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Burnout High Among Podiatrists

Discussion in 'General Issues and Discussion Forum' started by admin, Nov 23, 2004.

  1. admin

    admin Administrator Staff Member

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    Burnout High Among Podiatrists, but Not Inevitable

    from Podiatry Online:
    Full story
  2. Dieter Fellner

    Dieter Fellner Well-Known Member

    ...and the solution is?

    erm .... what am I missing here? :confused:

    The reasons for burn out are:

    lack of status and recognition;
    a perception of over-demanding patients;
    keeping up to date with changes in clinical practice;
    time pressures; and
    providing a service perceived as value for money.

    the solution appears to be:

    1. sort out your life and / or
    2. excercise
    3. get out of podiatry

    use 'em and loose 'em - fab! :eek:
  3. Craig Payne

    Craig Payne Moderator

    A couple of years ago when I was in USA I recall a front page headline in USA Today about the very high suicide rate in Dentists --- it was put down to the isolation that many feel in solo or small practices. I guess there is no reason to assume that Podiatry may be any different :confused:
  4. Felicity Prentice

    Felicity Prentice Active Member

    Pleased to see you

    Re Dentists and Suicide

    It has always struck me that very rarely do you say to your Dentist at the end of a procedure "That was great, we must do it again sometime." (Well, perhaps because your talking muscles are paralysed from the LA, and all you can do is dribble and mumble...but you get the gist). I have found, however, that patients are generally consistently pleased with Podiatry procedures, and usually say upon donning their footwear - "Oh, that feels much better, thankyou..." So Dentists top themselves because no-one really wants to see them, and no-one gives them cheerful positive feedback about what they have done for them. Podiatrists, however, spread joy and hapiness where e'er we go! Ergo, we are much better insurance risks.

    Now, about burnout....Yep, the isolation is a killer. Having twenty identical conversations a day is mind numbing, and we are SO at the bottom of the medical food chain we begin to see ourselves as single celled organisms. So what we need is better mentoring, more colleagial support, lots of seminars and mini-conferences where the papers are practice-oriented, and that bottle of whisky in Matthew Oates's bottom drawer. And most of all a sense of humour, because if we start taking ourselves too seriously it will all become too tragic!


  5. davidh

    davidh Podiatry Arena Veteran

    I suppose podiatrists may be able to communicate with their patients a little more easily than dentists :confused: ?
    David :D
  6. Dieter Fellner

    Dieter Fellner Well-Known Member


    ahhhh - whiskey - THAT's the answer, sure 'nuff ! :D Single Malts are especially therapeutic :rolleyes:
  7. Felicity Prentice

    Felicity Prentice Active Member

    Beating the Blues

    There is no doubt about the therapeutic value of a good single malt (but not too peaty please). But, on a drearily serious note, I have had a thought (yes, just the one, but it is all new to me).

    I am just collating the feedback forms from Pod students who have undertaken placement in private practices ad hospitals. You should read the words they use - "fantastic, invaluable, excellent, inspiring...", and the level of appreciation of their supervisors is equally stunning - "enthusiastic, encouraging, caring, welcoming, knowledgable, professional, extraordinary.." and so on. This is were we can find the enthusiasm we need to keep going - in the Podiatrists of the future.

    So - find out if your local Uni/College needs placement opportunities for their students. You will have the chance to be with someone who values you and your knowledge, and there is nothing like teaching to help you learn. No doubt I am preaching to the converted on this forum, but perhaps if we all suggested it to a colleague, then the word would spread. Perhaps at the next conference someone might be willing to give a brief paper on the benefits of hosting a student on placement - it would be of benefit to all.

    Now, for that whisky. (Damn, I forgot, I don't drink anymore - I drank all my share at once in younger days).


  8. NewsBot

    NewsBot The Admin that posts the news.

    Prevalence and Associated Risk Factors of Burnout Among US Doctors of Chiropractic
    Shawn P. Williams, Genevieve P. Zipp
    Journal of Manipulative and Physiological Therapeutics; Article in Press
  9. Pauline burrell-saward

    Pauline burrell-saward Active Member

    I have been doing this job for 22yrs and still love it.

    I work for myself ,when I want, I take hols as I want, do the hours I want, and yes I make a decent living!

    Yes I sometimes think I will scream when another corn needs doing and the pts. say for the 10th time that day how lovely it is outside, but every job has its down side.

