Paul McNamara is a GP in Glasgow and honorary clinical lecturer at the University of Glasgow
Zara Tebay is a 4th year medical student at the University of Glasgow
The short, dark days matched her mood — dull and grey. The work she once loved now drained her of all energy. She sat at her desk, watching with detached apathy as the vibrant green leaves of summer turned to brittle gold and fell to the cold, damp ground. At the base of the old oak tree, the autumnal detritus gathered — the tree itself, once radiant and full of life, now skeletal and starved.
‘You okay, doctor?’
The voice startled her from her daydream. She managed a faint smile, reaching for the mask of composure she’d worn so often. Outside, another gust of wind swept through the empty branches.*
Burnout doesn’t arrive suddenly. It seeps in quietly — a slow erosion of joy, a fatigue that no weekend can repair. Many doctors recognise it in their patients long before admitting it in themselves.**
In general practice, we often prescribe the advice we fail to follow: to rest, to take time away from work, to protect boundaries. Yet the system we inhabit rewards the opposite — productivity, endurance, self-sacrifice.
The drivers are familiar: rising workload, shrinking resources, and the relentless pressure to deliver more with less.
A BMA survey conducted before the pandemic found that the risk of burnout among GP partners was as high as 88%.1 In 2021, burnout among UK GPs was described as being at ‘crisis level,’2 and recent data from more than 3,000 GP registrars showed that three-quarters were still experiencing symptoms.3
Burnout — defined by the ICD-11 as a response to chronic workplace stress characterised by exhaustion, cynicism, and a sense of ineffectiveness4 — has become an occupational hazard. The drivers are familiar: rising workload, shrinking resources, and the relentless pressure to deliver more with less.
When time to think, connect, or reflect is stripped away, the work risks becoming mechanical. Continuity of care, long known to improve outcomes and even reduce mortality,5 is increasingly difficult to sustain. The irony is that what protects patients — time, trust, consistency — also protects doctors.
In Deep End practices, these pressures intensify. Complex multimorbidity, poverty, and social fragility make continuity both harder and more necessary. The work demands empathy, yet slowly drains the very reserves it requires.
The consequences extend beyond the individual. Burnout erodes clinical curiosity and emotional availability. It heightens the risk of error and detachment. Some doctors withdraw; others push through until they can’t. A few leave altogether.
…lasting change will depend on structural reform — the redistribution of time, trust, and resource. Without that, we will keep losing doctors to the very condition we try to treat in others.
There are no easy fixes. Protected time, meaningful peer support, and realistic workloads are not luxuries — they are conditions for safe practice. Teams that pause together, eat together, or simply acknowledge the strain often cope better. Small acts of humanity can blunt the edges of an unforgiving system.
But lasting change will depend on structural reform — the redistribution of time, trust, and resource. Without that, we will keep losing doctors to the very condition we try to treat in others.
Outside, the oak tree still stands — stripped back, but standing all the same. Its roots hold firm beneath the frost. She wonders if that’s all any of them can do — hold fast until the light of spring returns.
*Deputy editor’s note: The GP in this vignette is fictional but based on the author’s experience and survey of the board general practice literature.
**Readers may also wish to access the following BJGPLife articles on the theme of burnout:
- https://bjgplife.com/balance-boundaries-and-burnout/
- https://bjgplife.com/is-loneliness-the-hpv-of-general-practices-burnout-cancer/
- https://bjgplife.com/not-helpful-but-harmful-competence-expansion-alone-increases-rather-than-decreases-burnout-in-gps/
- https://bjgplife.com/burnout-patient-and-physician-safety/
References
- British Medical Association. Caring for the mental health of the medical workforce. 2019 [cited 24 Sep 2025]. Available from: https://www.bma.org.uk/media/ckshvkzc/bma-mental-health-survey-report-september-2024.pdf
- Whitehead IO, Moffatt S, Jagger C, Hanratty B. A national study of burnout and spiritual health in UK general practitioners during the COVID-19 pandemic. PLoS One 2022; 17(11): e0276739.
- British Medical Association. New BMA survey highlights worrying trends of burnout and future concerns from GP registrars. BMA Press Release 2024 [cited 25 Sep 2025].
- World Health Organization. Burn-Out an “Occupational Phenomenon”: International Classification of Diseases. Geneva: WHO; 2019 [cited 23 Sep 2025].
- Baker R, Freeman GK, Haggerty JL, Bankart MJ, Nockels KH. Primary medical care continuity and patient mortality: a systematic review. Br J Gen Pract. 2020 Aug 27;70(698):e600-e611. doi: 10.3399/bjgp20X712289. PMID: 32784220; PMCID: PMC7425204.
