array:24 [
  "pii" => "S2254887420300503"
  "issn" => "22548874"
  "doi" => "10.1016/j.rceng.2020.01.003"
  "estado" => "S300"
  "fechaPublicacion" => "2020-08-01"
  "aid" => "1805"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "edi"
  "cita" => "Rev Clin Esp. 2020;220:354-5"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0014256520300588"
      "issn" => "00142565"
      "doi" => "10.1016/j.rce.2020.01.004"
      "estado" => "S300"
      "fechaPublicacion" => "2020-08-01"
      "aid" => "1805"
      "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "edi"
      "cita" => "Rev Clin Esp. 2020;220:354-5"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "&#191;Has pensado alguna vez que ya no sirves como m&#233;dico&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "354"
            "paginaFinal" => "355"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Have you ever thought that you are no longer fit to be a physician&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "J&#46; Canora Lebrato, R&#46; Barba Mart&#237;n"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Canora Lebrato"
              ]
              1 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Barba Mart&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2254887420300503"
          "doi" => "10.1016/j.rceng.2020.01.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300503?idApp=WRCEE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256520300588?idApp=WRCEE"
      "url" => "/00142565/0000022000000006/v1_202007290630/S0014256520300588/v1_202007290630/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2254887420300552"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2019.11.009"
    "estado" => "S300"
    "fechaPublicacion" => "2020-08-01"
    "aid" => "1773"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "edi"
    "cita" => "Rev Clin Esp. 2020;220:356-8"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Clinical stability in heart failure&#46; Myth or reality"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "356"
          "paginaFinal" => "358"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Estabilidad cl&#237;nica en la insuficiencia cardiaca&#46; Mito o realidad"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;I&#46; P&#233;rez Calvo, J&#46; Rubio Gracia"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "J&#46;I&#46;"
              "apellidos" => "P&#233;rez Calvo"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Rubio Gracia"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256519303017"
        "doi" => "10.1016/j.rce.2019.11.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256519303017?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300552?idApp=WRCEE"
    "url" => "/22548874/0000022000000006/v2_202102250828/S2254887420300552/v2_202102250828/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2254887420300473"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2019.11.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-08-01"
    "aid" => "1782"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "edi"
    "cita" => "Rev Clin Esp. 2020;220:352-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "The challenge of following up patients with heart failure after discharge&#46; Are specific management programs needed&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "352"
          "paginaFinal" => "353"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El reto del seguimiento del paciente con insuficiencia cardiaca tras el alta&#44; &#191;son necesarios programas de gesti&#243;n espec&#237;ficos&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Gonz&#225;lez-Franco, L&#46; Manzano"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Gonz&#225;lez-Franco"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Manzano"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256520300023"
        "doi" => "10.1016/j.rce.2019.11.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256520300023?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300473?idApp=WRCEE"
    "url" => "/22548874/0000022000000006/v2_202102250828/S2254887420300473/v2_202102250828/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Have you ever thought that you are no longer fit to be a physician&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "354"
        "paginaFinal" => "355"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "J&#46; Canora Lebrato, R&#46; Barba Mart&#237;n"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "J&#46;"
            "apellidos" => "Canora Lebrato"
            "email" => array:1 [
              0 => "jesus.canora@salud.madrid.org"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Barba Mart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Medicina Interna&#44; Hospital Universitario Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Medicina Interna&#44; Hospital Universitario Rey Juan Carlos&#44; M&#243;stoles&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Has pensado alguna vez que ya no sirves como m&#233;dico&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We are sure we have all had this feeling at some point&#46; Although we have no doubt that we should be the linchpin for managing the current problems that healthcare systems face &#40;chronicity&#44; frailty&#44; limited resources&#44; equity&#41;&#44; the day-to-day of an internist is tough&#46; We all know what it is to work on an inpatient ward in the winter months&#44; or to manage the holidays without being able to reduce our patient care activity because we are dependent on Emergency Department consultation rates&#44; or to care for complex patients of all ages who have passed through multiple specialists who have not solved their problem&#46; In most cases&#44; we do not solve it either&#44; but our idiosyncrasy allows us to live with uncertainty&#44; even though we can only partially alleviate the symptoms of a disease or&#44; in rare cases&#44; cure it definitively&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The frustration that arises from these circumstances begins to contaminate our routine clinical practice&#44; leading to a pessimistic and skeptical response in the exercise of our profession that can progress to a feeling of professional failure&#44; loss of self-esteem&#44; and depersonalization&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Among healthcare professionals&#44; like in other professions that work with people&#44; the onset of burnout syndrome is