Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T19:54:11.618Z Has data issue: false hasContentIssue false
  • English
  • Français

Physician burnout, a new term, a well-known concept in the medieval era: a thematic review of Ruhawi’s Adab al-Tabib

Published online by Cambridge University Press:  11 November 2019

S. Sadeghi Open the ORCID record for S. Sadeghi [Opens in a new window] ,
F. Ghaffari ,
M-R. Sohrabi  and
G. Heydarirad
S. Sadeghi
Affiliation:
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
F. Ghaffari
Affiliation:
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
M-R. Sohrabi
Affiliation:
Social Determinants of Health Research Center, Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
G. Heydarirad*
Affiliation:
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
*Address for correspondence: Ghazaleh Heydarirad, Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, No.8 Shams Alley, Vali-e-Asr Street, Tehran, Iran. (Email: ghazalrad@yahoo.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

In 1974, Herbert Freudenberger introduced the phrase ‘Burnout in Healing Professional Workers’. Despite the existence of numerous investigations on physician burnout, only a few studies on its historical aspects can be found. This is the first research to present historical evidence on ‘physician burnout’ as pointed out in the book ‘Adab al-Tabib’ written by Ruhawi (9th century AD). He is shown to have an understanding of this concept by talking about job stress in his book, although he offers no exact equivalent definition for this state. In fact, finding an equivalent term to 20th century burnout in a book written a thousand years ago is almost impossible. Most interestingly, the same preventive strategies for physician burnout and its causes as those scientifically discovered in recent years can be evidenced to have been introduced by Ruhawi. Hence, ‘Adab al-Tabib’ is an outstanding work on physician burnout in the medieval era.

