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Prystowsky MB, Cadoff E, Lo Y, Hebert TM, Steinberg JJ. Prioritizing the Interview in Selecting Resident Applicants: Behavioral Interviews to Determine Goodness of Fit. Acad Pathol 2021; 8:23742895211052885. [PMID: 34722866 PMCID: PMC8552388 DOI: 10.1177/23742895211052885] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/02/2021] [Accepted: 08/07/2021] [Indexed: 12/30/2022] Open
Abstract
From our initial screening of applications, we assess that the 10% to 15% of applicants whom we will interview are all academically qualified to complete our residency training program. This initial screening to select applicants to interview includes a personality assessment provided by the personal statement, Dean's letter, and letters of recommendation that, taken together, begin our evaluation of the applicant's cultural fit for our program. While the numerical scoring ranks applicants preinterview, the final ranking into best fit categories is determined solely on the interview day at a consensus conference by faculty and residents. We analyzed data of 819 applicants from 2005 to 2017. Most candidates were US medical graduates (62.5%) with 23.7% international medical graduates, 11.7% Doctors of Osteopathic Medicine (DO), and 2.1% Caribbean medical graduates. Given that personality assessment began with application review, there was excellent correlation between the preinterview composite score and the final categorical ranking in all 4 categories. For most comparisons, higher scores and categorical rankings were associated with applicants subsequently working in academia versus private practice. We found no problem in using our 3-step process employing virtual interviews during the COVID pandemic.
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Affiliation(s)
| | - Evan Cadoff
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Yungtai Lo
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Tiffany M. Hebert
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Jacob J. Steinberg
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
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Soltan MR, Soliman SS, Al-Hassanin SA, ElSherief WA, Elnaggar MS, Gohar SF. Burnout and work stress among medical oncologists: Egyptian multi-centric study. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00046-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cancer-care health professionals are at great risk of workplace stress and high burnout levels. Only a few studies were studying the prevalence of workplace stress and burnout in medical oncologists in Egypt. The aim of the work is to study the prevalence of burnout levels and work stress among medical oncologists working at multi-centers in Egypt (Cairo, Menoufia, Fayoum, and Assiut university hospitals). A cross-sectional study was conducted on a total of 100 medical oncologists at four medical oncology centers in Egypt. Self-administered Maslach Burnout Inventory (MBI) questionnaire and Workplace Stress Scale (WSS) were used to assess the burnout and stress levels respectively among the participants.
Results
Out of 100 participants, 32% were overall burnout positive as they met the criteria for all the burnout subscales. The percentages of emotional exhaustion, depersonalization, and reduced personal capacity were 30%, 30%, and 25%, respectively. About 60% were having job stress. The present study showed that younger age (≤ 40 years), female gender, being single, with no children, junior physicians (residents or physicians < 10 years in practice), with work time directed to both patient care and research, and those with more than 6 shifts per month were associated with higher burnout and workplace stress.
Conclusion
Medical oncologists experienced high burnout levels and workplace stress. More studies are needed to assess these problems in large scales to try to mitigate them.
