In light of these six factors, an approach to ameliorating burnout that focuses on individuals, rather than systems, is fairly ineffectual, Maslach said. “I am not opposed to helping people become more resilient,” she explained, but because “burnout is often mistakenly labeled as a problem of individuals,” the classic one-on-one approach leaves “the underlying system and cultural problems unaddressed.”
As a case in point, Maslach cited a workplace she had studied in which burnout rose and morale plummeted partially as a result of a much-touted annual award that had become unpopular.
“People so hated the award that they didn’t want others to know that they had been nominated,” Maslach said.
After reviewing the results of the workplace’s scores on the six risk factors for burnout, administrators learned there was a widespread belief that the award was not administered fairly, she explained. Some employees thought that deserving recipients had not been nominated simply because their supervisors had neglected to fill out the required paperwork. Others sensed that bosses were taking credit for achievements earned by their staffs. Still others alleged that the award, which came with a substantial monetary gift, was a poor substitute for a salary increase.
A year after this situation had come to light and administrators had worked to correct perceived inequities associated with the award—making the selection process more collaborative in nature—the institution again measured the six risk factors. This time, scores improved markedly in the area of fairness. But they also improved in the five other areas, particularly in community and rewards.
“If you start working in one area of improvement, you get positive results across the board,” Maslach said. But taking an incremental approach is only part of the treatment to addressing burnout systemically, she said. You also need to demonstrate a long-term commitment to the process. This generally translates into a six-month period, at a minimum, to allow for workplace buy-in by most physicians and staff. A further caveat: The time to initiate it, she added, “is when things are going pretty well, not disastrously.”
Whatever the causes of burnout, Maslach said, it does not take a study to understand that physicians will fare better when there is a greater sense of collaboration and congeniality among colleagues. “Work engagement is the opposite of burnout,” she said, so whatever individuals, groups and institutions can do to build positive professional relationships, physicians and the people they care for will ultimately benefit.