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 Table of Contents  
LETTER TO THE EDITOR
Year : 2020  |  Volume : 25  |  Issue : 1  |  Page : 53-54

Envisaging the burnout conundrum in health-Care settings under the lens of organizational behavior and professional self-concept


Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Date of Submission08-Oct-2019
Date of Acceptance04-Feb-2020
Date of Web Publication14-Apr-2020

Correspondence Address:
Dr. V Dinesh Kumar
Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmgims.jmgims_66_19

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How to cite this article:
Kumar V D, Rajasekhar S S. Envisaging the burnout conundrum in health-Care settings under the lens of organizational behavior and professional self-concept. J Mahatma Gandhi Inst Med Sci 2020;25:53-4

How to cite this URL:
Kumar V D, Rajasekhar S S. Envisaging the burnout conundrum in health-Care settings under the lens of organizational behavior and professional self-concept. J Mahatma Gandhi Inst Med Sci [serial online] 2020 [cited 2020 May 25];25:53-4. Available from: http://www.jmgims.co.in/text.asp?2020/25/1/53/282365



Sir,

Burnout is one of the emerging topics of concern in contemporary medical education forums, and it needs to be considered in multiple dimensions. Ratnakaran et al.[1] documented that more than one-third of their study participants (n = 558) had burnout in one or other forms. The quantum of burnout was highest among interns, especially in personal and patient-related domains compared to junior residents who had significant burn out due to work. A recent synthesis of literature[2] has suggested that subliminal levels of burnout might manifest as depression, substance abuse and mental health compromise after crossing a threshold level.[3] The factors influencing burnout could be classified into work specific, including exuberant work hours, lack of recognition, and impaired social support culminating in diminished work satisfaction, and person specific such as personality traits, inability to cope with stress, and home responsibilities.[4] On reading the literature related to burnout, we felt that there could be some missing pieces of the bigger picture, namely the nature of the organization and the role of professional self-concept. This letter intends to address the issue of burnout in the light of the abovementioned factors, as they are not addressed elsewhere.

An individual, who is new to an organization, consciously observes whether the organizational demands are congruent with their abilities (demands–abilities fit). When there is a congruent fit of demands and abilities, the chances of burnout are less because of the increased levels of intrinsic motivation. Unfortunately, a significant proportion of young medical professionals suffering from the burnout have a sense of despair that they are not suitable to meet the demands of the organization. This despair would generate a sense of “giving up” after initially trying to narrow the gap between the actions and expectation of the organization resulting in early burnout. For example, a young medical resident, who feels that the job demands of the department in which he opts for residency are beyond his abilities, falls short in intrinsic motivation. However, in such cases, factors such as avoidance of harsh criticism and getting accolades for the work done and other ego boosters act as extrinsic motivators which attach the individual to the organization. From our experience, we noted that the young medical professionals who are vulnerable for burnout cope up differentially depending on their ability to “internalize” the complex of dynamics of external factors and regulate their actions according to the degree of motivation.[5] As the young medical professionals get more and more internalized into the organization and acclimatized to the work culture, they become decreasingly reliant on extrinsic motivators and increasingly reliant on intrinsic motivators such as shame, regret, and contentment. Finally, he develops the desire for a “professional identity” necessary for shining in the organization, and he analyzes the value of various activities based on his presumptions and the results of his past deeds. Developing a sense of relatedness with the peers and near-peer groups also helps in achieving a state of adequate internalization and those young medical professionals who cannot relate themselves adequately end up feeling disconnected from the professional environment. We perceived that in organizations with limited and lower expectations of professional performance, even a reduced autonomy to the young medical professional did not result in burnout because of the development of a strong sense of relatedness. In their recent groundwork, Duke et al.[6] tried to figure out the relationships between departmental context and three major subscales of Maslach Burnout Inventory. They proposed that an ideal organizational leadership should ascertain three major criteria to mitigate the degree of burnout among their faculty: (a) empowerment to communicate individual professional needs, (b) sense of being valued for contributions to the department, and (c) department should be committed enough to support faculty well-being.

In conclusion, we submit that developing a “professional self-concept,” a self-reflective perception by which the young medical professionals identify themselves as members of the working organization, helps in combating burnout. The professional self-concept is a cumulative product of self-beliefs, intrinsic values, and attitude that is continuously shaped by experience and interaction with peers. Self-isolation, in any form, makes one vulnerable for the intrinsic and extrinsic trepidations and ultimately leads to burnout pressure. It is imperative for the health-care organizations to elucidate the institutional/departmental factors leading to burnout because this might manifest as loss of effective workforce and increased rate of faculty attrition. Programs involving mindfulness and socialization exercises should be grounded on the objectives of achieving the desired level of professional self-concept and reducing the levels of burnout.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ratnakaran B, Prabhakaran A, Karunakaran V. Prevalence of burnout and its correlates among residents in a tertiary medical center in Kerala, India: A cross-sectional study. J Postgrad Med 2016;62:157-61.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Hariharan TS, Griffin B. A review of the factors related to burnout at the early-career stage of medicine. Med Teach 2019;41:1380-91.  Back to cited text no. 2
    
3.
Prins JT, Gazendam-Donofrio SM, Tubben BJ, van der Heijden FM, van de Wiel HB, Hoekstra-Weebers JE. Burnout in medical residents: A review. Med Educ 2007;41:788-800.  Back to cited text no. 3
    
4.
Ishak WW, Lederer S, Mandili C, Nikravesh R, Seligman L, Vasa M, et al. Burnout during residency training: A literature review. J Grad Med Educ 2009;1:236-42.  Back to cited text no. 4
    
5.
Tjin A Tsoi SLNM, de Boer A, Croiset G, Koster AS, van der Burgt S, Kusurkar RA. How basic psychological needs and motivation affect vitality and lifelong learning adaptability of pharmacists: A structural equation model. Adv Health Sci Educ Theory Pract 2018;23:549-66.  Back to cited text no. 5
    
6.
Duke NN, Gross A, Moran A, Hodsdon J, Demirel N, Osterholm E, et al. Institutional factors associated with burnout among assistant professors. Teach Learn Med 2020;32:61-70.  Back to cited text no. 6
    




 

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