burnout normalisation and the naivety of the burnout reversal statement are compounded further by burnout trap number 3. 
Here the premise is - "We have heinous levels of burnout so we need to give our crisply burnt out, overworked, poorly rested people...."
  • A once a week yoga class
  • A meditation course/app/ room 
  • An on-site gym
  • A healthy lunch.... etc.

What... to help  them ‘cope’ with the chronic excessive long hours, overwhelming tasks, job spec creep and work that follows them everywhere? A yoga class?!!! A salad? 

The words horse ... gate.... & bolted come to mind as do these - too little too late.

For any burnout sufferer such remedies sit in the face of a towering edifice of endemic reasons for burnout and unless those reasons are tackled there will be no real impact on burnout.

There is plenty of research on burnout but precious little valid, quality research on burnout interventions so the above mentioned simple and quick ideas, whilst attractive in terms of cost and unthreatening ease of introduction - do not really cut the mustard where burnout is concerned. How can I be so sure? Burnout is increasing - in most industries and many organisations. Despite such interventions. The evidence suggests that the aforementioned measures are drops in the ocean when delivered within fundamentally dysfunctional working environments.  Of course the core reasons for the burnout are much more difficult to address. The low cost initiative can not be said to equate to a reduction in burnout unless the burnout is specifically measured before and after any wellbeing initiative.

Dr. Christina Maslach a respected burnout researcher (I don’t have it in for all researchers!) since the 1970s - also dismisses similar patch ups such as mindfulness -  calling these superficial attempts at containing burnout ...."window dressing" and "not a solution for the stress problems we’re having on the job." Something more radical is clearly needed.

Gym, healthy canteen & opportunities to meditate are part of encouraging a healthier lifestyle all round and many organisations gauge their effectiveness by reduced sickness absence or increased engagement. Many however do not even measure before and after outcomes and besides they are not cures for rampant, institutionalised, embedded burnout.

What is more, the cultures perpetuating work overload and ‘office follows everywhere’ expectations can offer yoga till the cows come home but the folk that really need it most likely won’t or can’t attend.

It’s not that these employee care steps are worthless ... but if they are measures intending to impact upon burnout - in reality they could even be cloaking the core burnout causing problems.
There is a real risk that the plasters will merely obfuscate and temporarily distract attention from burnout which is still there lurking 90% under the water  & doing untold damage.

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I’d say avoid sticking plaster approaches to burnout and instead explore things like....

  • Job spec creep 
  • How people think their efficiency/enjoyment balance can be maximised 
  • Promoting debate and clarity around the questions ‘what is reasonable  work?’ and ‘should work follow you everywhere?’
  • Educating on burnout (my own favourite)
  • Reviewing policies so that they do not merely state intentions to prevent overwork but reward adhering to it.

But if the culture is grind yourself into the ground to please/ placate your boss, stay late & tick boxes or secure profits at all costs ... then no amount of exercise, salad leaves, job spec reevaluations or half-hearted attempts at limiting work hours - will turn the tide of burnout. 

I’m not saying don’t bother with simple health and wellness initiatives or employee benefits - there are many reasons for introducing these - for recruitment, for general workforce wellbeing, for showing the company cares and more.

However to know you have had an impact on burnout it is burnout you have to measure.

Sonia Hutton-Taylor  MBBS FRCS FRCOphth DO
Burnout... face it - fix it - be free 
Burnout Geese offers a low-cost way for individuals and companies to learn about and face up to burnout 

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