Changes in the burnout profile of chairs of academic departments of obstetrics and gynecology over the past 15 years

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

Healthy And Unhealthy Lifestyles As Factors Of Occupational Burnout In Obstetrics And Gynecology Physicians

This article investigates healthy and unhealthy lifestyles and its components (physical activity, drinking alcohol, consumption of caffeinated products, tobacco use) as factors of occupational burnout in obstetrics and gynecology physicians. Material and Methods. A total of 132 physicians and nurses from the different clinics of Irkutsk were surveyed. We used Maslach Burnout Inventory (MBI), SF-12, and Godin Leisure-Time Exercise Questionnaire. Results: Differences in healthy and unhealthy lifestyles between physicians and nurses employed in obstetrics and gynecology, with or without a high burnout, were revealed. According to the obtained results, the frequency of alcohol consumption was directly related to burnout. In study subjects engaged in low and moderate physical activity, burnout occurred briefly or rarely. The differences became more pronounced when we excluded physicians and nurses with poor physical health from consideration, because they did not exercise much. According to the results of logistic regression, the probability of burnout and reduced level of quality of life among physicians and nurses increased with a bigger family size, lower work experience, and less time spent on moderate physical activity. Conclusion: Healthy and unhealthy lifestyles can cause healthcare employee burnout. Physicians and nurses with a high burnout consumed stronger alcohol and spent less time in moderate physical activity.

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis

BACKGROUND

Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada.

STUDY DESIGN

We systematically reviewed MEDLINE, Embase, and PsycINFO for studies assessing surgeon burnout from January 1981 through September 2021. Changes in dichotomized Maslach Burnout Inventory scores and mean subscale scores over time were assessed using multivariable random-effects meta-regression.

RESULTS

Of 3,575 studies screened, 103 studies representing 63,587 individuals met inclusion criteria. Publication dates ranged from 1996 through 2021. Overall, 41% of surgeons met criteria for burnout. Trainees were more affected than attending surgeons (46% vs 36%, p = 0.012). Prevalence remained stable over the study period (-4.8% per decade, 95% CI -13.2% to 3.5%). Mean scores for emotional exhaustion declined and depersonalization declined over time (-4.1 per decade, 95% CI -7.4 to -0.8 and -1.4 per decade, 95% CI -3.0 to -0.2). Personal accomplishment scores remained unchanged. A high degree of heterogeneity was noted in all analyses despite adjustment for training status, specialty, practice setting, and study quality.

CONCLUSIONS

Contrary to popular perceptions, we found no evidence of rising surgeon burnout in published literature. Rather, emotional exhaustion and depersonalization may be decreasing. Nonetheless, burnout levels remain unacceptably high, indicating a need for meaningful interventions across training levels and specialties. Future research should be deliberately designed to support longitudinal integration through prospective meta-regression to facilitate monitoring of trends in surgeon burnout.

Training Surgery Residents to be Leaders: Construction of a Resident Leadership Curriculum

SUMMARY

Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plastic surgery residents who had served as chief residents before plastic surgery training. Their maturity emotionally and surgically allowed them to immediately concentrate on the new language and principles of plastic surgery. They had led others and were capable of leading themselves in a new surgical discipline. Today, medical students typically match into surgical specialties directly out of medical school and need to spend their time learning basic surgical skills and patient care because of the contracted time afforded to them. Formal leadership training has historically been limited in surgical training. The authors set out to delineate the creation, implementation, and perceptions of a leadership program within a surgical residency and provide guideposts for the development of engaged, conscious, and dedicated leaders within the residencies they lead.

Gynecologic Surgery and Obstetrics Leadership Roles in Academic Military Treatment Facilities by Subspecialty and Gender

INTRODUCTION

Gender distribution in academic ob-gyn leadership positions has previously been examined in the civilian sector, but not in military medicine.

OBJECTIVE

To characterize the distribution of department-level leadership positions by gender and subspecialty in academic military facilities in comparison to those reported in the civilian sector.

METHODS

This is an observational cross-sectional study. We queried military obstetrics and gynecology (ob-gyn) specialty consultants, for title and gender of personnel assigned to academic military treatment facilities. Roles were characterized by gender and subspecialty, and the proportion of female leaders was compared to published civilian leadership data.

RESULTS

Women comprised 25% of Department Chairs, 45% of Assistant Chairs, and 42% of Division Directors. In educational leadership roles, women comprised 25% of Residency Program Directors, 0% of Fellowship Directors, and 62% of medical Student Clerkship Directors. Female department chairs were most often uro-gynecologists (44%) followed by specialists in ob-gyn (37%). Most female residency program directors were specialists in general obstetrics and gynecology. The proportion of women in leadership roles in military departments was not different than in the civilian sector.

