The real truth about burnout

Okay, I don't know if you've been noticing this or not, but one of the more surprising trends in pop culture right now is betting. Like if you are watching the Golden Globes, for example, betting company Polymarket, they ran this ticker of popular bets on who would win the award. Like it was like right bear on the screen. And I mean up to Mahmoud and this week on commotion, I talked to some culture critics about why betting feels like it's everywhere. Why everyone wants to take a gamble on who's going to win an Oscar, on who's going to be the most Google celebrity of the year. You can find and follow the commotion on YouTube or wherever you get your podcast. This is a CBC podcast. I'm Dr. Brian Goldman. This is White Coplecker. Well, the holidays are done and a long stretch of winter lies ahead. I've actually heard some people say that they've got winter burnout. Patients who feel tired, sad and who lack get up and go during the colder months and shorter days may be suffering from something called seasonal effective disorder. That's a medical diagnosis. Winter burnout is not a medical condition. It's not even burnout. Just two of many widely held misconceptions about burnout that you and I hold that just aren't true. So I want to give an overview, a sort of a quick overview of the research that's been done on burnout. Bring us up to the present and then explain some of the challenges and the problems we have in learning from that work. Recently I spoke at a conference of radiologists in London, England, where I got to hear one of the world's top experts on burnout. Professor Christina Masleck is Professor Emerida of Psychology at UC Berkeley. She was one of the first researchers in the world to study burnout. Beginning with prison guards and eventually in front line healthcare providers like me. Hi, my name is Christina Masleck. I'm a professor of psychology at the University of California Berkeley. Recently retired, but I've been doing research on job burnout for almost 50 years now and have learned a lot in that time. It wasn't something that I thought I would be studying. It sort of became something that I thought was important and wanted to follow up on. And have had really interesting adventures in learning a lot from people about this phenomenon and what you can do about it. She's published hundreds of research papers on burnout, often collaborating with Michael Leiter, professor Emerida of Psychology at Acadia University in Wolfville, Nova Scotia. Their work was instrumental in getting the World Health Organization to define burnout as an occupational phenomenon, resulting from chronic workplace stress, characterized by feelings of exhaustion, cynicism related to your job, and a sense of personal ineffectiveness. I'm interested in the condition because of high rates of burnout among healthcare providers. According to the 2025 National Physician Health Survey, 46% of MDs report high rates of burnout. Professor Christina Masleck, welcome to Waiko Blackheart. Thank you so much for having me as a guest on your show. It's so important that you learn about each domain that you enter because burnout isn't about the person. I mean, it happens to the person, but it's about the system in which they work. Yeah, and so social, the challenge sometimes is to try and get at, are there some sort of basic generic concepts that you then have to customize to say, what is that going to look like in an educational setting as opposed to a hospital setting? So it's, what are some key principles that we see across these different places, but maybe get done or carried out in different ways? I'm sure you've heard the word burnout and maybe even used it to describe how you're feeling. Another reason why I was dying to meet Professor Masleck is that she introduced the word burnout to the scientific world and from there to me and you. That happened in the early 1970s, and it's quite the story. Where did you get the name burnout from? I think that was this story from the woman that I was sitting next to at a dinner dinner party and she was a new person who was going to join the law school. So she was a lawyer and she was sitting next to me at a table, you know, we're all Canada table and we're all chatting. So who are you? What's your name? What do you do? You know, kind of thing. And I told her I was a new assistant professor in psychology and she asked me about that. And so, you know, so what are you doing? What kind of research do you do? I said, well, right now I'm doing some interviews with people. So she asked me, you know, she got intrigued by kind of that I was talking to people about, you know, how they cope with emotions and things. And she said, could you sort of describe kind of what they're talking about or what they're saying? So I gave her a few samples of the comments that had been made, but what people would talk about how they got to a point where they could not stand having one more client come in the door with a problem that it was just going to, I mean, I've had it up to here. I just want to say slam the door shut. I don't want to hear it. I don't want to deal with it. That kind of thing that people were saying that they get to the point where they're treating the people they're supposed to be helping, you know, or coaching or, you know, providing assistance to information. They're