004 - Physician Burnout: Definition, Controversies and Etiology

Physician Burnout: Definition, Controversies and Etiology <br /><br />The last episode waded into the murky waters of graduate business education. Anyone listening to that podcast should have emerged with serious doubts about whether an MBA is a desirable credential for healthcare, much less for healthcare leadership. <br /><br />This Licensed to Lead Podcast is the first of four episodes zeroing in on physician burnout. What is it? Why is it? And how is it that the word “burnout” has become radioactive? This episode defines the terms, takes a look at the assessments used to determine the presence of burnout, and fleshes out the controversies and the causes. <br /><br /> <br /><br />Part 1: What is burnout? How is it measured? <br /><br />Research tells us that on day one of medical school, medical students have lower rates of burnout and depression than a matched cohort. The impending medical students are more mentally healthy and stable than their counterparts. Research also tells us that once in medical school, students develop very high rates of depression and burnout. So they go in more mentally stable than their peers, and they get sick. The “canary in the mine” analogy is apt. <br /><br />And everyone who’s anyone in the world of burnout agrees: <br /><br />The World Health Organization, Berkeley professor emeritus Christina Maslach (of the eponymous Maslach Burnout Inventory), even Pamela Wible, MD (author of “Burnout is Bullshit!”) agree that burnout is an occupationally induced syndrome. It is caused by the workplace. It’s not the doctor’s lack of resilience or predisposition to mental illness or Patchouli oil deficiency that creates a 50% burnout rate. Doctors don’t start out with it. A damaging work environment ushered in by unenlightened, unskilled, or uncaring leaders is the source. <br /><br />How is burnout measured? In 1981, Christina Maslach and Susan Jackson developed the Maslach Burnout Inventory (MBI). The standard 22-item questionnaire has three domains: <br /><br />1. Exhaustion, typi