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Keller DS, Narula N, Schwarz E, Mellinger JD, Feldman LS, Dort J, Asbun HJ, Romanelli J. A cross sectional survey on burnout and career satisfaction in surgeons: a joint work from the SAGES quality, outcomes, and safety and reimaging the practice of surgery burnout task forces. Surg Endosc 2024:10.1007/s00464-024-11123-z. [PMID: 39103663 DOI: 10.1007/s00464-024-11123-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION The growth of surgeon burnout is of significant concern. As we work to reimagine the practice of surgery, an accurate understanding of the extent of surgeon burnout is essential. Our goal was to define the current prevalence of burnout and quality of life (QOL) among SAGES surgeons. METHODOLOGY An electronic survey was administered to SAGES members to establish a current baseline for QOL, burnout, depression, and career satisfaction. To assess outcomes, we utilized the validated Maslach Burnout Inventory for Medical Personnel, the Medical Outcomes Study Short Form, and the Primary Care Evaluation of Mental Disorders. All scoring followed validated norm-based methods. RESULTS Of 4194 active members, 604 responded (14.40%). 69% met burnout threshold, with high levels of emotional exhaustion and depersonalization, and low personal accomplishment. 81% reported "being at the end of their rope", 74% felt emotionally drained, and 65% felt used up daily. Nearly all maintained caring about what happened to their patients (96%), easily understanding how their patients feel (84.3%) and being capable of dealing effectively with their patient's problems (87.6%). However, respondents never, rarely, or occasionally felt energetic (77.5%) or experienced a sense of professional accomplishment (57.8%). The overall QOL score was 69/100, with lower Mental than Physical scores (62.69 (SD 10.20) vs.77.27 (SD 22.24)). More than half of respondents met depression criteria. While 77% supported they would become a physician again, less than half would choose surgery again or recommend surgery to their children. Furthermore, less than a third felt work allowed sufficient time for their personal lives. CONCLUSIONS Participating SAGES surgeons reported alarmingly high rates of burnout and depression. Despite experiencing emotional exhaustion and depersonalization, they maintained a strong commitment to patient care. These findings likely reflect the broader state of surgeons, underscoring the urgent need for action to address this critical issue.
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Affiliation(s)
- Deborah S Keller
- Department of Digestive Surgery, University of Strasbourg, 1 Place de L'Hopital, 67000, Strasbourg, France.
| | - Nisha Narula
- Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Erin Schwarz
- BSC Management and Vivacity Consulting, Los Angeles, CA, USA
| | | | - Liane S Feldman
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Jonathan Dort
- Department of Surgery, Inova Health System, Falls Church, VA, USA
| | | | - John Romanelli
- Department of Surgery, Baystate Health, Springfield, MA, USA
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Grigoroiu M, Paul JF, Brian E, Aegerter P, Boddaert G, Mariolo A, Jorrot P, Bellahoues M, Seguin-Givelet A, Perduca V. 3D printing in anatomical lung segmentectomies: A randomized pilot trial. Heliyon 2024; 10:e31842. [PMID: 38867971 PMCID: PMC11168317 DOI: 10.1016/j.heliyon.2024.e31842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
Objective This pilot study evaluated the impact of using a 3D printed model of the patient's bronchovascular lung anatomy on the mental workload and fatigue of surgeons during full thoracoscopic segmentectomy. Design We performed a feasibility pilot study of a prospective randomized controlled trial with 2 parallel arms. All included patients underwent digital 3D visual reconstruction of their bronchovascular anatomy and were randomized into the following two groups: Digital arm (only a virtual 3D model was available) and Digital + Object arm (both virtual and printed 3D models were available). The primary end-point was the surgeons' mental workload measured using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score. Setting Between October 28, 2020 and October 05, 2021, we successively investigated all anatomic segmentectomies performed via thoracoscopy in the Thoracic Department of the Montsouris Mutualiste Institute, except for S6 segmentectomies and S4+5 left bi-segmentectomies. Participants We assessed 102 patients for anatomical segmentectomy. Among the, 40 were randomly assigned, and 34 were deemed analysable, with 17 patients included in each arm. Results Comparison of the two groups, each comprising 17 patients, revealed no statistically significant difference in primary or secondary end-points. The consultation of the visual digital model was significantly less frequent when a 3D printed model was available (6 versus 54 consultations, p = 0.001). Notably, both arms exhibited high NASA-TLX scores, particularly in terms of mental demand, temporal demand, and effort scores. Conclusion In our pilot study, 3D printed models and digital 3D reconstructions for pre-operative planning had an equivalent effect on thoracoscopic anatomic segmentectomy for experienced surgeons. The originality of this study lies in its focus on the impact of 3D printing of bronchovascular anatomy on surgeons, rather than solely on the surgical procedure.
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Affiliation(s)
- Madalina Grigoroiu
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Jean-François Paul
- Institut Mutualiste Montsouris, Département de Radiologie, 42, Boulevard Jourdan, 75014, Paris, France
| | - Emmanuel Brian
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Philippe Aegerter
- GIRCI-IDF, Cellule Méthodologie, 4, Av Richerand, 75010, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, 12, Av Paul-Couturier 94807, Villejuif, France
| | - Guillaume Boddaert
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Alessio Mariolo
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Pierre Jorrot
- Institut Mutualiste Montsouris, Département de Rythmologie, 42, Boulevard Jourdan, 75014. Paris, France
| | - Mouloud Bellahoues
- Institut Mutualiste Montsouris, Département de Recherche Clinique, 42, Boulevard Jourdan, 75014, Paris, France
| | - Agathe Seguin-Givelet
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Vittorio Perduca
- Université Paris Cité, CNRS, MAP5, 44, Rue des Saint Pères, 75006, Paris, France
- Université Paris Saclay, UVSQ, INSERM, CESP U1018, « Exposome, Heredity, Cancer and Health » Team, Gustave Roussy, 12, Av Paul-Couturier, 94807, Villejuif, France
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Abolfotouh SM, Alnori O, Choma T, Moore D, Abolfotouh MA. Epidemiology of Work-Related Neck Pain Among Spine Surgeons. Global Spine J 2024; 14:1515-1523. [PMID: 36564909 DOI: 10.1177/21925682221148685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVES This study aimed to investigate work-related neck pain among AO spine surgeons in different regions by estimating its prevalence, predictors, consequences, and management methods. METHODS A cross-sectional survey of 411 spine surgeon members of AO spine was conducted during March-May 2021, using the Modified Nordic Questionnaire and the Neck Disability Index. Data on neck pain experience during the last 12 months and its consequences and risk factors were collected. Logistic regression analysis was done to identify significant predictors of neck pain. Significance was set at P < .05. RESULTS The 1-year neck pain was experienced by 66.7% of surgeons. According to the Neck Disability Index, more than one-half (52.8%) experienced disability due to neck pain of mild (45.5%), moderate (6.5%), and severe (.8%) grades. Neck pain was responsible for stopping work in 17.5% of surgeons, with a median of 3.5 (IQR, 2-7.8) days off work. One-half of the participants (56.3%) were treated by medical care, 31.5% by physiotherapy, and 16.5% requested rest days and sick leave. Physical stress (P < .001) and non-exercising (P = .04) were the significant predictors of neck pain. CONCLUSION The 12-month prevalence of neck pain was high among spine surgeons, with an impact on activities of daily living, mainly of a mild degree, reported by one-half of surgeons. Physical stress was the only significant predictor, while sports practice was a protective factor against neck pain. Medication was the primary management adopted-an increased focus on pain prevention through improved workplace ergonomics and sports activity programs is recommended.