being rude. They're being kind of nasty. I'm done. I've had it, you know, for the day. And so she said, oh, well, that's interesting because when we talk about it, you know, I don't know what you call it, but we call it burnout. And she talked about lawyer or legal burnout. Was it in a home moment for you when you heard it? It was a bit of a surprise at first when I heard it because burnout, I'm the daughter of an engineer who was a professor of engineering, but who did research on rarified gas dynamics, which meant that he's research was important for the space program, you know, so we would hear a lot about what was then developing at that time in terms of the space program. So I would hear the term burnout periodically from not just light bulbs, but ball bearings burn out, you know, rocket boosters burn out, you know, do their job, get the thing up over gravity and then they're done, you know devices. Yeah, yeah, yeah. And so it was kind of like, hmm, you know, I'm trying to think how this this relates to what people were saying in terms of legal things. I wasn't really sure about it at first, and then I had to try it out on other people, and that's why I would then at the end of the interview and said, well, I've heard this term burnout, does that, you know, and it was like people would react, you know, to that. Yes, yes, that's it, that's it, that captures it, you know, there were used to be flames, there used to be passion, there used to be energy, and now it's just like gone. The imagery of flames and fire and then ashes and, you know, it's cold, it's, you know, there's, there's nothing there, things are gone. So something was there, and now it's not, something was good, now it's bad, and you've lost the energy, you've lost the commitment, you're making it through, but. You just made me understand something burnout is a dynamic term, it's not just a static term, you know, it's not with a burnt out, but it before the flame burnt bright. Yeah, yeah, oh yeah, it doesn't, yeah, and now it doesn't. Try these terms out to attach concern, yeah, at the end of the interview, dehumanization and self-defense, that doesn't fall trippingly upon the tongue. I just would say, you know, I'm curious how people kind of talk about the experience you've just described to me, and I've come across these things, and I'm wondering if, how you think about them, I mean, does it kind of fit, does it, does it make sense, you know. And then after I had that dinner where the lawyer had told me about burnout, I then said, well, how about burnout? And that was when very different reaction. White balls went off. Oh yeah, yeah, yeah, people said, yeah, that will do it, that will describe it, because they would then they may not have said anything before about having passion, having fire burning, having, you know, energy, having all that kind of stuff, and now it's just, it's gone, it's dead. But it bugs you that people have appropriated the term and often misuse it. Well, it seems to be a shorthand of saying something bad happened, you know, like, I don't know, I'm kind of burned out on Pilates, I think I'll have to try, you know, something else in the gym now, you know. And it's kind of like, well, that's a different kind of meeting, that means like, you're getting tired, you're getting bored of it, it doesn't, you know, do anything for you anymore. Or, I don't know, I'm just so burned out, I haven't had a good idea all week, you know, and so it's like the fire is not coming up with new ideas or new things that I can write about. Fix for that is very different from the from the fix for burnout. Yeah, yeah, but what I'm saying is there's something about, you know, a force and a energy that was present or a likeness, I'd like this, I love this, you know, a passion, this is whatever. That was there and somehow it's gone, it's left. So I find people using the term in all kinds of ways, I used to like it, but I don't anymore like shardonnay burnout. Is that actually the thing if you heard that? Oh, absolutely. Oh, absolutely. You got tired of drinking shardonnay. Yeah, okay. That's if I have Pinot noir, you know, no, I mean, I find it in all kind of strange places, diabetes burnout. The thing is that that in some cases people recognize, you know, what we're describing is happening to people in, you know, certain kinds of job situations. And they can see a parallel to something else in their life. I think for example, parents say, oh, come on, parent burnout, really? This is, you know, this is a thing. And when they heard, for example, the World Health Organization saying, this is, we're talking about only in, it's an occupational phenomenon. They was kind of rolling their eyes, oh, God, don't they know about parents and parent burnout. And it wasn't that World Health was arguing against them. It was that all the literature out there, very little on parent burnout. And the term is being used, but there's not the research in what they were doing and saying of all the literature that's been talking about burnout. In the workplace, we have enough now that we can say just something going on here. It's a phenomenon that has health consequences. As part of her research, Christina Maslak co-created the Maslak burnout inventory over 40 years ago. Today, it remains a validated and widely used scale to evaluate burnout using three main