CONCLUSION

In contrast to civilian academic leadership positions, Department Chairs were most likely to be uro-gynecologists. Similar to civilian programs, women remain underrepresented as chairs, Assistant Chairs, Fellowship Directors, and Division Directors and similarly represented as Residency Program Directors. Despite a smaller pool of women available to fill academic leadership positions in military ob-gyn departments, the proportion of women in leadership roles reaches parity with the civilian sector. This suggests that a greater proportion of women rise to leadership positions in military academic ob-gyn departments than in the civilian sector.

Prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era of COVID-19 in China

Few people have paid attention to community epidemic prevention workers in the postpandemic era of COVID-19. This study aimed to explore the prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era. Mental health status was evaluated by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Chinese Perceived Stress Scale, Insomnia Severity Index, and Maslach Burnout Inventory-General Survey. The results showed that a considerable proportion of community epidemic prevention workers reported symptoms of depression (39.7%), anxiety (29.5%), high stress (51.1%), insomnia (30.8%), and burnout (53.3%). The prevalence of depression and anxiety in community epidemic prevention workers was higher than in community residents. Among community epidemic prevention workers, short sleep duration was a risk factor for depression, anxiety, high stress and insomnia. Concurrent engagement in work unrelated to epidemic prevention and current use of hypnotics were risk factors for depression, anxiety and insomnia. Our study suggests that during the postpandemic era, the mental health problems of community epidemic prevention workers are more serious than those of community residents. Several variables, such as short sleep duration and concurrent engagement in work unrelated to epidemic prevention, are associated with mental health among community epidemic prevention workers.

Curbing Burnout Hysteria With Self-Compassion: A Key to Physician Resilience

BACKGROUND

Never before has physician suffering received as much attention in the peer-reviewed medical literature and popular media as now. The purpose of this paper is to propose that the manner in which these concerns are being addressed is further complicating physician and medical family well-being due to the perpetuation of work ambivalence.

METHODS

A search of the English literature was conducted using PubMed to identify papers addressing physician burnout and other forms of psychosocial suffering. In addition, a review of case records from the past 40 years of clinical experiences as counselors and life coaches to physicians and their life mates was conducted.

RESULTS

Reported levels of physician burnout and psychosocial morbidity have escalated over the past 10 years, as have clinically observed levels of work/life conflict expressed both by physicians and their spouses.

DISCUSSION

We contend that the contemporary rhetoric addressing physicians' psychosocial experience is yielding the iatrogenic effect of promoting work ambivalence, which is a key building block in fostering physician burnout and its sequelae. We propose that curbing physician burnout requires a combination of empathy about the plight of physicians today, compassion that fuels workplace redesigns and family support, and self-compassion on the part of individual physicians.

CONCLUSIONS

Both clinical experience and research suggest that physician well-being can be enhanced by coaching physicians to protect positive engagement in their work while practicing resilience-enhancing tactics and strategies.

Factors associated with burnout syndrome in surgeons: a systematic review

INTRODUCTION

To date, studies have shown a high prevalence of burnout in surgeons. Various factors have been found to be associated with burnout, and it has significant consequences personally and systemically. Junior doctors are increasingly placing their own health and wellbeing as the most important factor in their decisions about training. Finding ways to reduce and prevent burnout is imperative to promote surgical specialties as attractive training pathways.

METHODS

The MEDLINE, PsychInfo and EMBASE databases were searched using the subject headings related to surgery and burnout. All full text articles that reported data related to burnout were eligible for inclusion. Articles which did not use the Maslach Burnout Inventory or included non-surgical groups were excluded; 62 articles fulfilled the criteria for inclusion.

FINDINGS

Younger age and female sex tended to be associated with higher levels of burnout. Those further in training had lower levels of burnout, while residents suffered more than their seniors. Burnout is associated with a lower personal quality of life, depression and alcohol misuse. Academic work and emotional intelligence may be protective of burnout. Certain personality types are less likely to be burnt out. Mentorship may reduce levels of burnout.

CONCLUSIONS

Workload and work environment are areas that could be looked at to reduce job demands that lead to burnout. Intervening in certain psychological factors such as emotional intelligence, resilience and mindfulness may help to reduce burnout. Promoting physical and mental health is important in alleviating burnout, and these factors likely have a complex interplay.

