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At the heart of general practice since 1960

GP burnout stories: 'My reaction to a suicidal patient was resentment'

Scores of GPs shared their personal experience of burnout with us on the condition of anonymity. Here is a selection of them

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Struggling to care

‘I realised I was suffering from burnout when a lady who was going through a really awful situation and who had seen me a few times about it came with even more bad news, distressed, crying and saying she did not think she wanted to live anymore. My only reaction was to resent her for coming to see me and taking up so much of my time.’

‘Sometimes find it difficult to really empathise with patients. Just look at them as one more hurdle in the race to finish surgery and tackle the next task.’

I care less: not careless or not caring, but just “care less”

‘Sheer volume of work is making me less sympathetic at the end of the day, and after a full day on duty I still have to offer an Extended hours routine surgery from 6.30 to 7.30pm for working patients. I am not the best GP I could be at this time.’

‘Reduced empathy at times, and at times seeing patients as a burden. One common theme when discussing with my colleagues that that when a complex or ill patient comes in, a gut reaction can be “Oh no, this is going to take ages” because of the pressure on time, even though it may be the only person who really needs to see you that clinic.’

‘When I was suffering from burnout in 2014 and early 2015, I reached a point where I didn’t really care about the wellbeing of my patients, because I was so utterly drained and exhausted. This caused me to be less patient and considerate to them, particularly the complex, demanding and difficult ones.’

‘I care less: not careless or not caring, but just “care less”.’

‘Compassion fatigue. Lack of time to adequately deal with patients’ emotional needs. Having to see patients on my days off and own time for this eg at end of a surgery.’

Turning to alcohol and prescription drugs

‘I notice that I am dreading my working days, and occasionally even dread calling in my patients when I am at work. When I feel tense before a day of work, I sometimes drink alcohol to ease the stress and remain calm at home. I am aware of this, and try to not drink over the recommended 14 units per week. But I am worried for the reasons I have a glass of wine, as it is not simply for enjoyment, but used as a way to deal with stress.’

I drink a bottle of wine most evenings after work, and often take codeine to help me get to sleep

‘For some time I have kept a supply of “beta blocker” tablets at hand in my consulting room. I often find myself reaching for one. They help stop the palpitations, tremors and sweats which I get when I am stressed. I did consider taking antidepressants but those are better for low mood not acute stress symptoms. Retirement is in my mind almost every day. What stops me is that I still enjoy the work - sometimes - and I feel my patients need experienced GPs, so I am carrying on for a while yet.’

‘I had to go onto antidepressants when I started suffering with burnout in 2013/14, and I remain on quite a high dose (20mg Escitalopram) otherwise I find that I get overwhelmed at work. I have also been unable to return to my job as a GP partner and now locum very part time.’

‘I drink a bottle of wine most evenings after work, and often take codeine to help me get to sleep. I am also on long-term antidepressants, as are a lot of my colleagues.’

‘I was drinking to excess in the evenings and this caused a marriage breakdown. I tackled this with help of family and I now only have alcohol on special occasions, I would not say I was an alcoholic but it could easily have gone that way as I was using alcohol to relieve the stress. I was then prescribed antidepressants by my GP which I still take now. I’ve handed my resignation into my partnership and I hope to do more locum-type work when my notice period ends in March next year.’

Negative perceptions

‘The “pointless crap” gets me down as does the workload and the persistent negative press. I find the on call days can be awful, that’s the really stressy/ burnout part. I feel the future of general practice is very depressing. The government seem to feel we can be replaced with a nurse practitioner or an app, well good luck with that and when secondary care is drowning it will be too late.’

‘I am completely sick of it. No one pays me any more for seeing what once would have been entire day’s patients in a single morning clinic. I just get the pleasure of dealing with more complaints and rising indemnity fees. In fact my pay was effectively cut by 2.2% in June when my indemnity fees went up 12% this year. I pay the fees out of my own salary and it costs me £680 a month for doing 2 1/2 days a week. My practice refused to cover the cost.’

Unsafe care

‘I have a feeling that I am working within an entire system which is unsafe, where the workload pressures have long since exceeded capacity, and where the basic infrastructure is so degraded that it makes my job more difficult, rather than easier.’

I am completely sick of it.

‘I am surrounded by constraints on investigating, referring and managing patients that cripple my ability to function. I can no longer rely on the rest of the system to counteract any errors I might make, and indeed the rest of the system seems to be making numerous errors.’

‘It takes a lot of concentration to carry out our job, particularly with increased comorbidity and complexity. I find it a struggle to spot patterns emerging and hence get a definitive diagnosis. As a result I’ve scaled down my out-of-hours commitment to spare myself for the day job.’

The personal effect

‘I didn’t realise how bad it was until I snapped and shouted at a member of staff, then broke down in tears at partner meeting when discussed. I took two weeks off and had planmed to reduce sessions at the surgery, but realised that wasn’t enough for me. I no longer wanted to be at the surgery I had originally planned to retire from and so instead resigned and found a new practice.’

‘Personally, I find the worry at the end of the day and sleeplessness most troublesome because I have been too busy and the day is a blur.’

If you are worried about your health, then you are able to access free counselling in England from the GP Health Service. Click here for more details.

 

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Readers' comments (5)

  • LetsCutTheCrap

    Okay, nice stats.
    On the surface it even looks like about half the doctors are unlikely to take time off due to stress in the foreseeable future.
    What a load of cr#p.
    That survey did not reach the target population, ie those of us who were already too tired, stressed and burnt out to give a sh&t.
    At that point, we have already reached out to all the "help" initiatives, received b$gger all from them, gave up, and decided to think for ourselves.
    At that stage one gives these "surveys" the same consideration as one would give the derriere of a small rodent.
    And in case anyone is wondering, yours truly doesn't drink to excess, and does not turn to drugs. So there. Hah.

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  • Even without having the need to drink, or take antidepressants, or even caring less (when it happened to me I became completely the oposite: Absolutely obsessive with doing everything...) It is not finding the energy to do anything else apart from work...
    Really sad we are like this

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  • Remember that you all have a choice. You don’t have to continue like this. The only thing you have the power to change is what you do, how you do it and how you choose to feel about it. A burnt out doctor is an unsafe doctor. The profession is unlikely to support you once the complaint comes in.
    You all have great skills and not only medicine wants them.

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  • Increase in Burnout is a sign of despair! General Practice is in crisis and the Government is not able to change the vicious spiral of slow disintegration!Workforce issues will exacerbate the steady decline!Sad!

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  • The 10 minute consultation time is ill suited for an influx of suicidal depressives. As we become later and later our anxiety and vitriol rises.
    Right, I'm starting on time, I'm staying on time....
    1st patient - depressed, suicidal - damn it, even with short cuts of counselling and pills that's 20 mins
    2nd patient - heart sink with shopping list who waited weeks just to see me as "you're the only one who understands". Dare I go all Copperfield, or just grin + bear it? Another 20 mins
    3rd patient - brilliant!! A sore throat! Bish, bash, bosh, 5 minutes.But defeat snatched from jaws of victory as I hand him his scrip when he utters the fateful word "also....". 20 mins
    4th patient - depression again, AARRGGHH!! 20 mins
    ---------------------------------------------
    Last patient - fungal nail infection, thank God! "But according to Google it could be......" I hate you.
    And not one single DNA to lighten the load

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