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Galaiya R, Kinross J, Arulampalam T. Factors associated with burnout syndrome in surgeons: a systematic review. Ann R Coll Surg Engl 2020; 102:401-407. [PMID: 32326734 PMCID: PMC7388944 DOI: 10.1308/rcsann.2020.0040] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2020] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- R Galaiya
- Barnet, Enfield and Haringey Mental Health NHS Trust
| | - J Kinross
- Department of Surgery and Cancer, Imperial College London, UK
| | - T Arulampalam
- School of Medicine, Anglia Ruskin University, Chelmsford
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Walker AL, Gamble J, Creedy DK, Ellwood DA. Impact of traumatic birth on Australian obstetricians: A pilot feasibility study. Aust N Z J Obstet Gynaecol 2019; 60:555-560. [DOI: 10.1111/ajo.13107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/11/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Andrea L. Walker
- School of Nursing and Midwifery Griffith University BrisbaneQueenslandAustralia
| | - Jenny Gamble
- School of Nursing and Midwifery Griffith University BrisbaneQueenslandAustralia
| | - Debra K. Creedy
- School of Nursing and Midwifery Griffith University BrisbaneQueenslandAustralia
| | - David A. Ellwood
- School of Medicine Griffith University Gold CoastQueenslandAustralia
- Gold Coast University Hospital Gold Coast Queensland Australia
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Williams ES, Rathert C, Buttigieg SC. The Personal and Professional Consequences of Physician Burnout: A Systematic Review of the Literature. Med Care Res Rev 2019; 77:371-386. [DOI: 10.1177/1077558719856787] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The well-being of the health care workforce has emerged as both a major concern and as a component of the “quadruple aim” to enable the “triple aim” of improving patient experiences, reducing costs, and improving population health. Physician burnout is problematic given its effects on physicians, patients, health care organizations, and society. Using conservation of resources theory as a frame, we conducted a systematic review of the empirical literature on the relationship of physician burnout with physician personal and professional outcomes that includes 43 articles. Nine outcomes were organized into three categories illustrating burnout as a dynamic loss spiral rather than a static end-state. Findings show that emotional exhaustion had the greatest impact with the outcomes explored, while depersonalization and lack of professional accomplishment manifested fewer associations. The results suggest that burnout is a complex, dynamic phenomenon, which unfolds over time. Future research and implications of these results are discussed.
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Brüggmann D, Herpe A, Quarcoo D, Schöffel N, Wanke EM, Ohlendorf D, Klingelhöfer D, Groneberg DA, Mache S. Descriptive review of junior OB/GYN physicians' work task financial compensation in German hospitals. J Occup Med Toxicol 2019; 14:6. [PMID: 30899318 PMCID: PMC6407265 DOI: 10.1186/s12995-019-0227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/26/2019] [Indexed: 11/29/2022] Open
Abstract
Beginning in the first decade of the 21st centruy, there was a growing disregard for the benefits of the German medical system concerning the junior obstetricians/gynecologists (OB/GYN) job situation. As in other fields of medicine, numerous colleagues left Germany to work in other countries such as the United Kingdom, Noway, Sweden, or Switzerland. According to studies, financial factors represent one of the reasons for the discontent. We here present a practical descriptive approach to assess/review the actual compensation of single work tasks of OB/GYNs on the basis of previously published, existing data. Using the workflow data from the Medical work Assessment in German hospitals (MAGRO) platform of twenty junior OB/GYNs with an average workday of 9:24:35 h (SD = 01:05:07 h), a large scale data analysis of 2,325,556 different time points was performed to calculate the financial valuation of single work tasks. In order to assess the evolution over the past years, different modern and historic (e.g. AiP) pay scales were used and analysed in relation to the actual work on a weekly, monthly and per annum basis. Our review shows that there has been a dramatic increase in the financial reward of the practical work tasks of junior OB/GYN physicians in German hospitals in comparison to the situation of the early 2000s years. In this respect, it can not be further argued that the German system has large disadvantages concerning the payment of junior doctors in comparison to other European countries.
