Burn out among French general practitioners

Objective Assess the extent of burn out among the general practitioners of the Loire region (France). Methods A questionnaire in 3 parts was sent to 480 general practitioners: the first concerned the socio-demographical variables such as the age of the practitioners, their marital status, time when the installed their practice, type of practice and quantification of their professional activity; the second corresponded to the French version of the Maslach Burn out Inventory (MBI) and the third part foresaw the eventual consequences of burn out, such as the wish for retraining, use of psychotropics or suicidal thoughts. Results 306 practitioners replied (response rate 64%). Mean scores on the three dimensions of burn out (emotional exhaustion, depersonalization, low personal accomplishment) were similar to those of other studies using the same instrument. Five per cent of the practitioners had high scores of burn out on the 3 subscales, but professional accomplishment remained high for a majority of physicians. More than 1 practitioner out of 2 had thought of retraining, 5.5% declared excessive drinking, 30% had taken psychotropics, and 13% have envisaged suicide. Emotional exhaustion was statistically associated with female sex, heavy workload, wish to retrain, drinking, psychotropics and suicidal ideation. The causes of burn out expressed by the practitioners were organizational and administrative (high workload, administrative demands, conflicts with social welfare organizations) but also relational (demands considered as excessive from their patients and families). Discussion Burn out among general practitioners is a reality. The quality of life of practitioners suffering from burn out appears significantly impaired, and published literature indicates that it may lead to deleterious consequences on the care provided to their patients. (C) 2004, Masson, Paris.