by Dr. Lauren Catenacci

Burnout syndrome is an important work-related illness that involves emotional exhaustion, depersonalization, and feelings of diminished personal accomplishment at work. People typically experience burnout in response to chronic work-related stress in an attempt to adapt, or to protect themselves. While researchers have historically contemplated burnout as a single phenomenon, a study based on a proposal by Dr. B.A. Farber, professor of psychology and education, suggests that three unique burnout subtypes exist, each requiring different coping mechanisms and prevention strategies. By recognizing and understanding these individual differences, prevention programs can be designed with a more person-oriented approach that considers the specific challenges the different groups face. The three burnout subtypes include frenetic, under-challenged, and neglect.

Frenetic burnout

A recent survey by VIS and Galaxy Vets found a direct correlation between caseload and burnout rate. However, frenetic burnout is more highly associated with work overload. People affected by this subtype tend to work harder, and to become increasingly more frantic in their search for success. These individuals are willing to risk their health, and their personal relationships, as they pursue their ambitions. When they don’t obtain the desired results, they respond by investing more time and effort until they are emotionally and physically drained, and unable to cope. Individuals who are classified as workaholics, perfectionists, and performance-oriented are more likely to experience the frenetic burnout subtype, which has been known to lead to neglect burnout.

Implications in the veterinary profession

Dedicated, hard workers make good employees, but this behavior limits them from remaining healthy. Primary care physicians have performed research that shows a link between the frenetic subtype and hours worked. Individuals who exhibit more frenetic burnout behaviors tend to work more hours than those who score lower on frenetic burnout behaviors. Since veterinarians typically work long hours, they are highly susceptible to frenetic burnout. Our recent survey revealed that the most burned out group comprised younger practitioners, potentially because new graduates lack some necessary skills, such as communication, negotiation, self-care, self-motivation, and work-life balance, which are typically neglected in veterinary schools. This may lead to new, ambitious veterinarians entering the workforce unprepared, and possibly holding unrealistic expectations that are based on an idealistic world view. Veterinary professionals are also at higher risk for frenetic burnout, because they are highly compassionate, and their inability to refuse a patient leads to hard work and long hours.

Prevention strategies

Veterinary professionals can help prevent frenetic burnout by setting boundaries and learning to say “No,” finding a stress management routine that allows them to take breaks, and learning to create time and space for themselves and their self-care, to create a better work-life balance. If their employer refuses to respect their professional boundaries, this may be a signal to look for other opportunities that offer a better work-life balance.

Our survey also demonstrated that veterinary professionals want their employers to help prevent burnout in the workplace. Steps employers can take include:

●      Discouraging a performance-oriented value system in the practice

●      Not using compensation models, which incentivize long hours

●      Discouraging heroism

●      Creating an environment where failures are perceived as a growth opportunity

●      Ensuring their employees have necessary breaks and vacations

●      Limiting the hours their employees work

Wheel of Life exercise

A poor work-life balance is likely a contributor to frenetic burnout. The Wheel of Life exercise is a reflection exercise that individuals can use to identify life priorities and the areas they neglect. Follow these steps to create a Life Wheel and assess your balance:

1. Brainstorm — Start by brainstorming six to eight important areas of your life. You can approach this by focusing on your roles in life, the areas in your life that take priority, or a combination of these aspects.

2. Record — Write these dimensions on the wheel diagram, placing one on each wheel spoke.

3. Assess — Mindfully consider how much time you devote to each dimension, and rate the areas on a scale from 0 (low) to 10 (high). Record these amounts on the appropriate wheel spoke.

4. Connect — Connect the dots around the circle to see if your wheel is balanced.

5. Evaluate — Determine your ideal level in each category and plot these scores around your life wheel.

6. Act — Once you have identified which areas require attention, take steps to correct the imbalances.

Under-challenged burnout

Individuals experiencing under-challenged burnout tend to feel underappreciated, desire more learning opportunities, are often bored, and struggle to find passion or enjoyment in their work. This can result in a tendency to distance themselves from their job, which can lead to cynicism, avoiding responsibilities, and overall disengagement. People affected by under-challenged burnout typically respond by performing their work-related tasks superficially and displaying indifference toward their assignments, leading to boredom and a lack of development. Individuals who are classified as self-confident and type A personalities are more likely to experience under-challenged burnout.

