Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper.

This study has demonstrated a high prevalence of burnout and factors associated with it among New Zealand psychiatrists. Further research is needed to ascertain why job satisfaction remains high in the presence of burnout, and factors predisposing to, or protective of, burnout.

Research is needed on the long-term effects of work-place stress on psychiatrists, to identify possible protective factors, and to utilize this information to inform the design of interventions that protect or mitigate the effects of work-place stress on psychiatrists.

Crowding was found to be significantly associated with aggressive incidents, and in particular with verbal aggression.

A preliminary profile of the burnout syndrome was established and has a potential role in the prevention of burnout in psychiatrists. Causative factors associated with burnout were identified and supported previous findings. Novel factors protective against burnout were suggested and require further investigation. No differences were apparent between the two subgroups of psychiatrists (high versus low EE).

Most factors associated with burnout are preventable and can be managed jointly between psychiatrists and administrators. Service providers need to address burnout seriously.

Forward relocation of the C-GF complex seems to be one of the mechanisms of action of functional appliances, while the internal anatomic arrangement within the temporomandibular joint (TMJ) complex normalizes to its pre-treatment position.

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