    As a nurse, I used to feel like yelling when yet another Pt. described their bowel movement ,the funny thing is as a nurse most of the pt.'s talked about themselves and their illnesses to the exclusion of all else( well they were sick!!)

    my Chiropody Pts. ( once they get to know you) will talk about all manner of interesting things
  10. admin

    admin Administrator Staff Member

    Occupational burnout

    According to the World Health Organization (WHO), occupational burnout is a syndrome resulting from chronic work-related stress, with symptoms characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."[1] While burnout influences health and may be a reason for people contacting health services, it is not itself classified by the WHO as a medical condition.[1]

    In 1974, Herbert Freudenberger became the first researcher to publish in a psychology-related journal a paper that used the term "burnout." The paper was based on his observations of the volunteer staff (including himself) at a free clinic for drug addicts.[2] He characterized burnout by a set of symptoms that includes exhaustion resulting from work's excessive demands as well as physical symptoms such as headaches and sleeplessness, "quickness to anger," and closed thinking. He observed that the burned-out worker "looks, acts, and seems depressed." After the publication of Freudenberger's original paper, interest in occupational burnout grew. Because the phrase "burnt-out" was part of the title of a 1961 Graham Greene novel A Burnt-Out Case, which dealt with a doctor working in the Belgian Congo with patients who had leprosy, the phrase may have been in use outside the psychology literature before Freudenberger employed it.[3]

    Christina Maslach described burnout in terms of emotional exhaustion, depersonalization (treating clients/students and colleagues in a cynical way), and reduced feelings of work-related personal accomplishment.[4][5] In 1981, Maslach and Susan Jackson published the first widely used instrument for assessing burnout, the Maslach Burnout Inventory.[6] Originally focused on the human service professions (e.g., teachers, social workers),[6] its application broadened to many other occupations.[4]

    In 2010, researchers from Mayo Clinic used portions of the Maslach Burnout Inventory, along with other comprehensive assessments, to develop the Well-Being Index, a brief nine-item self-assessment tool designed to measure burnout and other dimensions of distress in health care workers specifically.[7]

    The WHO adopted a conceptualization of burnout that is consistent with Maslach's.[8] There are, however, other conceptualizations of burnout that differ from the conceptualization adopted by the WHO. Shirom and Melamed with their Shirom-Melamed Burnout Measure conceptualize burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion;[9][10] however, an examination of Shirom and Melamed's emotional exhaustion subscale indicates that the subscale looks more like a measure of Maslach's[8] concept of depersonalization.[11] Demerouti and Bakker (with their Oldenburg Burnout Inventory) conceptualize burnout in terms of exhaustion and disengagement.[12] There are other conceptualizations as well that are embodied in these instruments: the Copenhagen Burnout Inventory,[13] the Hamburg Burnout Inventory,[14] Malach-Pines's Burnout Measure,[15] and more. Kristensen et al.[13] and Malach-Pines (who also published as Pines)[16] advanced the view that burnout can also occur in non-work roles such as that of spouse.

    The core of all of these conceptualizations, including that of Freudenberger, is exhaustion. Alternatively, burnout is also now seen as involving the full array of depressive symptoms (e.g., low mood, cognitive alterations, sleep disturbance).[17][18] Marked differences in understanding of what constitutes burnout have highlighted the need for consensus definition.[19][20]

