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SA Orthopaedic Journal

versão On-line ISSN 2309-8309
versão impressa ISSN 1681-150X

SA orthop. j. vol.17 no.1 Centurion Fev./Mar. 2018




Professional burnout



Pradeep Makan

BSc(Med), MBChB, FCS SA, MMed(Orth) President: South African Orthopaedic Association




Could there be a higher calling than the practice of medicine? Medical professionals are entrusted to listen, diagnose, manage, and intervene on behalf of their patients. We unselfishly teach our skills to our students and trainees (registrars and fellows). As surgeons, patients invariably place their ultimate trust in us when they are at their most vulnerable. Our perception of ourselves often becomes altered by the sometimes-unrealistic demands of our work and we forget that we are essentially no different from our fellow man.




Since my junior years at medical school, I was attracted to Orthopaedics as a career because it gives one immense job satisfaction. I am certain that there are many times our partners think we are having an affair because we are so passionate about our work that we dedicate too much time and energy to our profession. I was privileged to be brought up in an era where parents and grandparents were always around. Although we somehow managed to balance the demands of both work and home, times have changed. In most modern families both parents work, and modern grandparents are often busy with their own lives. If you left having children till late, the grandparents have either passed on or are too old to be of assistance. You are then sandwiched between caring for your young children and your elderly parents. You are therefore at risk of a burnout while trying to balance your busy professional career with family life.

What is a good life? This question dates back to the ancient Greeks. Traditionally we define success by power and material possessions. Power and money by themselves are like a two-legged stool - you can balance on them for a while but eventually you will topple over. Unfortunately, many professionals topple over at some stage in their lives.

Robert Frost (1874-1963) was one of the most popular American poets of the twentieth century. His wife died in 1938, two of his daughters suffered mental breakdowns, and his son committed suicide. According to Robert Frost, if you want to burn out or incinerate, you should have the following characteristics or somehow acquire them:

1. Be perfectionistic and idealistic and complain if everything is not just right.

2. Be time-conscious and always keep in the back of your mind that you have got a lot of things to do before the end of the day. Keep these thoughts in your head so that you don't relax during the day's appointments. This is called Hurry Disease.

3. Compete with everyone, including yourself.

4. Try and control everything from the filing cabinet, reception, outpatients and emergencies to telephone calls.

5. Take all interruptions, telephone calls, fit in appointments and overbook your day (known as operating multiphasically). Never take time off to organise your days as you will lose income.

6. Come to work when you are sick (known as tolerating self-suffering).

7. Try and prime yourself to see the world as full of demands.

8. Try and work up a lather and get angry each day when any obstacles get in the way of your achieving your objectives (called free-floating hostility).

9. Finally, resist social support or advice if you see someone about your burnout. but I have promises to keep, and miles to go before I sleep, and miles to go before I sleep.'

Leonardo da Vinci advised: 'Every now and then go away, have a little relaxation, for when you come back to your work your judgment will be surer. Go some distance away because then the work appears smaller and more of it can be taken in at a glance and a lack of harmony and proportion is more readily seen.'

Rest should not be an optional leftover activity, for the better you are at resting, so much more will you be capable of accomplishing in the workplace.

The SAOA, with the assistance of our CEO and congress committee, will for the first time introduce a well-being session at our annual congress in Pretoria later this year.

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