[Burnout, patient compliance and psychological withdrawal among GPs: an exploratory study]

When GPs are afflicted by burnout, patients' demands are perceived to create a relational imbalance. It can be supposed that in this situation, GPs will react by distancing themselves from the patient. Effectively, various studies suggest that health professionals who are suffering from burnout adapt withdrawal strategies towards their patients: less implication, etc. In the present study, we make the assumption that when the GP is suffering from burnout, the withdrawal will be even more important with a noncompliant patient.

Two hundred and seventy GPs responded to the case of an 84 year-old female patient who lives alone and falls regularly. After having broken the neck of the thigh bone, she leaves the hospital and remains dependent for the next months. The patient is presented in two ways: compliant vs. non compliant. The GPs were asked to indicate the degree to which they would choose each of the solutions that were proposed. These solutions vary according to their degree of implication. Information on the participants' level of burnout was also gathered.

When the patient is compliant, the implicating solutions (home assistance and home care) are chosen equally as much by the participants, whatever their level of emotional exhaustion. But when the patient is noncompliant, these solutions are always chosen as much by the participants with a low level of emotional exhaustion, but are significantly less chosen by those with a high level of emotional exhaustion. The opposite is found for withdrawal solutions (independent living residence, medium term hospital stay, retirement home). When the patient is compliant, the choice of these solutions does not vary in function of the level of exhaustion. However, when the patient is noncompliant, these solutions attract the GPs significantly more if they are exhausted (but not if they are slightly exhausted).