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Affiliation(s)
- Sameh M Abolfotouh
- Orthopedics Department, Medcare Hospital, Dubai, UAE
- OrthoCure Medical Center, Dubai, UAE
| | - Omar Alnori
- Orthopedics Department, Hamad General Hospital, Doha, Qatar
| | | | - Don Moore
- Spine Unit, University of Missouri, MO, USA
| | - Mostafa A Abolfotouh
- King Abdullah International Medical Research Center(KAIMRC)/ King Saud Bin-Abdulaziz University for Health Sciences (KSAU-HS)/ King Abdulaziz Medical City (KAMC), Ministry of National Guard-Health Affairs (MNGHA), Riyadh, Saudi Arabia
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Norasi H, Kim J, Hallbeck MS, Cerri PE, Elli EF, Tollefson MK, Harold KL, Pathak RA, Pak R. Surgeons' dominant surgical modality: Impacts on wellbeing, burnout, and interventions for neuromusculoskeletal disorders. Am J Surg 2024:115769. [PMID: 38796376 DOI: 10.1016/j.amjsurg.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND This study investigated the impact of surgical modalities on surgeon wellbeing with a focus on burnout, job satisfaction, and interventions used to address neuromusculoskeletal disorders (NMSDs). METHODS An electronic survey was sent to surgeons across an academic integrated multihospital system. The survey consisted of 47 questions investigating different aspects of surgeons' wellbeing. RESULTS Out of 245 thoracic and abdominopelvic surgeons, 79 surgeons (32.2 %) responded, and 65 surgeons (82 %) were able to be categorized as having a dominant surgical modality. Compared to robotic surgeons, laparoscopic (p = 0.042) and open (p = 0.012) surgeons reported more frequent feelings of burnout. The number of surgeons who used any treatment/intervention to minimize the operative discomfort/pain was lower for robotic surgeons than the other three modalities (all p < 0.05). CONCLUSIONS NMSDs affect different aspects of surgeons' lives and occupations. Robotic surgery was associated with decreased feelings of burnout than the other modalities.
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Affiliation(s)
- Hamid Norasi
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Joseph Kim
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - M Susan Hallbeck
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA; Department of Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Petrine E Cerri
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Enrique F Elli
- Department of Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Matthew K Tollefson
- Department of Surgery, Mayo Clinic, Rochester, MN, USA; Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | - Ram A Pathak
- Department of Urology, Mayo Clinic, Jacksonville, FL, USA
| | - Raymond Pak
- Department of Urology, Mayo Clinic, Jacksonville, FL, USA
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Fernández-Villa de Rey-Salgado J, Curiel-Montes A, Abarca-Olivas J, González-López P, Borrás-Rocher F, González-Sánchez L, Nieto-Navarro JA. Burnout in Neurosurgery. World Neurosurg 2024; 184:e586-e592. [PMID: 38336209 DOI: 10.1016/j.wneu.2024.01.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Burnout is a pervasive psychosocial syndrome that manifests as a chronic response to interpersonal stressors encountered in the occupational setting. Neurosurgeons exhibit a high prevalence rate of burnout, ranging from 33% to 67%. The primary objective of this study is to examine the prevalence of Burnout syndrome within the neurosurgical community and identify the contributing factors. METHODS A prospective observational study was conducted utilizing an anonymous survey format, incorporating the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire. Additional inquiries were made regarding demographic characteristics, occupational factors, lifestyle choices, and the Hospital Anxiety and Depression Scale (HADS) questionnaire. The survey was disseminated between March 23rd, 2023, and April 4th, 2023, utilizing the email registries of the Spanish Society of Neurosurgery (SENEC) and the Latin American Federation of Neurosurgical Societies (FLANC). Descriptive analysis was performed, comparing responses between participants with and without burnout syndrome using cross-tabulation and the Chi-square test to assess the presence of dependency. RESULTS A total of 282 neurosurgeons completed the survey. The sample comprised 30.1% females and 69.9% males, with a median age within the 30-40 range. Among the surveyed neurosurgeons, 66.7% exhibited a prevalence of burnout, while 23.4% met the criteria for defined burnout. Significantly higher rates of burnout syndrome were observed among residents, specifically those in their fifth year of residency, as well as those whose departments perform a moderate range of surgeries (500-1000), participating in on-call duties, lacking regular physical exercise (at least twice a week), engaging infrequently in social activities with friends, lacking extracurricular hobbies, and obtaining scores exceeding 10 points in any of the HADS subscales. CONCLUSIONS Burnout syndrome affects nearly a quarter of the neurosurgical specialists included in this study. Moreover, a distinct profile associated with defined burnout among neurosurgeons emerges, encompassing characteristics such as being a fifth-year resident, belongs to departments with a moderate number of surgeries, with few extra-occupational distractions and exhibiting symptoms of depression or anxiety.