    1. ^ a b "Burn-out an "occupational phenomenon": International Classification of Diseases". WHO. 28 May 2019. Retrieved 2019-06-01.
    2. ^ Freudenberger, H.J. (1974). "Staff burnout". Journal of Social Issues. 30: 159–165. doi:10.1111/j.1540-4560.1974.tb00706.x.
    3. ^ Greene, Graham (1961). A Burnt-Out Case. William Heinemann Ltd. pp. cover title. ISBN 978-0140185393.
    4. ^ a b Maslach, C.; Jackson, S.E; Leiter, M.P. (1996). "MBI: The Maslach Burnout Inventory: Manual". Palo Alto: Consulting Psychologists Press.
    5. ^ Ruotsalainen, JH; Verbeek, JH; Mariné, A; Serra, C (7 April 2015). "Preventing occupational stress in healthcare workers". The Cochrane Database of Systematic Reviews (4): CD002892. doi:10.1002/14651858.CD002892.pub5. PMC 6718215. PMID 25847433.
    6. ^ a b Cite error: The named reference Maslach2 was invoked but never defined (see the help page).
    7. ^ Dyrbye, Liselotte N.; Szydlo, Daniel W.; Downing, Steven M.; Sloan, Jeff A.; Shanafelt, Tait D. (2010-01-27). "Development and preliminary psychometric properties of a well-being index for medical students". BMC Medical Education. 10 (1): 8. doi:10.1186/1472-6920-10-8. ISSN 1472-6920. PMC 2823603. PMID 20105312.
    8. ^ a b Maslach, C.; Schaufeli, W. B.; Leiter, M. P. (2001). S. T. Fiske; D. L. Schacter; C. Zahn-Waxler (eds.). "Job burnout". Annual Review of Psychology. 52: 397–422. doi:10.1146/annurev.psych.52.1.397. PMID 11148311.
    9. ^ Shirom, A.; Melamed, S. (2006). "A comparison of the construct validity of two burnout measures in two groups of professionals". International Journal of Stress Management. 13 (2): 176–200. doi:10.1037/1072-5245.13.2.176.,
    10. ^ Toker, S., Melamed, S., Berliner, S., Zeltser, D., & Shapira, I. (2012). Burnout and risk of coronary heart disease: A prospective study of 8838 employees. Psychosomatic Medicine, 74, 840–847. https://doi.org/10.1097/PSY.0b013e31826c3174
    11. ^ Toker, S., Melamed, S., Berliner, S., Zeltser, D., & Shapira, I. (2012). Burnout and risk of coronary heart disease: A prospective study of 8838 employees. Psychosomatic Medicine, 74, 840–847
    12. ^ Demerouti, E., Bakker, A.B., Vardakou, I., & Kantas, A. (2003). The convergent validity of two burnout instruments: A multitrait-multimethod analysis. European Journal of Psychological Assessment, 19, 12-23
    13. ^ a b Kristensen, T.S.; Borritz, M.; Villadsen, E.; Christensen, K.B. (2005). "The Copenhagen Burnout Inventory: A new tool for the assessment of burnout". Work & Stress. 19 (3): 192–207. doi:10.1080/02678370500297720
    14. ^ Wurm, W., Vogel, K., Holl, A., Ebner, C., Bayer, D., Mörkl, S., … Hofmann, P. (2016). Depression-Burnout Overlap in Physicians. Plos One, 11, e0149913.
    15. ^ Malach-Pines, A. (2005). The Burnout Measure, Short Version. International Journal of Stress Management, 12(1), 78–88.
    16. ^ Pines, A. M. (1987). Marriage burnout. Psychotherapy in Private Practice, 5, 31–44.
    17. ^ Bianchi, R.; Schonfeld, I.S.; Laurent, E. (2015). "Burnout-depression overlap: A review". Clinical Psychology Review. 36: 28–41. doi:10.1016/j.cpr.2015.01.004. PMID 25638755.
    18. ^ Bianchi, R.; Schonfeld, I. S.; Vandel, P.; Laurent, E. (2017). "On the depressive nature of the "burnout syndrome": A clarification". European Psychiatry. 41: 109–110. doi:10.1016/j.eurpsy.2016.10.008. PMID 28135592.
    19. ^ Cite error: The named reference Rotenstein2018 was invoked but never defined (see the help page).
    20. ^ Heinemann, L.V.; Heinemann, T. (2017). "Burnout Research: Emergence and Scientific Investigation of a Contested Diagnosis". Sage Open. doi:10.1177/2158244017697154.
  11. admin

    admin Administrator Staff Member

  12. Boots n all

    Boots n all Well-Known Member

    l think Felicity hit the nail on the head, regular contact with your peers, be that conferences or even once a month or 2nd month meeting up with a few peers in your area or past uni mates for Coffey.

    Keep it fresh and remember the difference you do make to so many lives.
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    NewsBot The Admin that posts the news.

  14. wdd

    wdd Well-Known Member

    Research about burnout and occupational stress relating to podiatry is lacking, although a study published earlier this year does shed some light on these important issues. The study compared levels of burnout between new podiatrists in the United Kingdom and Australia. Geographical differences may limit the study's applications, but podiatrists everywhere can relate to the overall findings.

    Looking back to the opening post in this thread I was interested to see that the comparison was between 'new' podiatrists. Does that mean that the subjectsts were on the verge of burnout as students and that qualification pushed them over the edge?

    I couldn't connect to the original research which would I am sure clarify this point.

  15. davidh

    davidh Podiatry Arena Veteran

    I don't know of too many pods of my generation who suffered from burn-out.

    There may be one or two. I know of one guy who was very stressed out by his BSc top-up degree:confused:
    I know of another who was stressed by having to give a Talk to the local Womens Institute:empathy:.

    But proper burn-out - no.
  16. NewsBot

    NewsBot The Admin that posts the news.


    Trista Agius, Cynthia Formosa
    Malta Journal of Health Sciences; 2014
  17. NewsBot

    NewsBot The Admin that posts the news.

