TY - JOUR T1 - Contentment in general practice — for now JF - British Journal of General Practice JO - Br J Gen Pract SP - 5 LP - 6 DO - 10.3399/bjgp08X263730 VL - 58 IS - 546 AU - Thomas O'Dowd Y1 - 2008/01/01 UR - http://bjgp.org/content/58/546/5.abstract N2 - Sources of poor morale and high levels of stress among GPs include our personalities, patients, and the system itself. Prior to the GP Charter in 1966, Cartwright found high levels of stress, discontent, and frustration among UK GPs, which had changed little on follow-up in 1977.1,2 High levels of stress are associated with increased workload which, in turn, leads to poor mental health and burnout in the profession. Maslach et al3 described how in burnout, ‘what started out as important, meaningful, and challenging work becomes unpleasant, unfulfilling, and meaningless. Energy turns into exhaustion, involvement turns into cynicism, and efficacy turns into ineffectiveness’. Burnout is often associated with anxiety and depression but is distinct from both in that burnout presents with work-related rather than physical or biological symptoms. Thankfully, more GPs seem to fear burnout than suffer from it.In an attempt to understand the causal links between stress and burnout McManus et al, in a 3-year longitudinal study of 331 hospital and GPs in the UK surveyed in 1997 and 2000, showed a dynamic pattern to stress and burnout.4 In a vicious circle, emotional exhaustion makes doctors more stressed and stress makes doctors more emotionally exhausted. Interestingly, the cynicism of burnout may be protective against excessive stress, acting as an adaptation and ego defence mechanism. Doctors are high achievers and the risk of burnout is ever present as the drive for achievement increases stress both directly and by increasing emotional exhaustion.GPs often look after distressed … ER -