- Education for Primary Care
Preventing burnout among general practitioners: is there a possible route?
WHAT IS ALREADY KNOWN IN THIS AREA
- A substantial proportion of GPs show signs of burnout; there is some evidence of beneficial interventions.
WHAT THIS WORK ADDS
- This study presents the first empirical findings on how prevention of burnout can be specifically incorporated in supervision groups.
Suggestions for future research
- Longitudinal prospective studies about how supervision groups may contribute to the prevention of burnout should be conducted.
Thanks to the participating GPs and their supervisor for the confidence they have shown me to give me admittance to this part of their professional lives. The project was supported by the Committee of Multipractice Studies in General Practice, the research fund of Danish Regions and PLU.
There was no need for approval of the ethical committee. (According to Danish law ethics approval is not needed for this sort of research.)
Conflicts of interest
Charlotte Tulinius has been supervisor for Helena Nielsen on this part of the research project. The project is part of a larger PhD study. There were no personal relationships between any of the authors to either the group of GPs or to the supervisor.
- Firth-Cozens J (2001) Interventions to improve physicians’ well-being and patient care. Social Science and Medicine 52: 215–22.
- Bruce SM, Conaglen HM and Conaglen JV (2005) Burnout in physicians: a case for peer support. Internal Medicine Journal 35: 272–8.
- Isaksson Rø K, Gude T, Tyssen R and Aasland OG (2008) Counselling for burnout in Norwegian doctors: one year cohort study. BMJ 337: a2004.
- Goehring C, Bouvier-Gallacchib M, Künzic B and Bovierd P (2005) Psychosocial and professional characteristics of burnout in Swiss primary care practitioners. Swiss Medicine Weekly 135: 101–8.
- Soler JK, Yaman H, Esteva M and Dobbs F (2008) Burnout in European family doctors: the EGPRN study. Family Practice 25 (4): 245–65.
- Delbrouck M (2003) Le Burn-out du Soignant. De Boeck & Larcier: Brussels.
- Benson J and Magraith K (2005) Compassion fatigue and burnout. The role of Balint groups. Australian Family Physician 34(6): 497–8.
- Brøndt A, Sokolowski I, Olesen F and Vedsted P (2008) Continuing medical education and burnout among Danish GPs. British Journal of General Practice 58 (546): 15–19.
- Burton J and Launer J (2003) Supervision and Support in Primary Care. Radcliffe Publishing: Oxford.
- Lambie GW (2006) Burnout prevention: a humanistic perspective and structured group supervision activity. Journal of Humanistic Counseling, Education and Development 45: 32–44.
- Rasmussen PB and Bentzen K (1997) Supervision of Talking Treatment in General Practice – the perspectives of doctors and supervisors. Danish Medical Association: Copenhagen.
- Nielsen HG (2007) Supervision for GPs in Denmark. Maanedsskr Prakt Laegegern 11: 1215–24.
- Nielsen HG (2008) Supervision in the county of Copenhagen. Maanedsskr Prakt Laegegern 86: 673–82.
- DSAM and DPS (2004) Bedre patientforløb for patienter med psykisk lidelse af ikke-psykotisk karakter [Better Treatment Courses for Mentally Disordered Non-psychotic Patients]. Danish College of General Practitioners and Danish Psychiatric Society: Copenhagen.
- Krøll V and Folmer E (2002) Supervision for General Practitioners – impact and outcome. Progress report. The County of Ringkjoebing. Available by contacting Central Denmark Region email@example.com
- Bernard JM and Goodyear RK (2003) Fundamentals of Clinical Supervision (3e). Allyn & Bacon Merrill: Boston.
- Figley RC (2002) Compassion fatigue: psychotherapists’ chronic lack of self care. Psychotherapy in Practice 58 (11): 1433–41.
- Andersen T (2007) Reflekterende processer. Samtaler og samtaler om samtalerne. [The Reflecting Team: dialogues and dialogues about the dialogues (3e).] Dansk Psykologisk Forlag: Copenhagen.
- Crabtree BF and Miller WL (1999) Doing Qualitative Research (2e). Sage Publications: London.
- Giorgi A (ed) (1985) Phenomenology and Psychological Research. Duquesne University Press: Pittsburgh, PA.
- Jorgensen DJ (1989) Participant Observation: a methodology for human studies. Sage: London.
- Spradley JP (1979) The Ethnographic Interview. Wadsworth Group/Thomson Learning: Belmont, USA.
- Malterud K (2003) Kvalitative Metoder I Medisinsk Forskning – en innfoering [Qualitative Methods in Medical Research – an introduction]. Universitetsforlaget: Oslo.
- Kvale S (2004) Interviews – learning the craft of qualitative research interviewing. Hans Reitzel’s Publishers: Copenhagen.
- Figley RC (1995) Compassion Fatigue: coping with secondary traumatic stress disorders in those who treat the traumatized. Brunner-Routledge: New York.
- Kilminster S and Jolly BC (2000) Effective supervision in clinical practice settings: a literature review. Medical Education 34 (10): 827–40.
- Wheeler S and Richards K (2007) The impact of clinical supervision on counsellors and therapists, their practice and their clients: a systematic review of the literature. Lutterworth: BACP.
- Rose ML and Best DL (2005) Transforming Practice Through Clinical Education, Professional Supervision and Mentoring. Elsevier: London.
- Balint M (2000) The Doctor, His Patient and The Illness. (Millenium reprint of second edition.) Churchill Livingstone: London.
- Kjeldmand D (2006) The Doctor, the Task and the Group: Balint groups as a means of developing new understanding in the physician–patient relationship. PhD Thesis, Uppsala University.
- Salinsky J and Sackin P (2000) What Are You Feeling Doctor: identifying and avoiding defensive patterns in the consultation. Radcliffe Publishing: Oxford.
- Kutter P (2002) From Balint method to profession-related supervision. American Journal of Psychoanalysis 62 (4): 313–25.
- Johnson AH (2001) The Balint movement in America. Family Medicine 33 (3): 174–7.
- Salinsky J (2002) The Balint movement worldwide: present state and future outlook: a brief history of Balint around the world. American Journal of Psychoanalysis 62 (4): 327–35.
- Kaltoft S and Thorgaard L (eds) (2005) The Doctor as Drug – about the doctor–patient relationship. Maanedsskr Prakt Laegegern.
- Epstein RM (1999) Mindful practice. JAMA 282: 833–9.
- Scho¨ n D (1987) Educating the Reflective Practitioner. Jossey-Bass: San Francisco.
- Fowler J (1998) Evaluating the efficacy of reflective practice within the context of clinical supervision. Journal of Advanced Nursing 27: 379–82.
- Williamson GR and Dodds S (1999) The effectiveness of a group approach to clinical supervision in reducing stress: a review of the literature. Journal of Clinical Nursing 8: 338–44.
- Hyrka¨ s K (2005) Clinical supervision, burnout, and job satisfaction among mental health and psychiatric nurses in Finland. Issues in Mental Health Nursing 26: 531–56.