  18. NewsBot

    NewsBot The Admin that posts the news.

    Press Release:
    Physicians and Burnout: It’s Getting Worse
    Embargo expired: 1-Dec-2015 5:00 AM EST
  19. NewsBot

    NewsBot The Admin that posts the news.

  20. NewsBot

    NewsBot The Admin that posts the news.

  21. LeonW

    LeonW Active Member

    I think too much paperwork is main culprit.
  22. NewsBot

    NewsBot The Admin that posts the news.


    Chiropractors? perception of occupational stress and its influencing factors: a qualitative study using responses to open-ended questions
    Shawn Williams
    Chiropractic & Manual Therapies 201624:2
  23. NewsBot

    NewsBot The Admin that posts the news.

    Press Release;
    Professional Burnout Associated With Physicians Limiting Practice
    April 1, 2016
  24. NewsBot

    NewsBot The Admin that posts the news.

    Strategy for preventing practice burnout: Suicide among physicians and surgeons
    Gerald T. Kuwada
    The Foot and Ankle Online Journal 9 (1): 10
  25. NewsBot

    NewsBot The Admin that posts the news.

  26. NewsBot

    NewsBot The Admin that posts the news.

    Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention
    Daniels, Alan H. MD; DePasse, J. Mason MD; Kamal, Robin N. MD
    Journal of the American Academy of Orthopaedic Surgeons: April 2016 - Volume 24 - Issue 4 - p 213–219
  27. NewsBot

    NewsBot The Admin that posts the news.

  28. NewsBot

    NewsBot The Admin that posts the news.

    Public Release: 27-Jun-2016
    Electronic medical practice environment can lead to physician burnout
  29. NewsBot

    NewsBot The Admin that posts the news.

    Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout
    Olivier D. R. van Wulfften Palthe, Valentin Neuhaus, Stein J. Janssen, Thierry G. Guitton, David Ring , on behalf of the Science of Variation Group
    Clinical Orthopaedics and Related Research August 2016, Volume 474, Issue 8, pp 1857-1863
  30. NewsBot

    NewsBot The Admin that posts the news.

    From Medical Economics:
    What is the price of physician stress and burnout?
  31. NewsBot

    NewsBot The Admin that posts the news.

    Mindfulness, stress management reduce physician burnout

  32. Stephen Warner

    Stephen Warner Welcome New Poster

    Whilst I claim no scientific basis to this observation, I can regrettably, comment from the point of personal experience. The point at which I reached meltdown was probably 2-3 years in the making. A period of increasing pressure due to growing patient numbers; generally not leaving clinics before 7:30 and usually 8:30 on a Friday, trying to keep up with professional development in 3-4 specialist areas, emails, 2nd opinions, training and mentoring, 2-2.5 hours a day commuting (I live 14 miles from work), mandatory training and having the temerity to want to have a life outside of the NHS all took their toll. On my return I was asked to fill out a workplace stress questionnaire, a 4 page electronic document. Completed, mine ran to just over 14 pages. I think it's now buried somewhere between occ health and Human Resources (personnel always sounded much friendlier) and remains ignored.

    4 years on and what has changed? Several more colleagues have resigned due to stress and the effect it was having on their health and families. The caseload has inexorably increased and we are facing more and more the issues of dealing with what is effectively end of life care. Patients developing a diabetic foot ulcer have a 48% , 5 year mortality rate. According to a counsellor I know, because we see our patients so frequently, often more than we see family or friends we undergo a mini bereavement with each death but rather than having time to acknowledge it, we press on with the next case. We no longer have adequate time for a proper lunch break. Pressure on communications is increasing, after a recent two week break I returned to 537 emails waits for me. IT infrastructure is lamentable, both software and hardware and results in regular late finishing in order to avoid compromising patient care in the short term. In the longer term we are all exhausted, cynical and frustrated. Recruitment is slow and we all continue to try to put people back together and shore each other up. I only have time to write this because I'm feeling like crap today and can't go in to work. Generally, my interactions with the forum have been limited by factors such as trying to stay awake long enough to eat, shower and go back to work.

    Excuse the rant but I am seeing signs of stress and burnout occurring in younger colleagues with far more years ahead in the job than I now have. We need to address this issue before it is too late. Keep an eye on yourselves and your colleagues, although that's just another job to add to the list.

    Meanwhile, I still like to pretend that there is life outside. There is an outside isn't there?
  33. Craig Payne

    Craig Payne Moderator

    @stephen - watch this: it is private practice orientated, but issues the same:
  34. davidh

    davidh Podiatry Arena Veteran

    I worked for most of my professional life in private practice. I did a couple of stint in full-time clinical NHS posts.