common&#46; Although its exact prevalence is not known&#44; some assert that it affects more than half of professionals in the medical field&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> This uncertainty is in part due to the fact that there is no single definition of the problem and that it is unknown what the most relevant symptoms are&#44; how to diagnose it&#44; and what its treatment should be&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The Maslach Burnout Inventory &#40;MBI&#41; survey is the most commonly used instrument for detecting this syndrome&#46; Some find that it is more effective to investigate a few sections of the survey rather than complete it in its entirety&#44; especially if the investigation is focused on the domains of emotional exhaustion&#44; depersonalization&#44; and personal accomplishment&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Nevertheless&#44; there is no consensus on the utility of the MBI among healthcare professionals&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The consequences of burnout syndrome are severe and cause problems among all actors involved in healthcare&#46; In regard to physicians themselves&#44; the use of illicit drugs&#44; depression&#44; suicidal tendencies&#44; and even traffic accidents increase&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;6</span></a> Although it can manifest in the form of organic diseases and psychiatric disorders&#44; it has not been determined at what point in time the risk of onset of these complications in professionals increases nor what other factors may have an influence on them&#46; In addition&#44; the syndrome can mask a latent depressive syndrome that requires a different approach&#46; With respect to the healthcare system itself&#44; the productivity of physicians decreases&#44; professional turnover increases&#44; and&#44; ultimately&#44; costs increase&#46; However&#44; in regard to patients&#44; there is no consensus&#46; The majority of published works report that physician burnout decreases quality of care&#44; increases frequency of errors&#44; decreases patient satisfaction&#44; and prolongs recovery times&#46; However&#44; a study has recently been published by members of the Stanford University School of Medicine which recognizes that burnout is indeed associated with lower-quality medical care&#44; but also indicates that the published studies are very heterogeneous and that&#44; as such&#44; it would be desirable to establish what the true reality of this relationship is&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">A work entitled &#8220;Burnout syndrome among internal medicine specialists&#58; prevalence and factors associated with its onset&#8221; is published in this issue of Revista Cl&#237;nica Espa&#241;ola&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> It presents the results of a survey administered to Spanish internists that investigates these aspects of physician burnout&#46; A total of 934 physicians participated&#59; the median age was 40 years and more than a third were younger than 35 years of age&#46; One out of every three internists had experienced physician burnout syndrome&#46; Job insecurity was one of the aspects that was most identified as being responsible for burnout&#46; This fact may explain why it was more frequent among young internists&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The approach to physician burnout must combine individual and organizational strategies in order to increase resilience and well-being among physicians&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Numerous measures&#44; which have generally focused on effecting change in people&#44; have been attempted&#46; However&#44; there are experiences that have demonstrated that the broader the approach&#44; the better the results&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> As the authors also indicate&#44; the possible solutions for counteracting this syndrome include&#44; first and foremost&#44; recognizing the problem&#46; For this&#44; we must attempt to standardize the definition of the syndrome and create assessment tools that explore the origin of stress-provoking situations&#8212;whether job-related or otherwise&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Furthermore&#44; it is necessary to restructure departments to try to improve professionals&#8217; working conditions and&#44; very importantly&#44; develop training programmes for the appropriate management of stressful situations&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In short&#44; we have to rehumanize healthcare systems&#44; but not just from the patients&#8217; perspective&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">What can we do individually to avoid the onset of burnout syndrome&#63; We can feel fortunate to go to a job in which we can help our patients to have a better physical&#44; mental&#44; and social health&#46; Easy&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Canora Lebrato J&#44; Barba Mart&#237;n R&#46; &#191;Has pensado alguna vez que ya no sirves como m&#233;dico&#63; Rev Clin Esp&#46; 2020&#59;220&#58;354&#8211;355&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El s&#237;ndrome de desgaste profesional Burnout en m&#233;dicos mexicanos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;I&#46; Hern&#225;ndez-Vargas"
                            1 => "M&#46;E&#46; Dickinson"
                            2 => "M&#46; &#193;ngel"
                            3 => "F&#46; Ortega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Fac Med UNAM"
                        "fecha" => "2008"
                        "volumen" => "51"
                        "paginaInicial" => "11"
                        "paginaFinal" => "14"
                        "itemHostRev" => array:3 [
                          "pii" => "S019096222030548X"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physician burnout &#8211; a serious symptom&#44; but of what&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;L&#46; Schwenk"
                            1 => "K&#46;J&#46; Gold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2018.11703"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2018"
                        "volumen" => "320"
                        "paginaInicial" => "1109"
                        "paginaFinal" => "1110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30422283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The problems with burnout research"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Eckleberry-Hunt"