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Affiliation(s)
| | - Alberto Curiel-Montes
- Department of Neurosurgery, Hospital General Universitario Dr Balmis, Alicante, Spain
| | - Javier Abarca-Olivas
- Department of Neurosurgery, Hospital General Universitario Dr Balmis, Alicante, Spain
| | - Pablo González-López
- Department of Neurosurgery, Hospital General Universitario Dr Balmis, Alicante, Spain
| | | | - Luz González-Sánchez
- Department of Neurosurgery, Hospital General Universitario Dr Balmis, Alicante, Spain
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Vaisman A, Guiloff R, Contreras M, Casas-Cordero JP, Calvo R, Figueroa D. Over 50% of self-reported burnout among Latin American orthopaedic surgeons: A cross-sectional survey on prevalence and risk factors. J ISAKOS 2024; 9:128-134. [PMID: 38036044 DOI: 10.1016/j.jisako.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Assess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. METHODS This study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p < 0.05). RESULTS The survey's response rate was 20 % (n = 358) out of the 1779 invitations that were sent. The most representative age range was 41-60 years (50 %) and 94 % were men. Of those surveyed, 50 % reported a burnout episode more than once per year, 60 % depersonalization when treating patients at least yearly, 13 % anhedonia, 11 % a depressive mood more than half of the month or almost every day, and 61 % weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p = 0.012), fewer years as a specialist (p = 0.037), fear of lawsuits (p < 0.001), a non-healthy diet (p = 0.003), non-doing recreational activities (p = 0.004), depersonalization when treating their patients (p < 0.001), weariness (p < 0.001), anhedonia (p < 0.001), depressive mood (p < 0.001), and career dissatisfaction (p < 0.001). The logistic regression demonstrated that fear of lawsuits (p < 0.001), weariness at the end of a workday (p = 0.016), and anhedonia (p = 0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p < 0.001). CONCLUSION Over 50 % of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 % of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factor. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Alex Vaisman
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - Rodrigo Guiloff
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile.
| | - Martín Contreras
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Juan Pablo Casas-Cordero
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Rafael Calvo
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - David Figueroa
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
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Yang L, Lei Y, Chu D, Jiang J, Li Z, Tang Y, Anita AR. Exploring antecedents and outcomes of burnout among emergency department staff using the job demands-resources model: A scoping review protocol. PLoS One 2024; 19:e0300040. [PMID: 38483916 PMCID: PMC10939206 DOI: 10.1371/journal.pone.0300040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION High levels of burnout are prevalent among Emergency Department staff due to chronic exposure to job stress. There is a lack of knowledge about anteceding factors and outcomes of burnout in this population. AIMS To provide a comprehensive overview of burnout and identify its workplace antecedents and outcomes among Emergency Department staff. METHODS The scoping study will follow the methodology outlined by the Joanna Briggs Institute. PubMed, Scopus, Web of Science, APA PsycInfo, and CINAHL databases will be searched using predefined strategies. Two reviewers will screen the title, abstract and full text separately based on the eligibility criteria. Data will be charted, coded, and narratively synthesized based on the job demands-resources model. CONCLUSION The results will provide insights into the underlying work-related factors contributing to burnout and its implications for individuals, healthcare organizations, and patient care.
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Affiliation(s)
- Luhuan Yang
- Faculty of Medicine and Health Sciences, Department of Community Health, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yunhong Lei
- Philippine Women’s University School of Nursing, Manila, Philippines
| | - Dongmei Chu
- Faculty of Medicine and Health Sciences, Department of Community Health, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Jiawei Jiang
- Faculty of Medicine and Health Sciences, Department of Community Health, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zifeng Li
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Three Gorges University/Yichang Central People’s Hospital, Yichang City, Hubei Province, China
| | - Yanhua Tang
- Faculty of Medicine and Health Sciences, Department of Community Health, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Abd Rahman Anita
- Faculty of Medicine and Health Sciences, Department of Community Health, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Izumi A, Nwakoby A, Verma R, Yanagawa B. Wellness and burnout in cardiac surgery: not black and white. Curr Opin Cardiol 2024; 39:98-103. [PMID: 38116804 DOI: 10.1097/hco.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Despite a growing emphasis on burnout in medicine, there remains a paucity of data in cardiac surgery. Herein, we summarize recent data on cardiac surgeon well being and identify factors for consideration in future burnout inquiries and management. RECENT FINDINGS Overall, 70-90% of cardiothoracic surgeons report job satisfaction in the United States. However, 35-60% still endorse burnout symptoms, and the specialty reports some of the highest rates of depression (35-40%) and suicidal ideation (7%). Such negative experiences are greater among early-stage and female surgeons and may be addressed through targeted, program-specific wellness policies. Canada's single-payer healthcare system might exacerbate surgeon burnout due to lower financial compensation and job autonomy. SUMMARY Cardiothoracic surgeons appear simultaneously burnt out and professionally fulfilled. They report a high incidence of depression and clock in the most hours, yet the majority would choose this specialty again. These findings reveal a more nuanced state of well being than previously appreciated and speak to ambiguities in how burnout is conceived and measured. A broader examination across surgical and social contexts highlights the hierarchical nature of burnout factors and potential ways forward. Collectively, these insights can inform assessments of burnout in Canadian cardiac surgery that remain absent to date.
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Affiliation(s)
- Aliya Izumi
- Division of Cardiovascular Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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Chong RIH, Yaow CYL, Chong NZY, Yap NLX, Hong ASY, Ng QX, Tan HK. Scoping review of the second victim syndrome among surgeons: Understanding the impact, responses, and support systems. Am J Surg 2024; 229:5-14. [PMID: 37838505 DOI: 10.1016/j.amjsurg.2023.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/11/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND It is thought that 50% of healthcare providers experience Second Victim Syndrome (SVS) in the course of their practice. The manifestations of SVS varies between individuals, with potential long-lasting emotional effects that impact both the personal lives and professional clinical practice of affected persons. Although surgeons are known to face challenging and high-stress situations in their profession, which can increase their vulnerability to SVS, majority of studies and reviews have focused squarely on nonsurgical physicians. METHODS This scoping review aimed to consolidate existing studies pertaining to a surgeon's experience with SVS, by broadly examining the prevalence and impact, identifying the types of responses, and evaluating factors that could influence these responses. The scoping review protocol was guided by the framework outlined by Arksey and O'Malley and ensuing recommendations made by Levac and colleagues. Three databases (MEDLINE, EMBASE and Cochrane Library) were searched from inception till March 19, 2023. RESULTS A total of 13 articles were eligible for thematic analysis based on pre-defined inclusion criteria. Effects of SVS were categorized into Psychological, Physical and Professional impacts, of which Psychological and Professional impacts were particularly significant. Factors affecting the response were categorized into complication type, surgeon factors and support systems. CONCLUSION SVS adds immense psychological, emotional and physical burden to the individual surgeon. There are key personal, interpersonal and environmental factors that can mitigate or exacerbate the effects of SVS, and greater emphasis needs to be placed on improving availability and access to services to help surgeons at risk of SVS.