phases, emotional exhaustion, depersonalization, or distancing, and personal accomplishment. I asked her to break these phases down. So we talked a lot about what burnout isn't. What is it? It's a response to chronic job stressors. So it is what we call a stress response. And stress, there are many kinds of stressors. The best way to talk about them are sort of the negative ones that we think of as threats. So this is the fight or flight, you know, kind of thing. Fight or freeze. Or freeze, or solve a problem, you know, and figure out what the hell to do here, you know, kind of thing. And the stress response when you're really highly stressed, you go through these phases and exhaustion where you just can't do anymore. I've got to go home. I've got to, you know, not get up tomorrow morning, et cetera. So that's the exhaustion phase that we talk about. And people just feel that by the end of the day, the week I'm drained, I happen, an ounce of energy left. I don't care anymore. I just want to get through it, get home, get through the weekend, you know, whatever. A second thing that happens is what we see is when people are experienced is they're beginning to distance themselves from the workplace as a way of kind of not getting overly involved, you know, not wearing my heart on my sleeve and, you know, having everything buffeted me around. So I'm pulling back. I'm minimizing what I'm doing. I'm doing the bare minimum, get the job done, but I'm not going the extra mile, the extra step, you know, et cetera. And when people do that and start doing more of this pulling back and minimizing, they're also kind of, you know, saying goodbye to this organization. You know, it doesn't matter. I'm here. They give me a paycheck, et cetera, et cetera. But you're not really committed to doing the best you can and proud of the work that you're here as opposed to somewhere else. And for me, that's that's really the hallmark of burnout is is that that pulling away that distance saying that treating things in a very impersonal way that could lead to things that are rude or abusive or neglectful. I mean, you just don't do your job the way you should. And then the third component is it's not just feeling negative about the job. You're beginning to then question and be feel negative about yourself. Maybe I've just made a mistake. Maybe this is really the wrong choice. I shouldn't be doing this kind of thing. I should be doing something else. Or maybe it's I can do the job. But oh my gosh, you know, I shouldn't have gone here. I should really, you know, and why can't I speak up? And you know, what am I going to do? And so it's it's blaming it's it's feeling like that things have gone wrong. You've used the term as well. And I've seen the term cynicism in in in discussions in the literature surrounding. Where does that fit in? That's in the distancing because what happens is as you beginning to do less, you're just going through the motions. You're doing the bare minimum. Okay, I have to stop in and say hello to each pregnant patient to see how she's doing. But I open the door say hi. How are you doing? Any questions? No. Okay. Boom. I'm out. Just going through the motions. Right. Right. And what that does is that it begins to make you just sort of feel less involved. It's I'm not really as responsible. It's not me is, you know, this isn't the place that I should just, you know, give my all to, I mean, you know, it's sort of feeds on itself in a way. And it gets into that there is a song. I think a country Western by Johnny Paycheck. Take this job and shove it. You know, so I think that's at that point, you know, you're saying there's not enough here just. I'm, you know, get me out of here. We'll be right back. It's been said that being neighbors with America is like sleeping with an elephant. One gets affected by every twitch and grunt. Well, these days there's a lot more than twitches and grunts in dealing with the US. I'm Paul Hunter and I'm Katie Simpson. We're reporters here in Washington and every Wednesday will bring you a smart conversation to help you make sense of how American politics are affecting Canada. Our new podcast is called two blocks from the White House. Find and follow now wherever you get your podcasts, including YouTube. You're listening to White Cop Black Art. This week, a feature interview with Christina Masleck, a professor, a merit of psychology at UC Berkeley. She's renowned for her research on burnout. So far, Professor Masleck and I have been talking about burnout in general. I first got interested in burnout when I heard about it as an occupational hazard in my line of work. Here's more of our conversation. What would be going on in a healthcare system that would predispose people to burnout? So I will hear from various healthcare workers. I'm in this hospital. It was after I mean, I was making a good salary and so forth, but I hated the culture. It was all about just bringing in patients. I'm bringing in money. There's a limited time. I can't actually do what I want when I with patients. I work or be. I hated it. I was burnt out and I quit and I left and I go into another hospital. And here's why I love it, even though I'm not making as much money because this is why I went into medicine. To really make a difference. And here's where I'm able to do it. So there's that sense of that value that