Keywords

Adab al-TabibIshaq ibn Ali al-RuhawiIslamic golden agesmedical historyphysician burnout
Type
Perspective Piece
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 4 , December 2022 , pp. 398 - 405
Copyright
© College of Psychiatrists of Ireland 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Ruhawi, I (2008). Adab al-Tabib [Practical Ethics of the Physician]. Iran University of Medical Sciences Publication: Tehran [in Arabic].Google Scholar
Al-Ruhawi, I (2011). Adab al-Tabib [Practical Ethics of the Physician] by Ishaq ibn Ali al-Ruhawi (ed. Anoushiravani, M). Translated by Shariat parsa, MS, Pooti, M, Alimirzaie, M, pp. 38–248. Traditional Iranian Medicine Publication: Tehran [in Persian].Google Scholar
Alexandrova-Karamanova, A, Todorova, I, Montgomery, A, Panagopoulou, E, Costa, P, Baban, A, Mijakoski, D (2016). Burnout and health behaviors in health professionals from seven European countries. International Archives of Occupational and Environmental Health 89, 1059–1075.10.1007/s00420-016-1143-5CrossRefGoogle ScholarPubMed
An, PG, Manwell, LB, Williams, ES, Laiteerapong, N, Brown, RL, Rabatin, JS, Linzer, M, Schwartz, MD, Lally, PJ, Linzer, M (2013). Does a higher frequency of difficult patient encounters lead to lower quality care? The Journal of Family Practice 62, 24–29.Google ScholarPubMed
Anandrajah, G, Hight, E (2001). Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment in office practice. American Family Physician 63, 81–88.Google Scholar
Azam, K, Khan, A, Alam, MT (2017). Causes and adverse impact of physician burnout: a systematic review. Journal of the College of Physicians and Surgeons Pakistan 27, 495–501.Google ScholarPubMed
Banerjee, S, Califano, R, Corral, J, de Azambuja, E, De Mattos-Arruda, L, Guarneri, V, Hutka, M, Jordan, K, Martinelli, E, Mountzios, G, Ozturk, MA, Petrova, M, Postel-Vinay, S, Preusser, M, Qvortrup, C, Volkov, MNM, Tabernero, J, Olmos, D, Strijbos, MH (2017). Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) young oncologists committee burnout survey. Annals of Oncology 28, 1590–1596.CrossRefGoogle ScholarPubMed
Bernburg, M, Vitzthum, K, Groneberg, DA, Mache, S (2016). Physicians’ occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals. BMJ Open 6, e011369.CrossRefGoogle ScholarPubMed
Bhutani, J, Bhutani, S, Balhara, YPS, Kalra, S (2012). Compassion fatigue and burnout amongst clinicians: a medical exploratory study. Indian Journal of Psychological Medicine 34, 332–337.CrossRefGoogle ScholarPubMed
Blume, E (1997). Hippocratic Oath versus managed care: physicians caught in ethical squeeze. Journal of the National Cancer Institute 89, 543–545.CrossRefGoogle ScholarPubMed
Chamsi-Pasha, H, Albar, MA (2016). Doctor-patient relationship: Islamic perspective. Saudi Medical Journal 37, 121–126.CrossRefGoogle ScholarPubMed
Chesanow, N (2017). Does the Hippocratic Oath promote burnout? Medscape (https://www.medscape.com/viewarticle/875993). Accessed 15 March 2018.Google Scholar
Cobb, S (1976). Social support as a moderator of life stress. Psychosomatic Medicine 38, 300–314.10.1097/00006842-197609000-00003CrossRefGoogle ScholarPubMed
Darban, F, Balouchi, A, Narouipour, A, Safarzaei, E, Shahdadi, H (2016). Effect of communication skills training on the burnout of nurses: a cross-sectional study. Journal of Clinical and Diagnostic Research 10, IC01–IC04.Google ScholarPubMed
Doolittle, BR, Windish, DM, Seelig, CB (2013). Burnout, coping, and spirituality among internal medicine resident physicians. Journal of Graduate Medical Education 5, 257–261.CrossRefGoogle ScholarPubMed
Freudenberger, HJ (1974). Staff burn-out. Journal of Social Issues 30, 159–165.CrossRefGoogle Scholar
Friberg, T (2009). Burnout: from popular culture to psychiatric diagnosis in Sweden. Culture, Medicine, and Psychiatry 33, 538–558.CrossRefGoogle ScholarPubMed
Ghaffari, F (2010). A perspective on medical ethics and observance of patient rights in some texts of traditional Iranian medicine and Islam. History of Medicine Journal (Quarterly) 2, 11–45 [in Persian].Google Scholar
Gottlieb, BH (1978). The development and application of a classification scheme of informal helping behaviours. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement 10, 105–115.CrossRefGoogle Scholar
Gundersen, L (2001). Physician burnout. Annals of Internal Medicine 135, 145–148.CrossRefGoogle ScholarPubMed
Győrffy, Z, Dweik, D, Girasek, E (2016). Workload, mental health and burnout indicators among female physicians. Human Resources for Health 14, 12.CrossRefGoogle ScholarPubMed
Halbesleben, JR, Rathert, C (2008). Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Health Care Management Review 33, 29–39.CrossRefGoogle ScholarPubMed
Hannan, E, Breslin, N, Doherty, E, McGreal, M, Moneley, D, Offiah, G (2018). Burnout and stress amongst interns in Irish hospitals: contributing factors and potential solutions. Irish Journal of Medical Science 187, 301–307.CrossRefGoogle ScholarPubMed
Hardavella, G, Aamli-Gaagnat, A, Frille, A, Saad, N, Niculescu, A, Powell, P (2017). Top tips to deal with challenging situations: doctor–patient interactions. Breathe 13, 129–135.CrossRefGoogle ScholarPubMed
Holoshitz, N, Wann, S (2017). Burnout—there’s an app for that: helping physicians deal with job-related stress. JAMA Cardiology 2, 1185–1186.CrossRefGoogle ScholarPubMed
Jafari, F, Alizadeh, F, Mortaz, SSS (2011). Physical and behavioral characteristics of physicians from the perspective of traditional Iranian medicine. Teb va Tazjkiye 20, 17–23 [in Persian].Google Scholar
Jafari, F, Alizadeh, F, Zafarghandi, N (2012). Financial relationship of physician and patient in Traditional Iranian Medicine. Daneshvar 19, 73–80 [in Persian].Google Scholar
