Family Medicine

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World Book of Family Medicine – European Edition 2015 Paperwork; feeling undervalued; long waits for accessing specialists, diagnostic tests, and community resources; difficult patients; obligation to undertake night shifts at the emergency departments of hospitals and medico legal issues are well known stressors of family practice. Unfortunately, workplace violence caused by patients and their relatives are increasing and this is another demotivating factor for the physicians. Measures to be taken improving skills and knowledge, improving conditions for work and rest, improvement of facilities and working conditions, increase in work motivation, changes in reward system, implementation of social programmes for self-protection, introduction of the system for psychosocial draining and stress relief after working day; improving organizational psychosocial atmosphere and recommendations to stop the development of burnout syndrome: ◦ introduction and implementation of new projects without waiting for the manager’s consent, ◦ maintenance of good health habits including provision for adequate sleep and nutrition, ◦ acquiring meditation skills, ◦ developing a satisfying social life, ◦ establishing contacts with some friends possibly from other professions, ◦ desire to achieve results without expecting to be always the best, ◦ ability to lose without the feeling of self-underestimation and aggressiveness, ◦ ability of self-assessment without thinking about the opinion of others, ◦ openness to new experiences, ◦ ability to provide sufficient time to achieve positive results in business and personal life, ◦ ability to take responsibility, ◦ to read literature not related to the profession, ◦ participation in seminars and conferences where there is a chance to meet new people and share experience with colleagues, ◦ occasionally working together with colleagues with whom you disagree in professional and/or private life, ◦ participation in the work of professional groups and thus have the opportunity to discuss personal problems connected with recommendations on the work, ◦ nurturing hobbies which bring joy and satisfaction (2). The American Association of Internist's proposed five basic measures which should be applied by every physician to prevent the development of burnout syndrome: 1. Care of yourself; first consider your own safety programme. Include fun or some other distraction in your work. When you are under stress, it is important to be with your family more than usual, and find time for your hobbies. 2. Define the boundaries/limits of your work, consider your practice and see where it is necessary to draw the line. Saying “no” to the patient and thus risk him leaving you and going to another doctor is healthier than constantly appeasing and satisfying unreasonable patient demands. 3. Determine methods for coping with stress. Select the person who you can confide in. If you don’t want to discuss your problems with your colleagues, contact old classmates, former professors or mentors. 4. Analyse yourself, figure out what your values and desires are, what your skills are and what you like doing and what you do not like or hate doing. Burning often results from the imbalance between desires, assessments and interest on the one hand and job requirements on the other. 5. Overcome the complex that others are always better than you and that this happens only to you. The physician’s job is very demanding and subject to constant changes. However, this happens in other professions as well. In order to be protected from the development of burnout syndrome the physician must develop skills which will help him/her to cope with constant change and to create the necessary defence mechanisms (6). 202
Take home messages World Book of Family Medicine – European Edition 2015 Burnout syndrome is characterized by mental or emotional exhaustion, fatigue and depression, with a greater emphasis on psychological rather than physical symptoms Job satisfaction is an important element; it should be seen as an action point for further research and intervention Not only individual but also organizational interventions should be developed to overcome the problem Original abstract http://www.woncaeurope.org/content/or1337-burn-out-and-job-satisfaction-among-turkish-family-physicians References 1. Lee FJ, Stewart M, Brown JB. Stress, burnout, and strategies for reducing them. What’s the situation among Canadian family physicians? Can Fam Physician 2008;54:234-5.e1-5 2. Stanetıć K, Tešanovıć G. Influence of age and length of service on the level of stress and burnout syndrome. Med Pregl 2013; 66(3-4): 153-162. 3. Soler JK, Yaman H, Esteva M, Dobbs F, Assenova RS, Katic M, et al. Burnout in European family doctors: the EGPRN study, Fam Pract 2008;25:245-65. 4. Maslach C, Goldberg J. Prevention of burnout: new perspectives. Appl Prev Psychol. 1998; 7: 63–74. 5. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001; 52: 397–422. 6. Zellars KL, Perrewé PL. Affective personality and the content of emotional social support: coping in organizations. J Appl Psychol 2001;86:459-67 203
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Family Medicine

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