                            1 => "H&#46; Kirkpatrick"
                            2 => "T&#46; Barbera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ACM.0000000000001890"
                      "Revista" => array:7 [
                        "tituloSerie" => "Acad Med"
                        "fecha" => "2018"
                        "volumen" => "93"
                        "paginaInicial" => "367"
                        "paginaFinal" => "370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28817432"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962218322023"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Moderating role of job satisfaction on turnover intention and burnout among workers in primary care institutions&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "X&#46; Chen"
                            1 => "L&#46; Ran"
                            2 => "Y&#46; Zhang"
                            3 => "J&#46; Yang"
                            4 => "H&#46; Yao"
                            5 => "S&#46; Zhu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12889-019-7894-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2019"
                        "volumen" => "19"
                        "paginaInicial" => "1526"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31727027"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962219327495"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Work stress&#44; burnout&#44; and perceived quality of care&#58; a cross-sectional study among hospital pediatricians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Weigl"
                            1 => "A&#46; Schneider"
                            2 => "F&#46; Hoffmann"
                            3 => "P&#46; Angerer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00431-015-2529-1"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Pediatr"
                        "fecha" => "2015"
                        "volumen" => "174"
                        "paginaInicial" => "1237"
                        "paginaFinal" => "1246"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25846697"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962220307088"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physician burnout&#58; contributors&#44; consequences and solutions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;P&#46; West"
                            1 => "L&#46;N&#46; Dyrbye"
                            2 => "T&#46;D&#46; Shanafelt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/joim.12752"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Intern Med"
                        "fecha" => "2018"
                        "volumen" => "283"
                        "paginaInicial" => "516"
                        "paginaFinal" => "529"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29505159"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of burnout among physicians a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;S&#46; Rotenstein"
                            1 => "M&#46; Torre"
                            2 => "M&#46;A&#46; Ramos"
                            3 => "R&#46;C&#46; Rosales"
                            4 => "C&#46; Guille"
                            5 => "S&#46; Sen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2018.12777"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2018"
                        "volumen" => "320"
                        "paginaInicial" => "1131"
                        "paginaFinal" => "1150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30326495"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome de burnout en especialistas de medicina internay factores asociados a su desarrollo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Mac&#237;a-Rodr&#237;guez"
                            1 => "D&#46; Mart&#237;n Iglesias"
                            2 => "J&#46; Moreno Diaz"
                            3 => "M&#46; Aranda S&#225;nchez"
                            4 => "G&#46; Ortiz Llaurad&#243;"
                            5 => "A&#46; Monta&#241;o Mart&#237;nez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2019.10.009"
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2020"
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962218322229"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physician burnout&#58; the need to rehumanise health systems"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The Lancet"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(19)32669-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2019"
                        "volumen" => "394"
                        "paginaInicial" => "1591"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31690430"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962219303688"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of a multimodal training programme to improve general practitioners&#8217; burnout&#44; job satisfaction and psychological well-being"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Barcons"
                            1 => "B&#46; Garcia"
                            2 => "C&#46; Sarri"
                            3 => "E&#46; Rodriguez"
                            4 => "O&#46; Cunillera"
                            5 => "N&#46; Parellada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12875-019-21036"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMC Fam Pract"
                        "fecha" => "2019"
                        "volumen" => "20"
                        "paginaInicial" => "155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31718542"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962219328208"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/22548874/0000022000000006/v2_202102250828/S2254887420300503/v2_202102250828/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "72714"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorials"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000006/v2_202102250828/S2254887420300503/v2_202102250828/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300503?idApp=WRCEE"
]
Share
Journal Information
Share
Share
Download PDF
More article options
Editorial
Have you ever thought that you are no longer fit to be a physician?
¿Has pensado alguna vez que ya no sirves como médico?
J. Canora Lebratoa,
Corresponding author
jesus.canora@salud.madrid.org

Corresponding author.
