Five minutes with . . . Suzy Jordache
Authors: Tom Moberly
Publication date: 17 May 2017
If burnout isn’t tackled, the NHS will fail, says the leader of MPS’s clinical communication programme for doctors at increased medicolegal risk
“Burnout is a triad. I think we understand emotional exhaustion, and perhaps the depressive feeling of low personal accomplishment, but it’s depersonalisation that has really stretched us. This is when doctors are struggling just to survive and they have to keep the patients at arm’s length. Patients hate this—they feel it, they don’t like it, and it means that the medicolegal risk to the doctor goes up, because there is no connection and less trust. Making it safe again for the doctor to reconnect with patients is really what we’re talking about.
“What I see in doctors suffering from burnout is lack of eye contact, lack of smiling, closed body language, lack of listening, telling patients what to do rather than entering into shared decisions. All those behaviours are the opposite of good medical practice in the 21st century, but they are all designed to just keep the doctor surviving.
“Because burnout is so normalised in medicine it is not stigmatised. A lot of people will talk about it if they are given a chance and look for answers and help. Others won’t, and they are a much more difficult group to work with. Where the insight is not there—the doctor is in survival mode but doesn’t recognise it—it takes some quite skilled work to try to get that insight generated.
“If you recognise that you are not looking forward to work, you’re not enjoying it, you can’t bear the thought of seeing another patient—those for me are big warning signs of burnout. You just need to take a step back and find the little things that might make a difference. It is about making sure that you are hydrated, you eat before you go to work, and you take breaks. I can’t believe that I am saying this in the 21st century, but I meet doctors all the time who don’t do these things, and they are burning out faster and faster. If you are in burnout then you need time to recover. I meet doctors who just don’t take time to recover and then they get angry and blame others. We need to very gently turn that and make them see that it’s their professional responsibility to manage their own energy.
“We’re at a point now in healthcare where it is as normal to be burnt out as not. Unless, organisationally, we really grab this and change the way that we do business, every patient is more likely to experience a doctor who cannot care or connect, and I don’t want to be that patient. It doesn’t have to be a complete redesign or to cost any money: it’s an attitude. It’s respect for doctors that is missing in the system, respect for nurses, and a respect for anybody working in the system.
“We have to tackle this otherwise the whole thing is going fail.”
Tom Moberly BMJ Careers