Levels of burnout in UK general practice are high, suggests a study of general practitioners (GPs) in one area of South East England, published in BMJ Open.

Male doctors, those who work in group practices, and those who repeatedly see the same patients seem to be at significantly greater risk, the research shows, prompting the authors to declare that “a significant group of doctors is in trouble.”

The researchers base their findings on a survey of 564 out of 789 eligible GPs working in the county of Essex, who were assessed for burnout, using a validated measure (the Maslach Burnout Inventory, or MBI).

The MBI assesses burnout by measuring emotional exhaustion; depersonalisation, expressed as negativity and cynicism; and a reduced sense of personal accomplishment.

The results showed that almost one in two of the respondents (46%) fitted the criteria for emotional exhaustion, while more than four out of 10 (42%) were depersonalised. And one in three (34%) felt they were not achieving a great deal.

A high score for one of the components was linked to high scores in the other two.

Male doctors were significantly more likely to be depersonalised than women doctors, as were those who had been qualified under 20 years ago compared with those who had been qualified for longer.

The authors suggest that the gender differences may be explained by a larger number of women doctors working part time or that women doctors are more patient centred than their male colleagues, which may boost professional satisfaction.

Depersonalised doctors were significantly more likely to work in group practices, rather than as single-handers, a finding the authors describe as “disappointing,” given that, in theory, group practice should offer more support.

“The finding could be the result of group practice creating extra demands on practitioners while raising the possibility of interpersonal tensions and conflicts,” suggest the authors: “Regardless of cause, these findings are worrying as group practices are increasing in size and number,” they add.

Depersonalised doctors were also significantly more likely to repeatedly see the same patients.

Burnout, however, did not seem to interfere with doctors’ professionalism. The results of a validated rating survey (DISQ) of 38 doctors, involving almost 1900 patients and 760 consultations, indicated no detrimental impact on their interpersonal skills or patient centredness.

The authors emphasise that their findings relate to doctors in one area of England, so may not be applicable across the UK, but confirm that this is the largest number of GPs ever to complete an MBI.

“Whatever the reasons [for depersonalisation], a significant group of doctors is in trouble,” conclude the authors, citing previous research indicating that GPs who distance themselves as a coping mechanism, evoke, over time, more demanding patients.

The results warrant attention from doctors themselves, their professional bodies, and the NHS, say the authors, warning: “The NHS nationally and locally needs to review its policies, especially when generating increased pressures for this, the largest group of NHS doctors.”

The most read article in December was Crawley et al‘s analysis of Chronic Fatigue System and school absence which was covered by several media outlets including the Telegraph, BBC News, The Guardian and the Nursing Times. Margel and Fleshner’s ecological analysis of oral contraceptive pill use and prostate cancer remained popular and McGlade et al’s study of variations in organ donation – originally published last October – was also in the top ten.

The most read BMJ Open article in November was Margel and Fleshner’s ecological study of the association between oral contraceptive use and prostate cancer. The paper received lots of press attention, with articles in the UK, India, Canada and the US.

Brett et al‘s paper on effective communication with parents of pre-term infants was also popular last month, going from 9th most viewed in October up to 2nd place in November. Overgaard et al‘s study of midwifery units also remained highly viewed.

Click on the titles to view the articles in full.

The most read article in October was Overgaard et al’s comparison of birth outcomes in freestanding midwifery units and obstetric units in Denmark. The article by Holden et al on the costs of prescribing analogue insulin remains highly viewed in second place and McGlade et al’s study of the regional variation in organ donation in the UK received coverage in the UK press.

Click on the titles to view the articles in full.

BMJ Open will be taking part in the The Guardian’s Higher Education Network’s live blog/debate tomorrow on Exploring open access in higher education.

Discussion kicks off at noon, BST and will run until 2 pm. There is a large panel, drawn from publishing, academia, industry and policy.

The event will ’consider the various ways in which higher education can become – and is becoming – more open. We will consider what the challenges ahead might be and what policy shifts, as well as cultural shifts are needed’.

If you can’t follow the discussion then, you can leave a comment or question in advance. Comments made during the chat will be shared on Twitter. The hashtag is #HElivechat

September’s most-accessed articles are topped by the article by Holden et al. on costs to the UK NHS of prescribing analogue insulin. This article prompted some strongly worded responses on our site, and you can read the responses here. The BBC, among others, also covered this research (view their report here).

Click on the titles to view the articles in full.

BMJ Open is proudly sponsoring Open Access Week 2011.

A global event, now in its fifth year, Open Access Week promotes open access as a new norm in scholarship and research. The website currently lists 119 upcoming events so have a look to see what is happening near you or browse their back catalogue of presentations and videos.

BMJ Open is the BMJ Group’s latest involvement with open access publishing, following the BMJ’s long-standing commitment to making its research open access and our specialty journals’ well-established Unlocked programme.

All BMJ Open articles are open access under a Creative Commons licence. As well as Open Access Week, BMJ Open and the BMJ Group also supports the Open Access Scholarly Publishers Association (OASPA) and deposits all its open access content with PubMed Central.

The list of the top 10 most-read articles in BMJ Open in August is topped by a protocol that sets out an implementation research study to assess the surgical scale-up process in the rural district of Achham, Nepal. You can see it here. There are three protocols in the top 10.

The list of the top 10 most-read articles in BMJ Open in July includes some recent content and some older papers. It’s good to see a range of topics covered, and two study protocols included also. Engkilde et al.’s recent paper on the association between cancer and contact allergy received considerable coverage in the press around the world.

We have now published two articles with supplementary data accompanying the article deposited with the Dryad repository: Heneghan et al. on medical device recalls with data here, and Dmello et al. on cystic fibrosis with data here.

Authors can share supplementary data or underlying datasets through Dryad. BMJ Open is the first medical journal to partner with Dryad, an online repository which provides a permanent, citable, and open access online home for datasets related to peer reviewed published articles in biosciences. Data depositiop is integrated with the manuscript submission system.

BMJ Open provides plenty of practical, ethical, and technical guidance on how to share data responsibly here.

Why share data?
Data sharing is increasingly being strongly encouraged by major academic research funders in the UK and the US, such as the Medical Research Council and the National Institutes of Health, for the benefit of both medical science and patients.

Data sharing aims to help scientists and doctors validate and scrutinise researchers’ findings in a bid to prevent fraud and eradicate the kind of selective reporting that has enabled some treatments to acquire regulatory approval, based on incomplete and biased data.

In some cases this lack of transparency has prompted the subsequent restriction or withdrawal of certain treatments because of patient safety or effectiveness concerns, which were already evident in the unpublished data.

Data repositories also allow researchers to develop new methods of analysis and use the data to answer questions that the original researchers have not thought of. They also facilitate the acquisition of data for meta analysis (more in-depth comparative reviews).

Data sharing is widespread in laboratory science, but is a new and more complex issue in medical research, because of the need to protect the privacy of research participants and/or seek their consent before sharing data.