, R. Barba Martínb
a Medicina Interna, Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain
b Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain

Purchase article

For the purchase of this article it is necessary to fill in the following form:

Afganistan
Albania
Alemania
Andorra
Angola
Anguilla
Antartica
Antigua and barbuda
Antillas holandesas
Arabia saudita
Argelia
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgica
Belice
Benin
Bermudas/antillas britanicas
Bhutan
Bolivia
Bosnia y herzegowina
Botswana
Brasil
Brunei darussalam
Bulgaria
Burkina faso
Burundi
Cabo verde
Camboya
Camerun
Canada
Chad
Chile
China
Chipre
Colombia
Comoros
Corea
Costa rica
Cote d´ivoire
Croacia
Cuba
Dinamarca
Djibouti
Dominica
East timor
Ecuador
Egipto
El salvador
Emiratos arabes unidos
Eritrea
Escocia
Eslovaquia
Eslovenia
España
Estados federados de micronesia
Estados unidos
Estonia
Etiopia
Fiji
Filipinas
Finlandia
Francia
Gabon
Gambia
Georgia
Ghana
Gibraltar
Grecia
Grenada
Groenlandia
Guadalupe
Guam
Guatemala
Guayana britanica
Guinea
Guinea ecuatorial
Guinea francesa
Guinea-bissau
Haiti
Holanda
Honduras
Hong kong
Hungria
India
Indonesia
Irak
Iran
Irlanda
Isla bouvet
Isla cocos (keeling)
Isla cook
Isla mauricio
Isla navidad
Isla norfolk
Islandia
Islas caiman
Islas falkland (malvinas)
Islas faroe
Islas georgia del sur y sandwich
Islas heard and mc donald
Islas marshall
Islas northern mariana
Islas salomon
Islas svalbard and jan mayen
Islas turks and caicos
Islas united states minor outlyi
Islas virgenes (britanicas)
Islas virgenes (u.s.a.)
Islas wallis and futuna
Israel
Italia
Jamaica
Japon
Jordania
Kazakhstan
Kenia
Kiribati
Kuwait
Kyrgyzstan
Lesoto
Letonia
Libano
Liberia
Libia arab jamahiriya
Liechtenstein
Lituania
Luxemburgo
Macao
Macedonia
Madagascar
Malasia
Malawi
Maldives
Mali
Malta
Marruecos
Martinica
Mauritania
Mayotte
Mexico
Monaco
Mongolia
Monserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Nicaragua
Niger
Nigeria
Niue
Noruega
Nueva caledonia
Nueva zelanda
Oman
Pakistan
Palau
Panama
Papua new guinea
Paraguay
Peru
Pitcairn
Polinesia francesa
Polonia
Portugal
Posesiones gran bretaña
Posesiones u.s.a.
Puerto rico
Qatar
Reino unido
Republica checa
Republica de africa central
Republica de cabo verde
Republica de congo
Republica de corea
Republica de moldova
Republica democratica de laos
Republica democratica del congo
Republica dominicana
Reunion
Ruanda
Rumania
Rusia
Sahara occidental
Saint kitts and nevis
Samoa
Samoa americana
San marino
San tomas y principe
San vincent and the grenadines
Santa lucia
Senegal
Serbia
Seychelles
Sierra leona
Singapur
Siria
Somalia
Sri lanka
St. helena
St. pierre and miquelon
Sudafrica
Sudan
Suecia
Suiza
Surinam
Swaziland
Tailandia
Taiwan republica de china
Tajikistan
Tanzania
Territorio de indias britanicas
Togo
Tokelau
Tonga
Trinidad and tobago
Tunisia
Turkmenistan
Turquia
Tuvalu
Ucrania
Uganda
Uruguay
Uzbekistan
Vanuatu
Vaticano
Venezuela
Vietnam
Yemen
Yugoslavia
Zambia
Zimbawe
Lebanon
Paises bajos
A coruña
Alava
Albacete
Alicante
Almeria
Asturias
Avila
Badajoz
Balears
Barcelona
Bizkaia
Burgos
Caceres
Cadiz
Cantabria
Castellon
Ceuta
Ciudad real
Cordoba
Cuenca
Girona
Granada
Guadalajara
Guipuzcoa
Huelva
Huesca
Jaen
La rioja
Las palmas
Leon
Lleida
Lugo
Madrid
Malaga
Melilla
Murcia
Navarra
Ourense
Palencia
Pontevedra
Salamanca
Segovia
Sevilla
Soria
Tarragona
Tenerife
Teruel
Toledo
Valencia
Valladolid
Zamora
Zaragoza
-- Not applicable --
I accept to receive information about Elsevier's special products and promotions by email
I accept to receive information about products and special promotions from Elsevier partners by email
I have read and understand the Privacy Policy and Terms and conditions and agree to be bound by all of its terms.
* Required fields
In addition to temporary access to the article, it will be sent by email.
Customer Support
Phone
Calls from Spain
932 415 960
Calls from abroad
+34 932 415 960
Hours from 9 a.m. to 6 p.m. except the months of July and August, which will be from 9 am to 3 pm.
Idiomas
Revista Clínica Española (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?