ITINERARY TO BURNOUT IN HEALTH PROFESSIONALS

Definition : burnout is

1.    an experience of physical, emotional and mental exhaustion, caused by long-term involvement in situations that are emotionally demanding.

2.    The index of dislocation between what people are and what they have to do. It represents an erosion in values, dignity, spirit and will and erosion of the human soul.

Manifestation :

1.    Emotional exhaution

2.    Depersonalisation

3.    Lack of personal accomplishment

Itinerary to burnout

Motivation to study medicine:

Humanistic values and ethics are the main motivators for students in medicine. During medical training there is still insufficient focus on health aspects in the health systems concerning health professionals. There is insufficient training in conflict - management, business management, team-work and job-sharing. There is insufficiency in intervisions and supervisions.

Once finishes university training the young doctors are exposed to :

1. daily contact with illness, pain and death

2. excessive work load

3. increasing lack of social support ore even hostilities and 
    attacks increasing ( 20% in 10 years ) in a context of 
    feminisation of medical profession.

4. often working with colleagues who suffer already burnout 
    síndrome

5. excessive bureaucratic load

6. increasing penetration of health systems by the market 
    society and its beliefs

confronted to that reality young doctors with their humanistic motivations and ideals too often enter into the process of burnout which goes through the following phases :

1. phase of illusion and enthusiasm

2. phase of dis-illusionment and disappointment

3. phase of profound frustration

4. phase of despair then falling apart and getting sick 
    or entering the following phases

5. phase of cynisme and detachment

6. phase of making money

7. phase of being eaten up by the market society

In the sake of healthy health systems, of healthy health professionals, of quality of care, of cost-effectiveness, of patient security, of motivated future young doctors and last but not least healthy society, the following preventive mesures are a must, whereby continuity of the process is of paramount importance.

1. redefinition of health professions in the context of 
    society and social security systems

2. systematic and continued analysis, identification and 
    updating of health aspects in health systems

2. structuring multiprofessional care-teams

3. prevention and assessment concerning burnout risks

4. training of health professionals in social competence 
    and networking

5. training in conflict - management

6. training in management of change ( change as an 
    opportunity rather than a threat )

7. intervention of trained coaches in health systems

8. intervision and supervision for health professionals

9. tutoring of medical students

10. enhancing job-sharing for a better job-family balance

11. enhancing personal development plan to foster 
      personal growth

12. training in human sciences