Burnout and areas of work-life among anaesthetists in South Africa Part 1: Burnout

Background: Burnout is a psychological syndrome that develops in response to chronic job-related stressors. Its three predominant manifestations are emotional exhaustion, cynicism, and feelings of ineffectiveness and unfulfillment (low efficacy). Our study objectives were to establish the prevalence and severity of burnout among South African anaesthetists and to compare the results with previous studies. We also identified areas of work-life that predispose to burnout and we report these results in a separate paper (Part 2).¹ Methods: We e-mailed invitations to 1 852 SASA members, requesting responses to two validated questionnaires, the Maslach Burnout Inventory and the Areas of Worklife Scale. We categorised respondents according to the “Emotional Exhaustion+1” principle, whereby a person is regarded as being clinically burned-out if he/she has a a high score for emotional exhaustion, plus either a high cynicism score or a low efficacy score. High scores for all three dimensions defined “extreme burnout”. Results: 189 public sector and 309 private sector anaesthetists responded. 85% of public sector respondents worked in academic hospitals. Compared to those in private practice, public sector anaesthetists exhibited a greater prevalence and severity of burnout. This was manifested by: (1) more adverse scores for all three burnout dimensions; (2) a greater prevalence of clinically diagnosable burnout (36.5% vs. 14.2%) as well as “extreme burnout” (17.5% vs. 6.5%). Public sector anaesthetists experienced more burnout than in other countries. Conclusions: The prevalence of burnout is unacceptably high among South African anaesthesia providers, particularly in public hospitals. This poses an immediate threat to both anaesthetists’ mental and physical health and to patient safety. The severity and prevalence in teaching institutions jeopardises the current effectiveness and future sustainability of the South African healthcare system.