purpose within or whatever they're doing in that in this case, we're talking about a hospital is no longer congruent with your values. You're not able to fulfill the mission that you have in your life because this hospital isn't letting you or maybe the rules aren't letting you. I've quoted from people who have made some amazing changes and some cases have worked in hospitals that you would think would be the most difficult thing in a war zone and stuff like that. And then they're back and they're working in another hospital, which you think must be really cushy and it's great, you know, something and they hated. It's not it's not fulfilling it, you know, the most meaningful experience they had was there. Can they find another job where it's not that, but I am able to make the kind of contributions that I can do, you know, given my specialty. I mean, nurses see a lot of trauma, but that's not all of what we're talking about. We're also talking about issues in the system, the healthcare system that make it hard for them to do their job. What are some of those things? Oh, yeah, other people like senior doctors, given them a hard time. Oh, boy. Yeah, that was just back. Absolutely. Yeah. A little in that. Yep. Yep. You know, not taking you seriously, like, you know, you don't really know, you know, and it's et cetera. Just missing their experience. Yes. So is that a lot of it? You know, because we hear about the working conditions, we hear about forced overtime, especially during the pandemic, having to work six, seven days in a row with nurses, nurses working in small rural emergency departments where they know that they're the last, they're the last one standing. And they call in sick that emergency department closed there. There's nobody there. What I have found in a number of places, healthcare, but also other places is what we used to call and I, or nicknamed for it was walk around leadership. And that was when a higher up would personally come down and be on the floor and spend the day kind of just getting to know people what's happening, talking to them, checking back in a few months later. It was kind of like, and then saw, oh, when you don't have a copier, Xerox machine working. There's nowhere else to go. And so you can't copy the thing for your patient, so you have to leave run around trying to find it doesn't have paper find another one, you know, and they said I can actually relate to that personally as an emerged physician, I have to do a lot of paperwork, probably five to 10 minutes of paperwork on each patient that I'm sending home, I do all the photocopying myself. Can't tell you how many times printers out of paper or the cartridge is exhausted and they have to get a new yeah. That's the pebble in the shoe. That's what I mean. It's not this like big, huge, you know, oh my god, you know, kind of thing. It's that the pebbles in your shoe is what some of these people talked about it. And I think that kind of gets at, you know, that the scale can sometimes be smaller, fixable. You know, it doesn't take rocket science to sort of figure out what we might not need to do, you know, there. And so I remember, you know, talking with symmetrical people and they talked about how finally they were able to get whoever this was to come down and spend the day and look at the that day he walked around and saw what was happening. They got a new machine because he could see. But it's like he wasn't trusting them before, you know, to sort of say, yeah, let's let's figure out how to do this. But once he could once he was there and talking to people and seeing what the problem was, then took action, you know, in some sense. It's so telling that that, you know, lives could be hanging in the balance and we're talking about getting another photocopier. Yeah. A pebble in a shoe. Yeah. It would be very easy for people listening to this show to say, to listening to our conversation to think, ah, that's burnout is the healthcare professionals problem. Why does this concern patients and their families? Why is burnout a bad thing for healthcare and for patients and families? Basically what happens when people are experiencing burnout, you know, and sort of losing that passion, that concern and feeling bad about what they're doing in the place they're working, it means that the way they're doing their job is not good. They are not being careful. They are more likely to make errors. They are sloppy. They miss things. They ignore things. And all of these can translate into things that have a negative impact on patient care or can actually cause problems for your colleague that you're working with in surgery or, you know, something like that. So the reason we care about it is not just because they're not feeling good and they're feeling lousy and, you know, and so forth, but what they're doing and what they're contributing through their work is actually not good quality and it can be sometimes dangerous quality. You can actually have errors that have serious consequences. So sending a nurse or a physician who's burned out to a spa isn't going to work. Isn't going to address the problem. You actually have to fix the hospital. At some point, they're going to have to come back to the hospital, a respite of any kind, and, you know, a vacation, a week off, all that kind of thing. Always people feel better. They come back. They feel