Kalani, SD, Azadfallah, P, Oreyzi, H, Adibi, P (2018). Interventions for physician burnout: a systematic review of systematic reviews. International Journal of Preventive Medicine 9, 81.Google ScholarPubMed
Kleiner, S, Wallace, JE (2017). Oncologist burnout and compassion fatigue: investigating time pressure at work as a predictor and the mediating role of work-family conflict. BMC Health Services Research, 17, 639.CrossRefGoogle ScholarPubMed
Lacy, BE, Chan, JL (2018). Physician burnout: the hidden health care crisis. Clinical Gastroenterology and Hepatology 16, 311–317.CrossRefGoogle ScholarPubMed
Larrimore, J (2011). Does a higher income have positive health effects? Using the earned income tax credit to explore the income-health gradient. The Milbank Quarterly 89, 694–727.CrossRefGoogle ScholarPubMed
Lee, BJ, Park, SG, Min, KB, Min, JY, Hwang, SH, Leem, JH, Kim, HC, Jeon, SH, Heo, YS, Moon, SH (2014). The relationship between working condition factors and well-being. Annals of Occupational and Environmental Medicine 26, 34.CrossRefGoogle ScholarPubMed
Levey, M (1967). Medical Ethics of Medieval Islam with Special Reference to Al-Ruhawi’s Practical Ethics of the Physician. American Philosophical Society: Philadelphia.CrossRefGoogle Scholar
Li, H, Zuo, M, Gelb, AW, Zhang, B, Zhao, X, Yao, D, Xia, D, Huang, Y (2018). Chinese anesthesiologists have high burnout and low job satisfaction: a cross-sectional survey. Anesthesia & Analgesia, 126, 1004–1012.10.1213/ANE.0000000000002776CrossRefGoogle ScholarPubMed
Lo, D, Wu, F, Chan, M, Chu, R, Li, D (2018). A systematic review of burnout among doctors in China: a cultural perspective. Asia Pacific Family Medicine 17, 3.CrossRefGoogle Scholar
Maslach, C, Leiter, MP, Schaufeli, W (2008). Measuring burnout. In The Oxford handbook of organizational well being (ed. Cartwright, S and Cooper, CL), pp. 2–4. Oxford University Press: UK.Google Scholar
Oquendo, MA, Bernstein, CA, Mayer, LE (2019). A key differential diagnosis for physicians—major depression or burnout? JAMA Psychiatry. Published online 17 July 2019 (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2737583). Accessed 26 September 2019.Google Scholar
Padela, AI (2007). Islamic medical ethics: a primer. Bioethics 21, 169–178.CrossRefGoogle ScholarPubMed
Penberthy, JK, Chhabra, D, Ducar, DM, Avitabile, N, Lynch, M, Khanna, S, Xu, Y, Ait-Daoud, N, Schorling, J (2018). Impact of coping and communication skills program on physician burnout, quality of life, and emotional flooding. Safety and Health at Work 9, 381–387.CrossRefGoogle ScholarPubMed
Rothenberger, DA (2017). Physician burnout and well-being: a systematic review and framework for action. Diseases of the Colon & Rectum 60, 567–576.CrossRefGoogle ScholarPubMed
Sadeghi, S, Ghaffari, F (2017). Physician’s professional competence exam in Adab al-Tabib. Journal of Islamic and Iranian Traditional Medicine 8, 389–397.Google Scholar
Salmoirago-Blotcher, E, Fitchett, G, Leung, K, Volturo, G, Boudreaux, E, Crawford, S, Ockene, I, Curlin, F (2016). An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in emergency medicine. Preventive Medicine Reports 3, 189–195.CrossRefGoogle ScholarPubMed
Schwenk, TL, Gold, KJ (2018). Physician burnout—a serious symptom, but of what? JAMA 320, 1109–1110.CrossRefGoogle ScholarPubMed
See, KC, Lim, TK, Kua, EH, Phua, J, Chua, G, Ho, KY (2016). Stress and burnout among physicians: prevalence and risk factors in a Singaporean internal medicine programme. Annals of the Academy of Medicine, Singapore 45, 471–474.CrossRefGoogle Scholar
Shenoi, AN, Kalyanaraman, M, Pillai, A, Raghava, PS, Day, S (2018). Burnout and psychological distress among pediatric critical care physicians in the United States. Critical Care Medicine 46, 116–122.CrossRefGoogle ScholarPubMed
Suzuki, S (2017). Exhausting physicians employed in hospitals in Japan assessed by a health questionnaire. Sangyo eiseigaku zasshi= Journal of Occupational Health 59, 107–118.CrossRefGoogle ScholarPubMed
Tarcan, M, Hikmet, N, Schooley, B, Top, M, Tarcan, GY (2017). An analysis of the relationship between burnout, socio-demographic and workplace factors and job satisfaction among emergency department health professionals. Applied Nursing Research 34, 40–47.CrossRefGoogle ScholarPubMed
Van Dierendonck, D, Schaufeli, WB, Sixma, HJ (1994). Burnout among general practitioners: a perspective from equity theory. Journal of Social and Clinical Psychology 13, 86–100.CrossRefGoogle Scholar
Voltmer, E, Spahn, C (2009). Social support and physicians’ health. Zeitschrift fur Psychosomatische Medizin und Psychotherapie 55, 51–69.CrossRefGoogle ScholarPubMed
Wang, Y, Liu, L, Wang, J, Wang, L (2012). Work-family conflict and burnout among Chinese doctors: the mediating role of psychological capital. Journal of Occupational Health 54, 232–240.CrossRefGoogle ScholarPubMed
Wang, Z, Xie, Z, Dai, J, Zhang, L, Huang, Y, Chen, B (2014). Physician burnout and its associated factors: a cross-sectional study in Shanghai. Journal of Occupational Health 56, 73–83.CrossRefGoogle ScholarPubMed
Williams, P (2005). What is social support? A grounded theory of social interaction in the context of the new family. PhD Thesis. University of Adelaide. (https://hekyll.services.adelaide.edu.au/dspace/bitstream/2440/49476/8/02whole.pdf). Accessed: 18 June 2018.Google Scholar
World Health Organization (2019). Burn-out an “occupational phenomenon”: international Classification of Diseases 2019 (https://www.who.int/mental_health/evidence/burn-out/en/). Accessed 1 September 2019.Google Scholar