As highlighted in previous STRIDE articles, research shows that burnout is a significant issue in the podiatry profession. It affects both practitioners and their patients; creating a knock-on effect for the entire sector.
In the following interview excerpt with Dr Daniel Bonanno, the study’s lead author, his honest reflections are shared on burnout at the individual and practice-wide level – with plenty of points to take away and into your own practice.
This research developed quite serendipitously. A podiatrist experiencing burnout reached out to discuss burnout in the profession and explore existing research, with the possibility of pursuing their own study. Although they ultimately didn’t pursue it, our conversation prompted me to reach out to Professor Cylie Williams, who had incredible data on this very topic from the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) study; ready to analyse.
Burnout was measured using the abbreviated Maslach Burnout Inventory (aMBI). This scale is specifically designed to measure burnout among health practitioners. On that point, it bears reminding that workforce challenges are prevalent across the entire health sector. This is not just a ‘podiatry’ problem; workforce shortages and burnout rates are part of a global, multi-sector challenge.
The PAIGE database was vast and it gave us a really good snapshot of the profession. Essentially, it helped to confirm specific factors that are associated with burnout.
To be honest, I was a little surprised by the practical nature of these findings. I’ve been involved in research projects where we get findings in which statistically, we find a difference, but it’s not always easily explained or intuitive.
This study encourages a very practical application. If you run a podiatry practice, or work in one, and you’re trying to prevent your staff and colleagues from experiencing burnout, the study shows us that the following specific factors may help.
If someone asked me to describe a person and workplace prone to burnout, the factors would include:
All these factors can contribute to burnout in any profession. In fact, if you went into any workplace in the wider health sector and said, “I’m going to create a scenario where you have a high patient load and all these other factors mentioned above,” then you would likely find that everyone would get despondent about their jobs pretty quickly.
Our research shows that podiatrists who feel supported, see fewer patients daily, and can use their full scope of practice in a pleasant workplace are less likely to experience burnout.
Other contributing factors include higher remuneration, access to sick leave, overall workplace support, and so forth. If you haven’t reviewed the study’s findings in more detail, I encourage you to do so.
It’s one thing to share these findings and identify the factors, but it’s entirely another undertaking to say, “What do we do with this knowledge?”
It may be challenging for podiatrists to potentially implement these changes because we know there is a shortage of podiatrists and there’s a high patient need. There are a lot of push and pull factors here, including the initial cost involved.
On the flip side, if you can prevent a practitioner from experiencing burnout, it could potentially lead to greater staff retention, which may improve patient satisfaction, as a supported practitioner is more likely to contribute to a positive practice environment. In this very real sense, a significant return on investment stands to be gained.
If you run your own practice and employ staff, consider asking yourself these questions:
Character variables in podiatrists as employees
Have you also considered the character traits of your employees as a factor in the likelihood of burnout? The study revealed that particular character variables are associated with burnout.
Using ‘multiple logistic regression analyses,’ the study found that:
If you recognise some of these aspects in your employees, perhaps reflect on what you can do to support them. While I certainly don’t have all the answers, this study helps to open up these conversations.
If we zoom our perspective out further still, it’s clear that we need to get more people coming into the profession and prevent people wanting to leave the profession. We know that this would make a significant difference to our workforce challenges, and burnout rates would be first in line to benefit. Our findings show that podiatrists experiencing burnout are more likely to intend to leave patient care within five years, highlighting the urgent need for change.
More podiatrists lead to more staff, which leads to shorter waiting lists and less pressure on practitioners. Take a look at ‘Motivators and barriers for studying podiatry in Australia and New Zealand: A mixed methods study,’ which looks at these issues in more detail.
We clearly need to get more podiatrists coming into the profession, which is something that every university is striving for. The Australian Podiatry Association can continue to help with this; we all have a part to play.
I also believe every podiatrist should be seen as a potential point of marketing for the profession. We are learning that a lot of students who choose podiatry are inspired by a podiatrist they saw as a patient, or who their parent had seen.
This is very powerful knowledge to have, as it shows just how much a person’s choice to study podiatry can be traced back to the podiatrist out there; practising in the suburbs, regional cities, or rural locations.
As a podiatrist, you might not realise the impact you have on influencing someone’s future, but you do. The factors that lead to burnout, when turned on their head, are the very same factors that can attract a would-be podiatrist (who may visit your clinic as a patient or carer). You could inspire them, through your actions, to want to become a podiatrist.
If someone bears witness to a podiatry practice that showcases a great sense of work-life balance, satisfied team members, podiatrists not feeling overworked, and enjoying their caseloads; this can go a long way to encourage more people to join the podiatry profession. In fact, that same person may return to your local town as a podiatry graduate in a few short years, ready to be employed.
This is why we don’t need burnt-out podiatrists. We need really positive, happy podiatrists which of course is easier said than done, given the constraints mentioned above.
I don’t underestimate how complex this goal is, but we can all play a part in getting there.
Studies such as these hand us the knowledge to see what needs to be happen if we are to decrease burnout rates. Now we can all hold each other accountable, against this data, to make some positive changes for ourselves, and our peers.
It’s not the whole solution, and constraints may overshadow expectations as changes are explored, but a willingness to change what we can certainly helps.
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