okay. And then that disappears like within a week. I mean, if you're back in the same conditions, they're not the solution that will last forever. It's a temporary, you know, kind of fix. It's been nearly half a century since Professor Mazlak started doing research on burnout. She's retired now, but still writes and gives keynote speeches at conferences. With high rates of burnout worldwide, I doubt she wants to take a victory lap. I've seen surveys that, you know, here in Canada, that 50% of physicians are burned out. Same percentage may be higher percentage of nurses. What does it tell you that these surveys continue to show high rates of burnout 50 years after the term was coined? It took a while for people to even take it seriously. I mean, I wasn't taken seriously at first. I, you know, I had to publish and do other research in order to get tenure. It wasn't that I could go back to this other stuff on burnout until till I had my tenure and did research for years and years is not my thing I really enjoyed, but anyway, got it to the measure that was really good. Send it off to a journal immediately sent back. We don't publish pop psychology, you know, and that's what they thought this work was. That's what they thought this work was. And it was like they didn't even read it. And all the data analyses, all the people that we involved, you know, you know, all this kind of so it took a while to even get it taken seriously as something in academia, you know, you know, then in the research publishing, you know, kind of arena I was in. So for a while, you know, you don't didn't have a sense that people were paying attention to it. Are they paying attention today? I think they're paying more attention to the fact that so many people are talking about it and saying we have an issue. I think what they haven't got straight is what they think the problem is and what do we do about it? And so that's why I keep getting these complaints from people who are just always being told it's you, you've got to be more resilient, you've got to take better care of yourself if you're having, you know, it comes across in a patronizing way like honey, you just have to do a better job of taking care of yourself, you know, resilient is becoming a bad word for a lot of people because it's essentially saying you don't have that and that's the thing you need to have in order to be successful. And you know, the job is just going to be what it is and if you can't take it, then I mean, I'm sorry, you know, that's your problem. You have an epidemic of burnout. Yeah, you know, and in some sense, we're not sort of saying that's telling us something else or should be it's that's why I'm using the canary in the coal mine analogy because I'm seeing burnout as a signal, things are heading in the wrong direction for a supportive, energetic, inspiring workplace that gets the best out of the people that they hire to come in and do that work and it could be better. There's a phenomenon that I've heard of in different organizations called gross. Have you heard of that? GROSS get rid of stupid stuff and basically they're saying there are things that really do not make sense that we're doing this or there's easier ways to get that information rather than having this done. Or we could, you know, change the rotation and, you know, in a way that would give people who just had a really difficult time with, you know, patients some time off. So it's really a much more of a, it should be much more of a we process rather than just me because my work is interconnected in different ways and we've got to sort of figure out, you know, what are the things we need to get done? How can we help each other out? Can we get rid of the stupid stuff that gets in the way? There are things that we really don't need to do that are not important so that we can focus on the important stuff. There's a lot of options. There's probably, you know, for each pebble in your shoe could come up with what five, 10 different solutions. It should be that you're trying to hire the best people and get the best work out of them and, you know, that's your goal. That's, you know, and to make it run and work, you know. But if they're going back to the same environment, it's like it's sending the canary back down into the mind without having done anything about the fumes. Professor Christina Maslak, I've really enjoyed speaking with you. Thank you. I've had a great time talking with you. Having worked in the ER almost as long as Professor Maslak has been doing research on burnout, I can attest that healthcare has a lot of stupid stuff to get rid of. Your plea for better patient care through teamwork should be a rallying cry for us. That's our show this week. Our email address is [email protected]. And in case you missed it, the first episode for 2026 of our sister podcast, The Dose, had Canadian researcher and Christina Maslak's long-time collaborator, Michael Lighter. We asked him the question, "Why do I need to know about burnout?" Whitecoat Black Art was produced this week by Samir Chopra, Jennifer Warren and me, with help from Stephanie Dubois and Andrea Belmere. Our digital producers Ruby Buiza and our senior producers Colleen Ross. I'm Brian Goldman, and I'm proud to bring you stories from the Canadian side of the gurney. See you next week. For more CBC podcasts, go to cbc.ca/podcasts.