True to his name, Dr Burnt Out reflects on how GPs can offer support to colleagues suffering from burn out and exhaustion
Sadly, we live in a health care system, and more specifically a primary care environment, where there is currently an epidemic of work-related stress and burnout. Doctors become seriously unwell due to work and may have to take some time off work to recover, or even leave their job completely.
Almost all GPs working in the NHS today will have themselves suffered, or seen a GP colleague struck down suddenly by this condition. It can happen to GPs at any stage in their career and often without warning. Like I said – it is at epidemic proportions.
I also think that the (perhaps slightly old-fashioned) phrase ‘nervous breakdown’ quite accurately describes what happens to individuals in this state. Symptoms are likely to include: overwhelming anxiety, dissociative symptoms, depersonalisation, derealisation, fatigue, and mood changes.
Many GPs who have suffered from burnout may have previously thought to themselves: ‘this will never happen to me’ – even as they witness their own colleagues struck down. That is of course, until it happens to them.
The scary thing is that when burnout strikes, it seems completely out of conscious or voluntary control: you do not choose it to happen; it happens to you. The condition is a result of complex unconscious processes and in some ways oddly is a ‘protective’ mechanism. It is your body telling you that something is clearly very wrong in terms of stresses, workplace, values, emotional demands, and regulation and emotional overwhelm. It may be the result of cumulative factors building up, or there may be a particular trigger or incident which unleashes these possibly unexpected traumatic symptoms and emotions.
The irony is that the very qualities that make us good GPs in the first place – empathy, dedication and perfectionism – are actually the characteristics that put us more at risk of burnout.
Whilst it is very well recognised that burnout is a big problem (indeed a whole ‘wellbeing industry’ has developed over the last few years, with lots of ‘resilience’ training, BMA webinars, coaching sessions, talks etc), less is said about how to respond as an individual human being and colleague to someone who is affected.
Unfortunately, despite all the words, training and emphasis on ‘kindness’ and ‘compassion’, the reality experienced for those affected can be very different indeed. I have it on very good authority that by far the most common response from colleagues when someone goes off work with burnout is complete silence. Nothing. Nada. Zilch. Not even an email or text asking if you are OK. Indeed, there may even be irritation, anger or ‘othering’ of the person involved.
Of course, there are also likely to be some colleagues who will have texted or emailed you, asked whether you would like to meet up for a coffee etc. Unfortunately though, these colleagues are likely to be in the minority.
It does not take that much to send a very brief email checking in with somebody when they are in a very bad psychological state. Even the briefest email of support from a colleague or friend can make a huge difference to how you are feeling. When you speak to people who have been afflicted with burnout, they often say it is the silence that is the worst – an email from a colleague saying ‘actually I’ve always disliked you anyway and hope not to see you again’ would be preferable.
People never forget those that reach out to them when they are feeling despair, fear, upset and grief. Those who are ‘bridges over troubled waters’ for their friends and colleagues at the time are never forgotten.
So… let me suggest an email template (maybe the BMA or LMCs would like to adopt this as a guide?) that you can send to a GP colleague when they are off, unwell, have burnout ,or other medical problems. I can assure you that it means the world to the recipient to get this from a colleague. It only takes a few seconds to write (or you could even copy and paste it).
Dear ….
I am so sorry that you’re off and not well at the moment. I just hope you can rest and can feel a bit better soon. Am thinking of you.
Please don’t worry about work (we are fine) – the priority is your health and your recovery.
Let’s try and meet for a coffee sometime – let me know when suits you
Speak soon!
My message to those who are struggling with this at the moment is: don’t give up. Although it might not feel like it currently, things will undoubtedly get better.
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When I entered this profession, I didn’t know it would be full of shit people———–I’m not talking about patients——-but colleagues, who could make one’s life a misery, and should know better
i really must echo JG Munro’s comments – it is very disheartening to find most of the problems caused by our colleagues’ bad behaviours, and I have seen a few.
Agree with JGM. Met some great earnest hardworking GP colleagues, but it’s the sh*t ones you never forget. In my first partnership, when I was younger, the three 60yr olds tried to sell premises share at over double the agreed independent valuation…criminal! Then when I and the youngest partner disputed this, they dissolved the partnership. The PCT of the time backed the elderly senile GPs (who had strong connections in the PCT).
Some GP principals, rotten apples, taint the whole profession…don’t get burnout, take control and get out.