INTERNATIONAL PERSPECTIVES ON WELL-BEING AND BURNOUT WITHIN HEALTH SYSTEMS

• Published in: International journal of person centered medicine Vol. 9; no. 1; pp. 11 - 25
• Main Author: Appleyard, James
• Format: Journal Article
• Language: English
• Published: Birmingham The University of Buckingham Press 01.04.2021
• Subjects: Burnout; Cybernetics; Patient-centered care; Pediatrics; Self compassion; Work environment
• ISSN: 2043-7730; 2043-7749
• DOI: 10.5750/ijpcm.v9i1.960

Objectives: To reflect on the present international culture of professional burnout in health care systems and the need for a radical new approach with an increased understanding of a person- and people-centered attitudes in the promotion of training in wellbeing and the prevention and management of burnout among physicians and health care professionals Methods: A literature search worldwide was undertaken for significant research papers on professional education related to burnout with particular reference to both medical staff resilience and health care system factors. Findings: Burnout among doctors is a global phenomenon. The incidence of burnout reported in a selection of studies among pediatric residents and staff are 25% in Argentina, 37% in the United Kingdom, and 70% in Saudi Arabia. In a national survey in the United States where the overall rate was 59% burned out residents reported significantly increased stress, poorer mental health, and decreased empathy, mindfulness, resilience, self-compassion, and confidence in providing compassionate care Three levels of change that should be the focus of training in prevention, health promotion, and stress reduction awareness have been recommended to reduce the risk of burnout: (1) modifying the organizational structure and work processes; (2) improving the fit between the organization and the individual doctor through professional development programs so that better adaption to the work environment occurs; and (3) individual-level actions to reduce stress and poor health symptoms through effective coping and promoting healthy behavior. Discussion: The history of burnout shows important links with increased work complexity. Narrow training interventions such as debriefing after an adverse clinical event have not been found effective. A more comprehensive personcentered approach with a variety of measurable interventions has resulted in a reduction of 50% in the pediatric faculty in one study. A person- and people-centered cybernetic approach is needed with six standards are to establish and sustain a healthy work environment (1) authentic leadership (2) meaningful recognition, (3) skilled communication, (4) true collaboration, (5) effective decision making, and (6) appropriate staffing. Conclusion: With such high levels of burnout, health systems worldwide can be viewed as failing their populations on a grand scale. Only an organizational paradigm change to a person- and people cybernetic centered system that incorporates complexity is adaptive and integrative will a health system be effective in preventing and ameliorating the effects of burnout and reduce the increasingly unaffordable misuse of human resources.