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Affiliation(s)
- Dörthe Brüggmann
- Department of Gynecology and Obtestrics, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Anja Herpe
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David Quarcoo
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Norman Schöffel
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Eileen M. Wanke
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Daniela Ohlendorf
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Doris Klingelhöfer
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David A. Groneberg
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Stefanie Mache
- Department of Medicine/Psychosomatics, Charité, Universitätsmedizin Berlin, Free University and Humboldt University, Luisenstrasse 13a, 10117 Berlin, Germany
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Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA. Prevalence of Burnout Among Physicians: A Systematic Review. JAMA 2018; 320:1131-1150. [PMID: 30326495 PMCID: PMC6233645 DOI: 10.1001/jama.2018.12777] [Citation(s) in RCA: 957] [Impact Index Per Article: 159.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022]
Abstract
Importance Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout prevalence among physicians would have important health policy implications, but the overall prevalence is unknown. Objective To characterize the methods used to assess burnout and provide an estimate of the prevalence of physician burnout. Data Sources and Study Selection Systematic search of EMBASE, ERIC, MEDLINE/PubMed, psycARTICLES, and psycINFO for studies on the prevalence of burnout in practicing physicians (ie, excluding physicians in training) published before June 1, 2018. Data Extraction and Synthesis Burnout prevalence and study characteristics were extracted independently by 3 investigators. Although meta-analytic pooling was planned, variation in study designs and burnout ascertainment methods, as well as statistical heterogeneity, made quantitative pooling inappropriate. Therefore, studies were summarized descriptively and assessed qualitatively. Main Outcomes and Measures Point or period prevalence of burnout assessed by questionnaire. Results Burnout prevalence data were extracted from 182 studies involving 109 628 individuals in 45 countries published between 1991 and 2018. In all, 85.7% (156/182) of studies used a version of the Maslach Burnout Inventory (MBI) to assess burnout. Studies variably reported prevalence estimates of overall burnout or burnout subcomponents: 67.0% (122/182) on overall burnout, 72.0% (131/182) on emotional exhaustion, 68.1% (124/182) on depersonalization, and 63.2% (115/182) on low personal accomplishment. Studies used at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, indicating substantial disagreement in the literature on what constituted burnout. Studies variably defined burnout based on predefined cutoff scores or sample quantiles and used markedly different cutoff definitions. Among studies using instruments based on the MBI, there were at least 47 distinct definitions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively. Overall burnout prevalence ranged from 0% to 80.5%. Emotional exhaustion, depersonalization, and low personal accomplishment prevalence ranged from 0% to 86.2%, 0% to 89.9%, and 0% to 87.1%, respectively. Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined. Conclusions and Relevance In this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality. These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians.
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Affiliation(s)
- Lisa S. Rotenstein
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Brigham Education Institute, Boston, Massachusetts
| | - Matthew Torre
- Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Marco A. Ramos
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Rachael C. Rosales
- Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute and Department of Psychiatry, University of Michigan, Ann Arbor
| | - Douglas A. Mata
- Harvard Medical School, Boston, Massachusetts
- Brigham Education Institute, Boston, Massachusetts
- Program in Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
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Murali K, Banerjee S. Burnout in oncologists is a serious issue: What can we do about it? Cancer Treat Rev 2018; 68:55-61. [DOI: 10.1016/j.ctrv.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
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Murali K, Makker V, Lynch J, Banerjee S. From Burnout to Resilience: An Update for Oncologists. Am Soc Clin Oncol Educ Book 2018; 38:862-872. [PMID: 30231394 DOI: 10.1200/edbk_201023] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Physician burnout remains a highly complex and topical issue. The negative impact of burnout on physicians, patients, and institutions has become increasingly apparent. Globally, a multitude of professional bodies and organizational leaders are giving this important subject much-deserved attention. In this review, we provide a summary of the latest evidence, with a focus on solutions and future strategies, while incorporating our own perspectives as practicing oncologists.
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Affiliation(s)
- Krithika Murali
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Vicky Makker
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - James Lynch
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Susana Banerjee
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
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Ben Zid A, Homri W, Ben Romdhane I, Bram N, Labbane R. [Burnout in Tunisian medical residents: About 149 cases]. Encephale 2017; 44:337-342. [PMID: 28870691 DOI: 10.1016/j.encep.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 06/20/2017] [Accepted: 06/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. AIMS Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout. METHODS A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment. RESULTS A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (P<0.001), bad job conditions (P=0.031), poor conditions of the workplace (P=0.046), relationship problems in workplace (P=0.01), work-family conflicts (P<0.001). The consequences of occupational stress associated with burnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (P<0.001). A significant correlation between depression and severe burnout was not found. CONCLUSION Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors as well as many consequences are related to severe burnout, which is in agreement with numerous studies. However, results between different studies are disparate.