    I can offer the following advice:
    Get out if you find it too stressful. There is a life outside of the NHS, outside of podiatry too.

    If you want to stay in and make life easier talk to your Line Manager. If he/she can't/won't help talk to their Line Manager.

    Be sure you know the treatment and management protocols in your Trust. If you work with diabetes bone up on NICE recommendations NG19, and any other relevant recommendations. Work within them, and refuse to work outside of them.

    If you get it right Podiatry is a very enjoyable job, no matter where you work.
  35. Griff

    Griff Moderator

  36. Dieter Fellner

    Dieter Fellner Well-Known Member

    I recently completed a three year hospital residency in medicine & surgery, after completing the 4 years of podiatry school required here. Working in the Bronx, 24/7. Residency here is insanity. 80-100+ hour working week, on-call at weekends. 24-48 hour on-call, servicing in-house patients, taking floor consults and ED consults, any hour of the day, rounding on patients at 6am, processing the emergency OR admission and operating for gas gangrene or sepsis or trauma (usually at 3 am), evaluating the trauma cases, attending the scheduled outpatient surgery sessions, outpatient clinics, managing to the needs and idiosyncrasy of numerous Attendings (doctors) , working in the mandatory off-service rotations (general medicine, general surgery, vascular surgery, pediatric orthopedics, adult orthopedics, radiology foot & ankle orthopedics, ER, psychiatry etc) that require a resident to work as equals alongside the medicine & surgery residents (managing their patients, not foot & ankle patients). Many a day I would leave the hospital blurry eyed, staggering in a curvy line (literally) to the car park and somehow safely navigating through Bronx traffic back to the apartment.
    I did all of that in my 50s. After the days/nights work you still have to find time to study for in-house exams and board qualifying exams. Even the kids burn out, and somehow we get through all that ... now pass me that malt. Thank you.
  37. davidh

    davidh Podiatry Arena Veteran

    I re-read this after reading Dieter's post.
    You don't leave work until 8.30pm on a Friday?

    I'm calling you out.
    No-one has to stay that late in a drone NHS post.
  38. Stephen Warner

    Stephen Warner Welcome New Poster

    To refer you back to my original point, the point at which the wheels fell off was 2-3 years in the making. It is perfectly possible that the late finishes were as much part of the symptoms as they were part of the problem.

    As you weren't there it is frankly asinine and arrogant to assume you know best.

    My line manager at the time tried to cover the clinics and admitted that it was impossible. Nobody, was aware of any problem until it all went horribly wrong. By burnout I mean that what I experienced was doing a clinic on a Thursday morning, leaving to go to the library in the afternoon; to this day I have no idea if I actually went there and waking up on Friday feeling physically sick at the thought of going to work. For the next six weeks I barely moved from the sofa and even simple decisions like what to eat were too much. I finally got back to work four and a half months later. That was in 2012 and to be honest most of that year has been obliterated from memory. I still have doubts and I still have days that are a struggle. I work in three specialist clinical areas as well as supporting less experienced colleagues. Before this I was involved in Podiatry education. I have been in the job for 34 years and I still enjoy the clinical work but latterly I have been looking at a change of direction.

    Yes, there was no compunction to stay as late as I was - now I just say No! Unfortunately, at the time local problems were causing issues I couldn't control but those are now history.

    Unfortunately, we all have our issues to deal with and generally we manage. Just be aware that stress and burnout can affect anyone and in most cases nobody including the person affected will know about it until it happens and I wouldn't recommend it to anybody as a life experience.

    I merely offered my account as one of personal background to an increasing problem for many people. I shall not comment further.
  39. W J Liggins

    W J Liggins Well-Known Member

    In fairness, and not being accusatory at all, didn't you contact your professional body for help? That's what they are there for.

    Thanks Deiter, for your update. It's obviously even worse than the early days of the PA (18 hours a day). I have the greatest of respect - stick with it!

    Bill Liggins
  40. Hi Stephen - a harrowing account of life in the NHS today. My sister is a nurse practitioner in GU Medicine where there is a dearth of medical consultants to run departments. Most days she doesn't finish until after 8.30pm and her clinics are routinely overbooked - trying to raise the issue with her line manager or her professional body proved a complete waste of time as the scale of the problem appears universal across the organisation. Given recent experience with our own professional bodies, I sincerely doubt you will obtain any satisfactory assistance other than a few words of condolence.

    Best of luck.


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