GP burnout, patient safety, and the importance of connecting with colleagues.

Problem

Levels of burnout in general practitioners (GPs) are consistently higher than the mean across physicians specialties. A recent UK survey found that 73% of GPs reported severe exhaustion and 49% severe disengagement. Burnout is linked with a range of negative personal and organisational outcomes, including suicidality and reduced patient safety. Potential interventions for burnout have often not been investigated within primary care settings. Furthermore, existing research has primarily focused on reducing burnout, without also investigating whether patient safety has improved. One potential low cost and pragmatic intervention could be the introduction of scheduled, shared breaks: these could reduce isolation through providing opportunities for positive social interactions with colleagues, whilst also allowing time for physical needs to be met. However, there is a lack of evidence exploring this.This study aimed to examine whether: 1) on days when physicians took a break at work, their levels of burnout improved, along with their ability to provide safe care; 2) effects of taking a break only impacted on burnout/safety that same day, or whether effects carried over onto the following day; 3) taking a break per-se was associated with lower burnout/improved safety, or whether positive interactions with colleagues were the central aspect of the break.

Approach

A within-subjects, interval contingent, daily-diary design was used. Fifty-eight GPs in the UK completed short online questionnaires before and after work, for seven consecutive days. Burnout, patient safety incidents, safety perceptions, and work breaks, were measured. Hierarchical linear modelling was conducted.

Findings

Taking at least one break during the working day was associated with lower disengagement that day, and lower exhaustion the following day. Having a positive interaction during the break was important: GPs who had at least one break with at least one positive interaction reported significantly lower overall burnout, disengagement, and exhaustion that day, and higher perceived patient safety that day, as well as lower exhaustion and improved perceptions of patient safety the following day.

Consequences

Having a break during the work day where GPs can interact with colleagues may be one path to alleviate and prevent burnout, and improve patient safety. Whilst it may not be the ultimate solution to the current GP shortages, it is practical, feasible, and could be implemented with relative ease compared to alternative solutions (e.g. recruiting more staff to reduce workload burdens and other job-stress causes). These findings have relevance for healthcare managers; the finding that the opportunity for positive social interactions was of key importance, suggests that breaks need organising at the organisation level, so physicians can take these together. GPs who are able to carve out time to take breaks, as a personal intervention, are unlikely to gain the full benefit of these, if they are not coordinated with their colleagues' breaks.