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Affiliation(s)
- Ryan Ian Houe Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Nicole Li Xian Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore; MOH Holdings Pte Ltd., Singapore.
| | - Hiang Khoon Tan
- Department of Head and Neck Surgery, Singapore General Hospital, Singapore
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Roth MF, Chick JFB, McLoughlin D, Shin DS, Chadalavada SC, Monroe EJ, Hage AN, Ji I, Lee E, Makary MS. Wellness Among Interventional Radiologists: Results From a Multidimensional Survey. Acad Radiol 2024; 31:1130-1140. [PMID: 37945493 DOI: 10.1016/j.acra.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 11/12/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate wellness among interventional radiologists using a multidimensional survey. MATERIALS AND METHODS An anonymous 53-item survey, including 36 Perceived Wellness Survey (PWS) prompts, was created in Qualtrics (an online survey tool) to assess wellness among interventional radiology attendings and residents. The survey was open from June to September, 2022, 2 years into the COVID-19 Pandemic. The survey was distributed via Society of Interventional Radiology Forums, social media (Twitter, LinkedIn, and Facebook), and personal correspondence. PWS scores were categorized into Wellness Composite and subscores (physical, emotional, intellectual, psychological, social, and spiritual). RESULTS 367 surveys were completed. 300 (81.7%) respondents were male and 67 (18.3%) were female. Respondents included attending physicians (297; 81.0%) and residents (70; 19.0%). Practice settings included academic (174; 47.4%), private (114; 31.0%), private-academic hybrid (62; 16.9%), and others (17; 4.7%). Mean Wellness Composite at academic centers (14.74 ± 3.16; range: 5.42-23.50) was significantly lower than at private (15.22 ± 3.37; range: 6.13-23.51) and hybrid (16.14 ± 2.47; range: 10.20-23.50) practices (p = 0.01). Respondents < 40 years old had significantly lower emotional wellness subscores compared to those ≥ 40 years old (4.34 ± 0.86 vs. 4.60 ± 0.87; p = 0.006). There were no significant differences between geographic regions in the United States, however, International respondents had significantly lower social and intellectual wellness (INT) subscores. Physical wellness subscore (4.00 ± 0.9) was significantly lower than the other subscores (4.59 ± 0.81) (p < .001). Overall mean Wellness Composite was 15.11 ± 3.13 (range: 5.42-23.51). CONCLUSION Overall self-reported wellness was lower among interventional radiologists practicing at academic centers. Interventional Radiologists < 40 years old and residents had lower emotional wellness, while international respondents had lower social and INT. Overall wellness scores were lower than prior PWS studies.
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Affiliation(s)
- Matthew F Roth
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.).
| | - Jeffrey Forris Beecham Chick
- Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.); The Deep Vein Institute, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.)
| | - Dane McLoughlin
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.)
| | - David S Shin
- Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.); The Deep Vein Institute, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.)
| | - Seetharam C Chadalavada
- Division of Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio, USA (S.C.C.)
| | - Eric J Monroe
- Division of Interventional Radiology, Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA (E.J.M.)
| | - Anthony N Hage
- Division of Vascular and Interventional Radiology, Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA (A.N.H.)
| | - Ido Ji
- Department of Information and Statistics, Chungnam National University, Daejeon, South Korea (I.J., E.L.)
| | - Eunjee Lee
- Department of Information and Statistics, Chungnam National University, Daejeon, South Korea (I.J., E.L.)
| | - Mina S Makary
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.)
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11
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Khalil S, Olds A, Chin K, Erkmen CP. Implementation of Well-Being for Cardiothoracic Surgeons. Thorac Surg Clin 2024; 34:63-76. [PMID: 37953054 DOI: 10.1016/j.thorsurg.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Well-being is a quality of positive physical, mental, social, and environmental experiences. Well-being enables thoracic surgeons to achieve their full potential across personal and work domains. Evidence-based guidelines to promote individual well-being include (1) progress toward a goal; (2) actions commensurate with experience, interest, mission; (3) interconnectivity with others; (4) social relatedness of the work one does; (5) safety; and (6) autonomy. Successful pursuit of well-being includes the development of individual skills of mindfulness, resilience, and connection with others. However, well-being among individuals cannot be achieved without support of workplace leaders and durable institutional infrastructure.
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Affiliation(s)
- Sarah Khalil
- Department of General Surgery, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
| | - Anna Olds
- Division of Cardiac Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, Suite 4300, Los Angeles, CA 90033, USA
| | - Kristine Chin
- Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140, USA
| | - Cherie P Erkmen
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Suite 501, Parkinson Pavilion, Philadelphia, PA 19140, USA.
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12
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Møller CM, Clausen T, Aust B, Budtz-Lilly JW, Eiberg JP. Burnout and Its Consequences among Vascular Surgeons and Trainees: A Danish National Survey. J Am Coll Surg 2023; 237:874-883. [PMID: 37694920 DOI: 10.1097/xcs.0000000000000853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Burnout among physicians has widespread negative consequences. Little is known about burnout among European vascular surgeons (VS). A previously published study found that 82% of VS and vascular surgical trainees (VST) in Denmark experience burnout symptoms. The present study aimed to investigate work- and health-related consequences of burnout. STUDY DESIGN An electronic survey was distributed to all VS/VST in Denmark in January 2020. Validated assessment tools were used to measure burnout, mental health, and psychosocial work environment aspects. RESULTS Of 104 invited VS/VST, 82% (n = 85) completed the survey. VS accounted for 72% (n = 61) of the respondents, and 40% (n = 33) were female. Statistically significant associations were found between higher levels of burnout and a range of work- and health-related outcomes, including a sense of meaning at work, workplace commitment, conflicts between work and private life, work stress, sick leave, and depressive symptoms. VS/VST using pain medication daily or weekly had significantly higher burnout scores than respondents who rarely or never use pain medication. A significant association between burnout and job satisfaction and retention was found, with respondents indicating an intention to stay within the specialty having significantly lower burnout scores than those who considered leaving within 5 years. Among those who indicated leaving the specialty, 35% (n = 13) attributed this to their current working conditions. CONCLUSIONS Burnout among VS/VST in Denmark is negatively associated with various work- and health-related outcomes. The work environment seems to play an essential role in these associations, and alterations in workplace organization may remedy this situation.