Implications in the veterinary profession

Our recent study showed that people who had professional goals reported significantly less burnout and felt happier and more valued than those who did not. Becoming a veterinarian is a long, challenging process that requires working toward many milestones, including a bachelor’s degree, veterinary school admission, a veterinary degree and possibly a specialty certification, and finding a job or purchasing a practice. These clear goals help maintain focus, but veterinarians may forget their objective once they begin practice, and no longer have an end target. Monotony and boredom are key contributors to the under-challenged burnout subtype. Without goals, veterinarians can lose their motivation and passion as they go about their daily routine. A large student debt burden may also contribute to this subtype. Veterinary professionals who are highly dependent on their salary may feel obliged to continue performing routine duties they don’t find satisfying, leading to frustration and discontent.

Prevention strategies

Steps that veterinary professionals can take to prevent under-challenged burnout include choosing employers who value opportunities for personal and professional growth, having long-term goals and short-term mechanisms for motivation, and advancing in small steps toward professional goals. Steps employers can take include:

●      Effectively communicating with your employees, so you know their values and motivations, and designing their job to meet their needs and wants

●      Constructively challenging your employees

●      Providing continuing education opportunities

●      Including tuition compensation in their benefits package

●      Regularly discussing your employees’ aspirations and planning their career path

Goal-setting exercise

Setting goals is one of the best ways to counteract under-challenged burnout. Veterinary professionals should write down their goals and review them regularly, to ensure they keep them at their mind’s forefront. Google offers "One Simple Thing," a goal-setting tool to encourage personal wellbeing.

Neglect burnout

Also known as worn-out burnout, this subtype describes individuals who feel incompetent at work or unable to fulfill the job’s demands, which leads to feelings of hopelessness. They also typically feel that their efforts are unacknowledged, and they eventually respond to work difficulties by omitting details, disregarding tasks, and neglecting assignments. These individuals may appear passive and unmotivated, and are often associated with inefficiency and incompetence after working many years in organizations that reward employees unfairly. Individuals who are classified as shy, not assertive, and overly dutiful are more likely to experience neglect burnout.

Implications in the veterinary profession

A practice’s culture and management can lead to neglect burnout. Risk factors include micro-managed employees who are given no autonomy, the organizational system’s disregard for effort and dedication, the absence of a feedback exchange system, and a lack of psychological workplace safety. Examples that can lead to this burnout subtype include:

●      A veterinarian performing a veterinary technician’s duties, such as the blood work, making the technician feel micromanaged, undervalued, and not trusted—our study showed that veterinary technicians reported the highest burnout level among all roles

●      Veterinary professionals who have to perform euthansias based on economic factors

●      Veterinarians dealing with frustrated or angry clients, with no adequate coping strategies

●      Veterinary professionals working in a psychologically unsafe environment, where people are afraid to speak up, ask for help, or make mistakes

●      Veterinary professionals working in an environment that motivates wrong behavior and imposes ethical dilemmas

●      Female veterinarians who struggle to reach a secure economic position, knowing their male counterparts are making more money

●      New graduates who have a large student debt burden and struggle to feel economically secure—veterinary student debt is currently growing 4.5 times as fast as income for new veterinary graduates

Prevention strategies

Veterinarians can take steps to help prevent neglect burnout, including learning and practicing assertive communication and finding a new job if they feel their employer does not appreciate their contributions. Individuals experiencing neglect burnout may also benefit from seeking professional mental health support, since they are likely to experience depression, including loss of self-esteem, and cognitive approaches may help rebalance their perceptions. Our recent study revealed that employees in practices where a clear burnout prevention strategy is in place burn out less. Steps employers can take include:

●      Improving psychological safety, and creating an environment where everyone feels comfortable voicing their concerns

●      Cultivating gratitude at work by noticing, celebrating, and appreciating good moments

Assertive communication exercise

Assertive communication is a powerful tool that can help individuals voice who they are and how they want to be treated, but remain aware of other people’s feelings and needs. Learning about assertive communication tools and techniques can help prevent neglect burnout.

Burnout can significantly impact veterinary professionals, leading to reduced productivity and quality of care, increased absenteeism and health care costs, and life-damaging physical and mental health effects. Organizational aspects, such as limiting work hours to mitigate frenetic burnout, offering promotion possibilities to help prevent under-challenged burnout, and providing job consolidation opportunities to help avert neglect burnout, can positively affect the veterinary professional’s work environment. Positive psychology is another approach that employers can use to help ensure the veterinary professionals in their practice are content and fulfilled.