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Affiliation(s)
- A Ben Zid
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie.
| | - W Homri
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - I Ben Romdhane
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - N Bram
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
| | - R Labbane
- Service de psychiatrie C, hôpital Razi, cité des Orangers, 2010 La Manouba, Tunisie
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Jesse MT, Abouljoud M, Eshelman A, De Reyck C, Lerut J. Professional interpersonal dynamics and burnout in European transplant surgeons. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.12928] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Michelle T. Jesse
- Transplant Institute; Henry Ford Health System; Detroit MI USA
- Psychosomatic Medicine; Behavioral Health; Henry Ford Health System; Detroit MI USA
- Center for Health Policy & Health Services Research; Henry Ford Health System; Detroit MI USA
| | - Marwan Abouljoud
- Psychosomatic Medicine; Behavioral Health; Henry Ford Health System; Detroit MI USA
- Transplant and Hepatobiliary Surgery; Henry Ford Health System; Detroit MI USA
| | - Anne Eshelman
- Transplant Institute; Henry Ford Health System; Detroit MI USA
- Psychosomatic Medicine; Behavioral Health; Henry Ford Health System; Detroit MI USA
| | - Chantal De Reyck
- Starzl Unit Abdominal Transplantation; University Hospitals Saint Luc; Universite catholique Louvain; Brussels Belgium
| | - Jan Lerut
- Starzl Unit Abdominal Transplantation; University Hospitals Saint Luc; Universite catholique Louvain; Brussels Belgium
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Medisauskaite A, Kamau C. Prevalence of oncologists in distress: Systematic review and meta-analysis. Psychooncology 2017; 26:1732-1740. [DOI: 10.1002/pon.4382] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/22/2016] [Accepted: 01/19/2017] [Indexed: 01/31/2023]
Affiliation(s)
- Asta Medisauskaite
- Department of Organizational Psychology; Birkbeck, University of London; London UK
| | - Caroline Kamau
- Department of Organizational Psychology; Birkbeck, University of London; London UK
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Hlubocky FJ, Back AL, Shanafelt TD. Addressing Burnout in Oncology: Why Cancer Care Clinicians Are At Risk, What Individuals Can Do, and How Organizations Can Respond. Am Soc Clin Oncol Educ Book 2017; 35:271-9. [PMID: 27249706 DOI: 10.1200/edbk_156120] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.
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Affiliation(s)
- Fay J Hlubocky
- From the Department of Medicine, Section of Hematology Oncology, The University of Chicago Medicine, Chicago, IL; Division of Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA; Mayo Clinic, Rochester, MN
| | - Anthony L Back
- From the Department of Medicine, Section of Hematology Oncology, The University of Chicago Medicine, Chicago, IL; Division of Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA; Mayo Clinic, Rochester, MN
| | - Tait D Shanafelt
- From the Department of Medicine, Section of Hematology Oncology, The University of Chicago Medicine, Chicago, IL; Division of Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA; Mayo Clinic, Rochester, MN
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Gracino ME, Zitta ALL, Mangili OC, Massuda EM. A saúde física e mental do profissional médico: uma revisão sistemática. SAÚDE EM DEBATE 2016. [DOI: 10.1590/0103-1104201611019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo desta revisão sistemática da literatura foi de identificar as principais doenças que acometem os médicos em todo o mundo, mediante uma pesquisa eletrônica na base de dados Biblioteca Virtual em Saúde (BVS) baseada na metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma). Foram analisados 57 dos 374 artigos científicos encontrados sobre o tema em inglês, português e espanhol, publicados entre 2005 e 2015. Os resultados encontrados apontaram que os acometimentos mentais prevaleceram, destacando-se o esgotamento profissional (síndrome de burnout). Entre as doenças físicas, predominaram os acometimentos musculoesqueléticos.