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Affiliation(s)
- Cecilie M Møller
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Thomas Clausen
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Birgit Aust
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Jacob W Budtz-Lilly
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Jonas P Eiberg
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
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13
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Bischoff A, Solecruz E, Mainard N, Faivre G, Canavese F. How are French pediatric orthopedic surgeons affected by burnout? Results of a nationwide survey. Orthop Traumatol Surg Res 2023; 109:103628. [PMID: 37105385 DOI: 10.1016/j.otsr.2023.103628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Burnout is a syndrome that adversely affects those who work in roles designed to assist and aid others, such as healthcare professionals. There is a paucity of data available on this topic among French pediatric orthopedic surgeons, registrars and interns. Therefore, we conducted a national survey to: (1) assess the prevalence of burnout syndrome among French pediatric orthopedic surgeons; (2) determine the risks and protective factors associated with this syndrome. HYPOTHESIS The prevalence of burnout among French pediatric orthopedic surgeons is at least as high as in other medical and surgical specialties. MATERIALS AND METHODS We conducted a nationwide survey during the months of June and July 2022 by distributing a digitized questionnaire by e-mail. The burnout syndrome was assessed by the MBI (Maslach Burnout Inventory) score. Demographic and professional practice data were also collected. RESULTS Thirty-eight interns and 65 pediatric orthopedic registrars took part in the survey, i.e. a participation rate estimated at 65.5% and 44.4% respectively. Twenty-six percent (n=10) of interns and 13.9% (n=9) of registrars had MBI scores suggestive of moderate or severe burnout. Respectively 20.8% (n=9) and 9.2% (n=6) of interns and registrars reported suicidal thoughts in the past year. After statistical analysis, medical errors (OR: 3.4336; 95% CI: 1.7164-6.869; p<0.001) and suicidal ideation (OR: 2.3075; 95% CI: 1.0480-5.081; p=0.038) were associated with severe burnout. Having children (OR: 0.495; 95% CI: 0.2491-0.983; p=0.044) emerged as a protective factor. DISCUSSION With a high participation rate, this study reveals a high burnout rate among French pediatric orthopedic interns and registrars, even if slightly lower than those found in other surgical specialties. Interns seem more exposed to this risk than their seniors. The consequences of burnout are diverse but can be significant. These results necessitate a vigilant approach to the occurrence of burnout among health professionals, and the appropriate management of it. LEVEL OF EVIDENCE III; descriptive cross-sectional study without a control group.
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Affiliation(s)
- Aline Bischoff
- Service de chirurgie orthopédique et traumatologique pédiatrique, département universitaire, CHR de Lille, 2, avenue Oscar Lambret, 59000 Lille, France.
| | - Eva Solecruz
- Service de neurologie, département universitaire, CHU de Marseille/Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Nicolas Mainard
- Service de chirurgie orthopédique et traumatologique pédiatrique, département universitaire, CHR de Lille, 2, avenue Oscar Lambret, 59000 Lille, France
| | - Grégoire Faivre
- Service de chirurgie orthopédique et traumatologique, CH de Dunkerque, 130, avenue Louis Herbeaux, 59240 Dunkerque, France
| | - Federico Canavese
- Service de chirurgie orthopédique et traumatologique pédiatrique, département universitaire, CHR de Lille, 2, avenue Oscar Lambret, 59000 Lille, France
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14
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Holzgang SA, Princip M, Pazhenkottil AP, Auschra B, von Känel R. Underutilization of effective coping styles in male physicians with burnout. PLoS One 2023; 18:e0291380. [PMID: 37682966 PMCID: PMC10490954 DOI: 10.1371/journal.pone.0291380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Ineffective coping is a risk factor for burnout among physicians, in whom the prevalence of burnout is high and has also increased in recent years. We examined in a cross-sectional study whether physicians with burnout show different coping styles compared with healthy controls. Male physicians (n = 60) were recruited into two groups (burnout vs. healthy). The Coping Inventory for Stressful Situations (CISS) and the Maslach Burnout Inventory (MBI) were applied. Wilcoxon rank-sum test showed group differences in two of the three coping styles, task-oriented and emotion-oriented, and also in one of the two subscales of the avoidance-oriented coping: social-diversion-oriented coping. Multiple binomial logistic regression, controlling for age, showed that lower task-oriented coping (OR = 0.38 (0.13 - 0.93), p = 0.048, d = 0.534) and lower social-diversion-oriented coping (OR = 0.33 (0.11 - 0.80), p = 0.024, d = 0.611) significantly predicted the burnout group. The findings suggest that male physicians with burnout differ from healthy controls in terms of less frequent utilization of effective coping styles. These findings could be explored for their utility in preventing burnout in future studies.
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Affiliation(s)
- Sarah A. Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P. Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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15
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AlAhmari FS, Aloqail A, Almansour S, Bagha M. State of well-being among residents in a tertiary center in Riyadh, Saudi Arabia. BMC MEDICAL EDUCATION 2023; 23:655. [PMID: 37684578 PMCID: PMC10492334 DOI: 10.1186/s12909-023-04596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician's professional development. This study aims to estimate the impact of the residency training program and demographic factors on the trainee's state of well-being (SOW). METHODS This was an observational cross-sectional study carried out in the year 2019-2020, which aimed to measure the SOW of residents undergoing clinical training in Riyadh, Saudi Arabia. A total of 260 residents participated in the study. A self-administered validated online the World Health Organization, Quality of Life Scale questionnaire- BREF was distributed to collect the data. The collected information on four different domains was analysed and compared across the baseline characteristics and different specialties. When appropriate, the independent sample t-test, bivariate correlation analysis, and ANOVA tests were used. RESULTS A total of 260 resident responses were included in the final analysis The results revealed a significant difference in physical health scores (p = 0.006), social relationship scores (p = 0.038), and environmental scores (p < 0.001) while no significant difference was found in psychological health scores among the physicians' specialties (p = 0.053). Post hoc comparison found statistically significant variations in the physical health domain between the medical and emergency specialties (p = 0.007), as well as surgical and emergency specialties (p = 0.024). There was also a significant difference between medical and emergency specialties (p = 0.008) in the social relationship domain. In the environment domain, significant variation was reported between medical specialties and emergency specialties (p = 0.001), as well asbetween surgical specialties and emergency specialties (p = 0.045). Female residents reported significantly lower quality of life in the physical (p = 0.020) and psychological (p = 0.032) domains. CONCLUSIONS A significant relationship was found between physical, social, and environmental domains according to residents' specialties. The factors that affected one or more domains included age, female gender, marital status, disease status, the number of on-calls received, and workload. We emphasize the importance of implementing policies to regulate working hours and on-call schedules as well as prioritizing mental health support.
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Affiliation(s)
- Fatimah Saeed AlAhmari
- College of Medicine, Alfaisal university, Riyadh, Saudi Arabia.
