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Asia Pacific Family Medicine
Published in: Asia Pacific Family Medicine 1/2018

Open Access 01-12-2018 | Review

A systematic review of burnout among doctors in China: a cultural perspective

Authors: Dana Lo, Florence Wu, Mark Chan, Rodney Chu, Donald Li

Published in: Asia Pacific Family Medicine | Issue 1/2018

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Abstract

Background

Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor.

Methods

Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including “burnout”, “doctors” and “China” in 3 electronic databases has been undergone. Traditional understanding of “work attitude” and “doctors’ humanity” from ancient Chinese literature has also been retrieved.

Results

Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors’ level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life.

Conclusions and implications

The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China.
Footnotes
1
The first author had a discussion with general practitioners from Denmark, Sweden, New Zealand and UK during a visit to a general practice clinic in Copenhagen, at the World Family Doctors’ Conference in 2016. The primary health care policy is very mature in Europe, with each citizen enrolled to the care of his own family doctor in the community with long-term relationship. The citizen cannot attend tertiary hospitals directly except in emergency. Hence, the overloading phenomenon for doctors working in tertiary hospitals is not commonly seen as what happening in China.
 
2
The first author was appointed as Honorary Professor of the First Affiliated Hospital of the Xi-an Medical School providing training on communication skill and medical humanities. During her stay in August 2016, the first author led a hot discussion with more than 100 local doctors in a communication skill workshop began by the question on why doctors felt frustrated when repeatedly reminded by patients that they were wealthy and could pay for the drug with the highest charge.
 
3
The first author conducted a workshop in June 2016 in Hong Kong, providing communication skill training to a group of doctors coming from different provinces of China. One of the case scenarios for demonstration was how to manage angry patients. Doctors from the floor were invited to share their ways of management in daily practices first, before the author shared her own experience with them.
 
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Metadata
Title
A systematic review of burnout among doctors in China: a cultural perspective
Authors
Dana Lo
Florence Wu
Mark Chan
Rodney Chu
Donald Li
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Asia Pacific Family Medicine / Issue 1/2018
Electronic ISSN: 1447-056X
DOI
https://doi.org/10.1186/s12930-018-0040-3

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