Moving From Physician Burnout to Resilience

We contend that work ambivalence is a key building block in fostering physician burnout and its sequalae, while engagement in meaningful work and receiving family support for that work enhances resilience. No singular approach to curbing burnout in OBGYN physicians has received empirical support. Clinical experience suggests that curbing physician burnout requires a combination of workplace redesigns, positive leadership behaviors, and resilience training that teaches practical applications from the fields of resilience, emotional intelligence, positive psychology, and relationship systems. This paper highlights organizational and leadership interventions that foster physician engagement, and describes how physicians can foster personal and family resilience.

The Impact of Burnout on the Obstetrics and Gynecology Workforce

Although there has been discussion of a shortage of surgical specialties including OB/GYN, consensus is difficult because of the multiple variables involved in estimating both supply and demand. In addition, burnout has become more recognized as a variable that has not been taken into account in estimating a shortage of OB/GYNs. We estimate OB/GYN physician shortages of 17%, 24%, and 31% by 2030, 2040, and 2050, respectively. Here, we examine the impact of burnout on the OB/GYN workforce. Specifically, we address the associations of burnout, reduction in clinical productivity as well as early retirement. We also discuss the implications of the substantial increase of female OB/GYNs to ∼66% of workforce over the next 10 years and how this may impact the impending OB/GYN shortage. Finally, we briefly consider possible solutions to workforce issues causing burnout.

Burnout in Chairs of Academic Radiology Departments in the United States

OBJECTIVE

We aimed to estimate the self-reported prevalence of burnout in chairs of academic radiology departments in the United States and identify factors associated with high burnout in chairs.

MATERIALS AND METHODS

An anonymous cross-sectional online survey was conducted of members of the Society of Chairs of Academic Radiology Departments. Burnout was measured using the abbreviated Maslach Burnout Inventory Human Services Survey. Associations between survey participants' characteristics and burnout were tested using Fisher's exact test and Wilcoxon rank sum test.

RESULTS

Of the 123 chairs invited to complete the survey, 87 responded (response rate, 71%). The mean age of the participants was 58 years. The survey respondents had an average of 9 years of experience as department chair. The average number of work hours per week was 62 hours. Four participants (5%) of the academic chairs met all three criteria for high burnout including high emotional exhaustion, high depersonalization, and low personal accomplishment. Thirty-three participants (38%) had high emotional exhaustion and/or high depersonalization score. Low professional satisfaction score, low work-life balance satisfaction score, and low chair effectiveness score were significantly associated with high burnout. High emotional exhaustion and/or high depersonalization were significantly associated with numerous professional stressors. Lack of an institutional support group for chairs and lower number of faculty members in the department were significantly associated with burnout.

CONCLUSION

A significant proportion of chairs of academic radiology departments are experiencing 1 or more symptoms of burnout. Efforts to address burnout in radiology chairs should be initiated promptly at the national, institutional, and departmental levels.

Academic physicians as factory workers: identifying and preventing alienation of labor

Recent changes in the culture of academic obstetrics and gynecology have increased the potential for disconnect between physicians and their patients. These changes include increased emphasis on productivity, burgeoning bureaucracies for purposes of compliance, arbitrary clinical goals such as low cesarean delivery rates, the electronic medical record, and lack of respect. These changes are predatory on professionalism when they alienate obstetrician-gynecologists from their patients. The concepts of alienated labor and non-alienated labor in the political philosophy of Karl Marx can be used to explain this alienation. We identify alienated labor by analogy to factory workers who perform routinized, thoughtless tasks for goals they do not set to create profit for others, the factory owners. We identify non-alienated labor by analogy to skilled craftsmen who use their highly advanced skills guided by deep experience to fully own the products of their labor. We then suggest that academic physicians are at increasing risk of becoming factory workers and experiencing decreased professionalism while their colleagues in private practice are better positioned to experience non-alienated labor and sustained professionalism. Based on this analysis, we propose five remedies to prevent alienated labor in academic obstetrics and gynecology: expanding the concept of rewarding productivity to include excellence in clinical care and teaching; critical appraisal of the compliance culture and the large bureaucracy it now seems to require; setting evidence-based and therefore clinically realistic goals such as a lower cesarean delivery rate; reforming the medical record to return to the original purpose of the record of promoting communication among care teams with data extraction for billing a secondary purpose; and creating an organizational culture that respects the contributions of clinical academic obstetricians to the mission of their department and medical school. We close by calling on academic leaders in the specialty to work with their clinical practice and teaching colleagues to identify and prevent alienation of labor in academic obstetrics and gynecology.