- Pediatrics Department, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia.
| | - Alaa Aloqail
- Pediatrics Department, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Shahad Almansour
- Pediatrics Department, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Mohammad Bagha
- Pediatrics Department, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
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16
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Mohr DC, Apaydin EA, Li BM, Molloy-Paolillo BK, Rinne ST. Changes in Burnout and Moral Distress Among Veterans Health Administration (VA) Physicians Before and During the COVID-19 Pandemic. J Occup Environ Med 2023; 65:605-609. [PMID: 37043388 PMCID: PMC10332509 DOI: 10.1097/jom.0000000000002861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND We investigated the impacts of workload, resources, organizational satisfaction, and psychological safety on changes in physician burnout and moral distress among physicians during the early pandemic. METHODS We obtained national administrative and survey data on burnout, moral distress, organizational satisfaction, psychological safety, COVID-19 burden, and state-level restrictions for 11,877-14,246 Veterans Health Administration (VA) physicians from 2019 and 2020. We regressed the changes in burnout and moral distress on the changes in reasonable workload, appropriate job resources, organizational satisfaction, and psychological safety, controlling for COVID-19 burden and restrictions, and individual and medical center characteristics. RESULTS Burnout and moral distress were not related to COVID-19 cases or restrictions but were reduced by improvements in workload, organizational satisfaction, and psychological safety. CONCLUSIONS Health systems should be conscious of factors that can harm or improve physician well-being, especially in the context of external stressors.
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17
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Zhang JK, Mattei TA. Response to a letter to the editor regarding, "Malpractice litigation in elective lumbar spinal fusion: a comprehensive review of reported legal claims in the U.S. in the past 50 years". Spine J 2023; 23:788-789. [PMID: 37100499 DOI: 10.1016/j.spinee.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Department of Surgery, Saint Louis University School of Medicine, 1402 S. Grand Blvd, Saint Louis, MO, 63104, USA
| | - Tobias A Mattei
- Division of Neurological Surgery, Department of Surgery, Saint Louis University School of Medicine, 1402 S. Grand Blvd, Saint Louis, MO, 63104, USA.
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18
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Brincin C, Payne DJL, Grierson J, Wood P, Robinson WP, Giustino VS, O' Sullivan J, Pilati F, Karydas S, Keeley B, Bright S, Bobis-Villagra D, Martin S, Schofield I, Matiasovic M. The value of routine radiographic follow up in the postoperative management of canine medial patellar luxation. Vet Surg 2023; 52:379-387. [PMID: 36625290 DOI: 10.1111/vsu.13933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/17/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To determine the influence of radiographic examination on the recommendations made at the time of planned re-evaluation of dogs after medial patellar luxation (MPL) surgery. STUDY DESIGN Retrospective multi-institutional case series. ANIMALS Client-owned dogs (N = 825) that underwent MPL surgery. METHODS Records of 10 referral institutions were searched for dogs that had been treated surgically for unilateral MPL and underwent a planned follow-up visit, including radiographs. The frequency of, and reasons for, changes in further recovery recommendations were investigated. RESULTS Follow up was performed at a median of 6 (range, 4-20) weeks postoperatively. Isolated radiographic abnormalities were identified in 3.3% (27/825) of dogs following MPL surgery and led to a change in recommendations in 3% (13/432) of dogs that were presented without owner or clinician concerns. Lameness, administration of analgesia at follow up, and history of unplanned visits prior to routine re-examination were associated with a change in postoperative plan (P < .001). In the absence of owner and clinician concerns, the odds of having a change in convalescence plans were not different, whether or not isolated radiographic abnormalities were present (P = .641). CONCLUSION Routine radiographs at follow up did not influence postoperative management of most dogs after MPL surgery in the absence of abnormalities on clinical history or orthopedic examination. CLINICAL SIGNIFICANCE Dogs that were presented for routine follow up after unilateral MPL surgery without owner concerns, lameness, analgesic treatment or a history of unplanned visits, and for which examination by a surgical specialist was unremarkable, were unlikely to benefit from radiographs.
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Affiliation(s)
| | | | | | - Philippa Wood
- Anderson Moores Veterinary Specialists, Winchester, UK
| | | | | | | | - Filipo Pilati
- Southern Counties Veterinary Specialists, Ringwood, UK
| | | | - Ben Keeley
- Manchester Veterinary Specialists, Manchester, UK
| | - Steve Bright
- Manchester Veterinary Specialists, Manchester, UK
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19
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Establishing the Essential Role of Household Extenders for Surgeon Wellbeing. Ann Surg 2023; 277:412-415. [PMID: 34417361 DOI: 10.1097/sla.0000000000005173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between a change in household support during the Covid-19 pandemic and surgeon stress. BACKGROUND The hours and unpredictability of surgical practice often necessitate the employment of household extenders (eg, child caregivers) to maintain a safe home environment for surgeons and their families. The Covid-19 pandemic destabilized these relationships and provided an opportunity to reflect on the role that household extenders play in a surgical household. METHODS A multi-institutional telephone survey of surgeons practicing at five geographically diverse academic institutions was conducted (May 15, 2020-June 5, 2020). Surgeons were classified by change in household extenders (HE) during the pandemic (decrease, increase, no change, or none). The primary outcome was self-reported surgeon stress level. Multivariable linear regression was used to examine the relationship between change in HE and surgeon stress, adjusting for training and relationship status, the presence of pets and children in the household, and study site. RESULTS The majority (182, 54.3%) of surgeons employed HE before the pandemic; 121 (36.1%) reported a decrease in HE during the pandemic, 9 (2.7%) reported an increase, and 52 (15.5%) reported no change. Stress scores varied significantly by change in HE group ( P = 0.016). After controlling for potential confounders, having an increase in HE was associated with a higher stress score (+1.55 points) than having no decrease in HE (P = 0.033), and having a decrease in HE was associated with a higher stress score (+0.96 points) than having no decrease ( P = 0.004). CONCLUSIONS Household extenders play a vital and complex role in enabling the healthcare workforce to care of the population. Surgeons who experienced a change in household extenders reported the highest stress levels. We suggest that health systems should proactively support surgeons by supporting the household extender workforce.
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20
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Ryan MT, Montgomery EA, Fryer J, Yang AW, Mills C, Watson N, Noller M, Riley CA, Tolisano AM. Ergonomics in Otolaryngology: A Systematic Review and Meta-analysis. Laryngoscope 2023; 133:467-475. [PMID: 35575629 DOI: 10.1002/lary.30216] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To determine the proportion of otolaryngologists with work-related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD. STUDY DESIGN Systematic review and meta-analysis. METHODS A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta-analysis. Random effects meta-analyses were used to estimate the proportion of otolaryngologists reporting WRMD. RESULTS The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%-84% of otolaryngologists underwent medical treatment for WRMD. 5%-23% took time off work and 1%-6% stopped operating completely as a result of WRMD. 23%-62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk. CONCLUSIONS Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467-475, 2023.