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15
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Stress and burnout among gynecologic oncologists: A Society of Gynecologic Oncology Evidence-based Review and Recommendations. Gynecol Oncol 2016; 143:421-427. [PMID: 27575910 DOI: 10.1016/j.ygyno.2016.08.319] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/10/2016] [Accepted: 08/17/2016] [Indexed: 11/20/2022]
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Poulsen MG, Khan A, Poulsen EE, Khan SR, Poulsen AA. Work engagement in cancer care: The power of co-worker and supervisor support. Eur J Oncol Nurs 2016; 21:134-8. [DOI: 10.1016/j.ejon.2015.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/17/2015] [Accepted: 09/22/2015] [Indexed: 11/15/2022]
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17
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Gender-based workplace assessment in gynecology and obstetrics in Germany: results from the iCEPT Study. Arch Gynecol Obstet 2016; 294:317-26. [DOI: 10.1007/s00404-016-4062-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/24/2016] [Indexed: 10/22/2022]
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18
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Beyond the body: A systematic review of the nonphysical effects of a surgical career. Surgery 2016; 159:650-64. [DOI: 10.1016/j.surg.2015.08.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/06/2015] [Accepted: 08/15/2015] [Indexed: 12/21/2022]
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Burnout and associated factors among members of the Society of Gynecologic Oncology. Am J Obstet Gynecol 2015; 213:824.e1-9. [PMID: 26226551 DOI: 10.1016/j.ajog.2015.07.036] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/23/2015] [Accepted: 07/21/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Burnout is specific to the work domain and in physicians is indicative of emotional exhaustion, depersonalization in relationships with coworkers and detachment from patients, and a sense of inadequacy or low personal accomplishment. The purpose of this study was to determine the burnout rate among gynecologic oncologists and evaluate other personal, professional, and psychosocial factors associated with this condition. STUDY DESIGN This study used a cross-sectional design. Current members of the Society of Gynecologic Oncology were sent an anonymous email survey including 76 items measuring burnout, psychosocial distress, career satisfaction, and quality of life. RESULTS A total of 1086 members were invited, 436 (40.1%) responded, and 369 (84.6%) of those completed the survey. Of physicians, 30% scored high for emotional exhaustion, 10% high for depersonalization, and 11% low for personal accomplishment. Overall, 32% of physicians scored above clinical cutoffs indicating burnout. In all, 33% screened positive for depression, 13% endorsed a history of suicidal ideation, 15% screened positive for alcohol abuse, and 34% reported impaired quality of life. Nonetheless, 70% reported high levels of personal accomplishment, and results suggested most were satisfied with their careers, as 89% would enter medicine again and 61% would encourage their child to enter medicine. Respondents with high burnout scores were less likely to report they would become a physician again (P = .002) or encourage a child to enter medicine (P < .001), and more likely to screen positive for depression (P < .001), alcohol abuse (P = .006), history of suicidal ideation (P < .001), and impaired quality of life (P < .001). CONCLUSION Burnout is a significant problem associated with psychosocial distress and lower levels of career satisfaction in gynecologic oncologists. Burnout in obstetrics-gynecology and gynecologic oncology is of particular concern as young age and female gender are often identified as risk factors for this significant problem. Interventions targeted at improving quality of life, treatment of depression, or alcohol abuse may have an impact on burnout. However, significant barriers may exist as 44.5% of respondents in this study reported that they would be reluctant to seek medical care for depression, substance use, or other mental health issues due to concerns about their medical license.
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Rua C, Body G, Marret H, Ouldamer L. [Prevalence of burnout among obstetrics and gynecology residents]. ACTA ACUST UNITED AC 2014; 44:83-7. [PMID: 24457022 DOI: 10.1016/j.jgyn.2013.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/25/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Prevalence assessment of burnout among obstetrics and gynecology residents and predisposing factors. PATIENTS AND METHODS Multicentric cross-sectional survey based on a questionnaire sent by email to the residents including demographics data and Maslach Burnout Inventory. RESULTS Mean burnout scores were 19.67±10.19 for emotional exhaustion, 33.94±5.01 for personal accomplishment and 8.72±6.10 for depersonalization, corresponding to a moderate burnout for each category. High scores of burnout were seen on 19.45 % of residents for emotional exhaustion, 33.33 % for depersonalization and 11.11 % for personal accomplishment. 36.11 % of residents showed evidence of high burnout in emotional exhaustion or depersonalization, and 5.55 % in the three dimensions. The number of semesters is correlated with depersonalization (P=0.01). CONCLUSION There is a strong personal accomplishment among obstetrics and gynecology residents; however, burnout and emotional exhaustion remains a reality during obstetrics and gynecology residency.
