by Lois Baldwin Southern, D.C.

What is Burnout? - The word "burnout" has become a very popular word and one that seems to crop up in all avenues of employment. We hear about it in the ministry, in the healing professions, in the teaching profession and it even extends into the factory and general office staff. Among non human-service workers, it is usually referred to as "job stress" or "blue collar blues." In this article, we will use the term "burnout" in reference to people who are serving other people most of the working day.

Just what does the term "burnout" mean? Dr. Sumner Garte defines it as "a specific response by a personality to a particular form of job stress. unless you have been on fire, you can't burn out!" The World Book Dictionary describes it as "using oneself up "using oneself up physically or mentally, exhausting one's store of energy, ambition or ideas; or used up, extinguished, exhausted, an apathetic burned out individual."

In a recent radio broadcast, Charles R. Swindoll, Senior Pastor of the First Evangelical Free Church in Fullerton, California, described a condition which he calls an "achievement addiction" which bears all the earmarks of burnout. He states that, "Success may be yesterday's nest from which the birds have flown." Read that one over again and ponder its meaning. Doesn't that pretty well describe the successful practitioner who is still not satisfied with his practice or life in general? Dr. Swindoll refers to it as a size addiction or a growth addiction. He goes on to say that size may not mean God has blessed our ministry (practice). Ask yourself, "Does my practice have to be bigger next year?" If so, why must it be bigger? Will I be content if it's not bigger each year? Are these goals (that I have set for my practice) MY goals or HIS goals? What I consider as wasted time when my practice slows down, Dr. Swindoll suggests, may be the very time God has chosen to renew my spiritual life and teach me more about Himself.

Burnout is a state of fatigue or frustration caused by being devoted to someone or something that failed to meet our expectations or failed to provide us with the reward which we expected. It is found among high achievers who always want to be at the top. I have talked with several professionals who have been in the work force long enough to have either suffered from burnout or have learned how to avoid it. When I asked for a definition of burnout, there seemed to be one common denominator in their definition, and that was a "a reaction to stress." Stress in noted by over involvement which leads to burnout and a sense of hopelessness and a lack of meaning of life. This stress can be in as many different forms as there are jobs; but paramount in their answers of the cause of stress was the statement: "this job wasn't what I expected."

What Causes Burnout: Am I Vulnerable?

If stress causes burnout, what is causing the stress? If failure to meet our expectations causes burnout, what expectations are involved? Let's look at this in our own profession. We see more and more chiropractors with burnout, those stating they would not want heir children to go into chiropractic. Are those professionals in the people-serving careers more vulnerable than those in non people-serving jobs? Perhaps they are. We are more vulnerable because our reward systems are very different than for others. For example, we really have no way of knowing when we have successfully completed a task. We have no specific end product; because the results we achieve are not base on the amount of word we do. We sometimes spend more time on the patient whose response is the least satisfactory. When human lives are involved, perfection is expected; while mistakes can often be tolerated in other lines of work. And of course, there is always the threat of malpractice.

Are chiropractors more vulnerable than other people-serving professionals? Of course, most of our stress is caused by the same type of adverse circumstances and work load as any other doctor. But we do have an added source of frustration, ie., "Acceptance." We have worked long years for our degree to practice chiropractic and we therefore expect people to look at us on a par with other health professionals. This touches on the :failure of expectations: mentioned earlier. It may appear on the surface that now that chiropracic is widely accepted in all the states, this is no longer a problem. but look at this a little more deeply. When I graduated in 1949, I wanted acceptance by the public, as does every young chiropractor of today. But I was lead to believe that this would not be the case. I was ridiculed, criticized and laughed at by my colleagues in pre-med college, and college professors encouraged me to to into some other profession before I even entered chiropractic college. Even pastors did not want their car to be seen parked in front of the chiropractor's office. so I had no expectations of prestige.

But there was one group of people who did not ridicule me or condemn me for wanting to be a chiropractor. The patients and the families of those whose lives had been saved by chiropractic care gave me ample encouragement. These were the people who inspired me to go into chiropractic. I didn't expect prestige, money, a Cadillac or even to be accepted by the church. All I wanted to do was help those who were suffering who no one else had been able to help. Therefore, as long as I kept my mind on these patients, I did not feel frustrated from the lack of acceptance by other.

But in many instances, the young chiropractor of today expects the prestige, the acceptance, and a church that will meet him with open arms. And in many instances, he will receive all this; but not always. About the time he thinks he is on a par with the medical profession, he crashes head-on with the insurance companies. He quickly learns that in most instances, he in not paid on the same basis as the medical doctor. He also begins to notice that he is being paid thirty-five dollars for an adjustment that gets the patient well, while the MD nest door is getting paid $500 for shot that may even threaten the patients life.

Another source of frustration is: When do I refer? In other professions, when a patient is referred to another specialty, he will be sent back to the referring doctor. Usually the chiropractor knows that when he refers out, he will not see that patient again unless the patient returns on his own. This creates a dilemma for the chiropractor. He may know that the patient's condition will be improved by chiropractic care, but he may have discovered an abnormality that he feels needs to be taking care of fist by another professional.

Many times we face the problem of trying to live up to our patient's expectations of us. If it's a fellow church member we are caring for, somehow we sense that a lot more is expected of us. And when there are fantastic results, we often do not receive the applause we feel is due us.

I remember the patient who told me early in my practice that if I could stop the pain from his ulcers, he would pay me a thousand dollars. Of course, I didn't expect a thousand dollars when, a week later, he was pain free; but I did expect him to pay the meager fee which he owed. He didn't.

Unfortunately, we usually only see patients when they are in pain or are suffering. Many times when they get well, they just don't come back. Sometimes we never know if they quit because they were dissatisfied or because they were no longer in pain. Therefore we do not have our expectations of appreciation met.


1. Sumner H. Garte, PHD; The Cost of Caring; ICA International Review of Chiropractic, July/August 1987.
2. Ibid.
3. Malcolm Smith; Spiritual Burnout, (Tulsa, Oklahoma, Honor, A Division of Harrison House, Inc.), p.11.
4. Erwin W. Lutzer, Burnout in the Ministry, Moody (Moody Bible Institute, Chicago, IL, July/August, 1985, p. 57.
5. Sumner H. Garte, PHD; The Cost of Caring, ICA International Review of Chiropractic, July/August 1987, p.9.