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Affiliation(s)
- Matthew T Ryan
- Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A
| | - Emily A Montgomery
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
| | - Jacob Fryer
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
| | - Alex W Yang
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
| | - Channah Mills
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
| | - Nora Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A
| | - Michael Noller
- Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A
| | - Charles A Riley
- Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
| | - Anthony M Tolisano
- Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A
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Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis. J Am Coll Surg 2023; 236:253-265. [PMID: 36519921 DOI: 10.1097/xcs.0000000000000402] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
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.
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22
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Nugent RE, Gaston TE, Markowitz MP, Cheesman QT, Herbst KA, Radack TM, Parekh SG, Daniel JN. Burnout Rates Among General Orthopedic Surgeons and Subspecialists: A Pilot Study. Orthopedics 2022; 45:333-339. [PMID: 36098570 DOI: 10.3928/01477447-20220907-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Burnout among physicians is a syndrome of emotional exhaustion, de-personalization, and reduced sense of personal accomplishment that can negatively affect personal relationships, physician well-being, and patient outcomes. Although burnout rates of up to 50% to 60% among orthopedic surgeons have been reported, no studies have evaluated burnout among orthopedic generalists and subspecialists. The primary goal of this study was to examine the prevalence of burnout among orthopedic disciplines. We conducted a multicenter study from March 2019 through December 2019 involving 149 orthopedists. An abbreviated Maslach Burnout Inventory-Human Services Survey was used to measure burnout. Demographic information, personal characteristics, professional characteristics, family life and spousal support, and depression were also assessed. The mean rate of burnout among all respondents was 62%, whereas 16.77% screened positive for depression. Subspecialties with the highest rates of burnout were oncology (100%), sports medicine (68%), and trauma (63%). Similarly, trauma (50.00%), oncology (40.00%), and general orthopedics (20.00%) had the highest positive depression screening rates. In contrast, shoulder and elbow (50%), pediatric (52%), and foot and ankle (54%) specialists had the lowest rates of burnout, whereas shoulder and elbow (0.00%), spine (0.00%), and sports medicine (6.50%) specialists had the lowest rates of positive depression screening. Older age, higher debt load, and oncology subspecialty were associated with increased burnout risk. This study sought to determine burnout rates within each orthopedic discipline, with a secondary aim of disclosing contributing factors. Trauma and oncology had the highest rates of burnout and positive depression screening. Because this study represents a small orthopedic cohort, larger studies are needed to appropriately manage burnout in the future. [Orthopedics. 2022;45(6):333-339.].
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Lund S, D'Angelo AL, Busch R, Friberg R, D'Angelo J. With a Little Help From My Friends: The Negating Impact of Social Community and Mentorship on Burnout. J Surg Res 2022; 278:190-195. [DOI: 10.1016/j.jss.2022.04.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/12/2022] [Accepted: 04/23/2022] [Indexed: 12/01/2022]
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Sauder M, Zagales I, Zagales R, Das S, Sen-Crowe B, Bilski T, Kornblith L, Elkbuli A. Comprehensive Assessment of Burnout Among Surgical Trainees and Practicing Surgeons: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1188-1205. [PMID: 35624025 DOI: 10.1016/j.jsurg.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Surgeon burnout has received increasing attention due to evidence of high prevalence across specialties. We aimed to (1) systematically characterize existing definitions of burnout, (2) evaluate tools to measure burnout, and (3) determine risk factors of surgical burnout. DESIGN PubMed, Google Scholar, and Embase databases were searched to identify burnout rates and tools used to measure the quality of life (QoL) published from January 2000-December 2021. PARTICIPANTS Surgical Trainees and Practicing Surgeons. RESULTS We identified 39 studies that defined surgical burnout, with 9 separate tools used to measure QoL. Surgeon burnout rates were found to be highest among general surgery trainees (20%-95%). Burnout among general surgery attendings ranged from 25% to 44%. Those most likely to experience burnout were younger and female. High rates of surgeon burnout were reported among all surgical specialties; however, these rates were lower than those of general surgeons. CONCLUSION Definitions of burnout vary throughout the surgical literature, but are consistently characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. The most utilized tool to measure surgical burnout has been the Maslach Burnout Inventory. Across specialties, there are high rates of burnout in both surgical trainees and attendings, indicating that this is a systemic issue within the field of surgery. Given the wide-scale nature of the problem, it is recommended that institutions provide support to surgical trainees and attending surgeons and that individual surgeons take steps toward mitigating burnout.
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Affiliation(s)
- Matthew Sauder
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Israel Zagales
- Universidad Iberoamericana (UNIBE) Escuela de Medicina, Santo Domingo, Dominican Republic
| | - Ruth Zagales
- Florida International University, Miami, Florida
| | - Snigdha Das
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Brendon Sen-Crowe
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Tracy Bilski
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida
| | - Lucy Kornblith
- Department of Surgery, Division of Trauma and Surgical Critical Care, Zuckerberg San Francisco General Hospital, San Francisco, California; University of San Francisco, San Francisco, California
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida.
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Ujjan BU, Hussain F, Nathani KR, Farhad A, Chaurasia B. Factors associated with risk of burnout in neurosurgeons: current status and risk factors. Acta Neurol Belg 2022; 122:1163-1168. [PMID: 35988123 PMCID: PMC9392991 DOI: 10.1007/s13760-022-02072-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/15/2022] [Indexed: 12/03/2022]
Abstract
Objective The study aimed to evaluate burnout and associated risk factors in neurosurgical residents and faculty members. Summary of background data Burnout is an occupational risk of emotional exhaustion, depersonalization, and reduced perception of personal accomplishment secondary to work stress. It burdens the individual with immense mental stress causing compromised professional performance. Healthcare workers, particularly surgeons, have been documented to be at high risk of developing burnout, considering the stressful routine and serious impact of their profession. Methods The modified Maslach Burnout Inventory was filled by fellow neurosurgical residents or consultants. The respondents were classified into burnout and non-burnout groups and then analyzed for the associated risk factors. The data were analyzed using SPSS v26. Results One hundred and thirty-eight neurosurgical healthcare workers, including 62 residents and 76 consultants, responded to the questionnaire. The burnout and non-burnout groups comprised 83 (60%) and 55 (39.9%) respondents. Female gender and few kids were observed as significant risk factors for the development of burnout (p = 0.013 and p = 0.006, respectively). Regardless of its year, residency was a risk factor for overall burnout, as well as in each subsection of the Maslach Inventory (p = 0.002). In consultants, recent qualifications and a high number of weekly calls were also associated with a significant risk of burnout (p = 0.012 and p = 0 .027, respectively). Marital status and national economic status did not reveal any influence on the status of burnout in neurosurgical healthcare workers. Conclusion Burnout syndrome is a prevalent and serious, yet overlooked, condition among neurosurgeons. Adequate assessment and steps should be encouraged to ensure physician and patient safety.