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Affiliation(s)
- C Rua
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France.
| | - G Body
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - H Marret
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - L Ouldamer
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
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Acton J, Leung Y, Tan J, Salfinger S. The evolving role of a gynaecologic oncologist in a tertiary hospital. Aust N Z J Obstet Gynaecol 2013; 54:26-9. [DOI: 10.1111/ajo.12146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Jade Acton
- Registrar; King Edward Memorial Hospital; Perth WA Australia
| | - Yee Leung
- Head of Department of Gynaecologic Oncology; King Edward Memorial Hospital; Perth WA Australia
| | - Jason Tan
- Gynaecologic Oncologist; King Edward Memorial Hospital; Perth WA Australia
| | - Stuart Salfinger
- Gynaecologic Oncologist; King Edward Memorial Hospital; Perth WA Australia
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Sablik Z, Samborska-Sablik A, Drożdż J. Universality of physicians' burnout syndrome as a result of experiencing difficulty in relationship with patients. Arch Med Sci 2013; 9:398-403. [PMID: 23847658 PMCID: PMC3701961 DOI: 10.5114/aoms.2012.28658] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 10/22/2011] [Accepted: 12/12/2011] [Indexed: 11/24/2022] Open
Abstract
The aim of our work is to present the universality of burnout syndrome among physicians worldwide and to demonstrate selected aspects of the relationship between patients and doctors as a common factor predisposing to burnout. We looked up 20 original pieces of research from the Medline database published in the last 10 years to determine the prevalence of burnout among doctors in different countries. In all quoted works a remarkable percentage of doctors of interventional and non-interventional specialties suffered burnout. Because it is the relationship with patients that constitutes a key denominator for their work, in the discussion we have exposed an important aspect of it, destructive patient games, described on the basis of transactional analysis. Since universal burnout causes a deterioration of doctors' service, for the optimal good of the patient to survive preservation of the doctor's well-being in the patient-doctor relationship is needed everywhere.
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Affiliation(s)
- Zbigniew Sablik
- Department of Cardiology, I Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
| | - Anna Samborska-Sablik
- Department of Emergency Medicine and Disaster Medicine, Chair of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Poland
| | - Jarosław Drożdż
- Department of Cardiology, I Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
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Lin BYJ, Lin YK, Juan CW, Lee S, Lin CC. Moderating Role of Interior Amenities on Hospital Medical Directors' Patient-Related Work Stresses. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2013; 6:77-92. [DOI: 10.1177/193758671300600207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Considering hospital medical directors' work stress, this study aims to examine how interior amenities might moderate the effect of work stress on their health. Background: Previous studies have revealed that hospital medical directors—senior physicians in the management positions with high-demand jobs in clinical practices and management—had a lower self-rated health. Methods: This was a cross-sectional survey study and 737 hospital medical directors in Taiwan were included. A developed and structured questionnaire covered the dimensions of patient-related work stress (i.e., physician-patient relationship stress and patient condition stress), hospital interior amenities (i.e., indoor plants, aquarium, music, art and exhibitions, and private or personalized spaces that are common or surround the workplace of healthcare professionals), and self-rated health status and health complaints. Hierarchical regressions were performed. Results: Hospital medical directors' physician-patient relationship stresses were found to have more negative effects on their self-reported health status and complaints than do their patient condition stresses; however, only indoor plants were found to have moderating effects on their short-term health complaints ( p < 0.05). On the other hand, the hospital medical directors' patient condition stresses were negatively related to their short-term health complaints; however, music, art and exhibitions, and private or personalized spaces in the workplaces had moderating effects ( p < 0.05). Conclusions: Considering the unavoidable patient-related work stresses imposed on hospital medical directors, some proposed interior amenities can produce buffering effects on work stress to some extent. Future studies could focus on finding alternatives to relieve hospital medical directors' physician-patient relationship work stresses.
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