What is burnout vs. compassion fatigue?

What is the difference between burnout and compassion fatigue?

The three primary characteristics of burnout are: emotional and physical exhaustion; depersonalization, or feelings of cynicism and detachment from one's job; and sense of lack of personal accomplishment, according to Christina Maslach, PhD, professor in the Psychology Department, University of California, Berkeley. Maslach has done a great deal of research on burnout, also known as "a sense of not really getting the job done, " says Michael K. Kearney, MD, an author of a recent paper published in the Journal of the American Medical Association on self-care of physicians.1

Burnout, Kearney says, is generated by stressors related to a physician's work environment, be they work-related stressor or institutional-related stressors, something akin to the administrative hassles or the daily grind. It also can result from the clash of one's personal values with the values of the institution or not feeling as if one has control over his or her work environment, he says.

Compassion fatigue, on the other hand, "is very different," Kearney notes. "Compassion fatigue is what results from stresses generated between the clinician and the patient's suffering." That kind of fatigue also is known as secondary traumatic stress disorder, he says, and it "essentially means that by being close to our patients, physicians, and nurses, in an empathic way, are at risk of being traumatized by the patient's suffering."

Compassion fatigue can lead to burnout and its myriad symptoms. "It's a personal tragedy, but it also leads to a failure of and breakdown in patient care, because of all the features — the exhaustion, the detachment, the cynicism — lead to a clinician who is less engaged, who is detached. So, to be a patient on the receiving end of that is maybe to be on the receiving end of the physician who is still doing the right thing, technically, but who is not able to be present in an engaged, humane, warm way, because they literally don't have it in them anymore," Kearney explains.

That fatigue can lead not only to a question of the quality of patient care, but the effectiveness of patient care over time, he adds.


1. Kearney MK, Weininger RB, Vachon MLS, et al. Self-care of physicians caring for patients at the end of life: 'Being connected ... a key to my survival.' JAMA 2009; 301:1,155-1,164.