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Affiliation(s)
- Badar Uddin Ujjan
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Farhad Hussain
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan.
| | - Karim Rizwan Nathani
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Aisha Farhad
- Department of Internal Medicine, Liaquat National Hospital, Karachi, Pakistan
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The Impact of Burnout on Police Officers’ Performance and Turnover Intention: The Moderating Role of Compassion Satisfaction. ADMINISTRATIVE SCIENCES 2022. [DOI: 10.3390/admsci12030092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Burnout should be seen as an important phenomenon influencing the services provided by police forces, due to its high exposure to stressful events. The study sought to examine the impact of burnout on performance and turnover intention of Portuguese police forces, as well as to analyze the moderating effect of compassion satisfaction (CS) on this relationship. Data were collected in 2021 from 1.682 Portuguese police officers, using individual surveys. The results showed that (1) burnout is negatively related to performance; (2) burnout is positively related to turnover intention; (3) CS, although it has a positive effect on performance, does not assume a moderating role, as expected, in the relationship between burnout and performance; (4) CS assumes a moderating role in the relationship between burnout and turnover intention. That is, when a person who still suffers from burnout feels CS, it decreases the intention to leave the organization. The implications and the bearings of this study are discussed and presented regarding the theoretical, empirical and practical perspectives in order to better support both the comprehension of burnout in police officers and offer the best practical recommendations.
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Discussion: Parenting in Plastic Surgery Residency. Plast Reconstr Surg 2022; 149:1472-1473. [PMID: 35613295 DOI: 10.1097/prs.0000000000009136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stein MK, Fryhofer GW, Blumenthal S, Huang V, Donegan DJ, Mehta S. Objects in Mirror Are Closer Than They Appear: Symptoms of Depression and Suicidality in Orthopaedic Surgeons. J Bone Joint Surg Am 2022; 104:959-970. [PMID: 35333812 DOI: 10.2106/jbjs.21.00666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Suicide and depression among orthopaedic surgeons have recently emerged as rising concerns. Prior research has suggested that orthopaedic surgeons have the highest prevalence of suicide among surgical specialties. We sought to determine the factors associated with depression and suicidal ideation (SI) in orthopaedics, including subspecialty. METHODS A survey including demographic questions, the Beck Depression Inventory, and the Columbia-Suicide Severity Rating Scale was administered electronically via a listserv to the orthopaedic subspecialties of trauma, adult reconstruction, hand and upper extremity, shoulder and elbow, foot and ankle, spine, pediatrics, sports medicine, and oncology. The responses were quantified according to previously published criteria. The associations of demographic factors, training, and current practice environment with depression and suicidality were assessed using Fisher exact tests. Reverse stepwise multivariable logistic regression models were developed to identify factors associated with depression and SI. RESULTS The responses were obtained from 661 board-certified, practicing orthopaedic surgeons. In this study, 156 surgeons (23.6%) endorsed some level of active SI in their lifetime, 200 surgeons (30.3%) reported either active or passive SI in their lifetime, and 33 surgeons (5%) reported that, on at least 1 occasion in their lifetime, they had experienced active SI with a specific plan and intention to harm themselves. Gender, relationship status, having children, and residency and/or current practice region were significantly associated with depression and/or SI. Younger age, divorce, adult reconstruction and foot and ankle subspecialties, and attending residency in the Western U.S. were found on multivariable testing to be associated with symptoms of depression and SI (odds ratios, 1.03 [per 1-year decrease in age] to 8.28). CONCLUSIONS Symptoms of depression and suicidality are not uncommon among orthopaedic surgeons, and variation by gender, relationship status, and geographic location are supported by prior research. Based on our results, depression and/or SI likely affect someone close to you or someone with whom you work. The normalization of discussions surrounding emotional well-being, depression, and SI is imperative.
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Affiliation(s)
- Matthew K Stein
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - George W Fryhofer
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sarah Blumenthal
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Vincent Huang
- School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Derek J Donegan
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Samir Mehta
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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Pandit AS, Reka A, Layard Horsfall H, Marcus HJ. Mindfulness Training for Young Neurosurgeons: A Virtual Multicenter Prospective Pilot Study. World Neurosurg 2022; 164:e446-e457. [PMID: 35533949 DOI: 10.1016/j.wneu.2022.04.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Burnout is prevalent among neurosurgeons and can negatively impact both technical and nontechnical skills and subsequent patient care. Mindfulness training has previously been shown to ameliorate the effects of burnout and improve performance in health care workers and high-stress occupations, but no such evaluation has been formally conducted for neurosurgeons. We aimed to determine the effectiveness and feasibility of a virtual mindfulness-based intervention (MBI) in neurosurgeons. METHODS A prospective trial of an MBI was implemented and hosted from our tertiary academic unit, running virtually from October to December 2020. Practicing neurosurgeons of all grades were recruited from 9 neurosurgical centers. Participants underwent 8 weeks of 90-minute MBI classes and suggested daily practice. Psychometric measures related to burnout, stress, wellbeing, and mindfulness competencies were assessed at baseline and on course completion. RESULTS Twenty-one neurosurgeons participated in the study (attendings = 2, residents = 18, interns = 1, mean age = 30.3 [standard deviation 3.9] years). Significant improvements after intervention were present in perceived stress (Z = -2.54, P = 0.04) and emotional exhaustion (Z = -2.41, P = 0.04). Mindfulness training was associated with improved mindfulness skills (Z = -2.58, P = 0.006), self-compassion (t = -4.4, P = 0.002), resilience (Z = -3.18, P = 0.004), and choice response times (Z = -2.13, P = 0.03). All neurosurgeons who completed the postintervention assessment stated they would recommend the course and agreed that it was relevant to their surgical practice. CONCLUSIONS Preliminary evidence from this trial cautiously supports the effectiveness and feasibility of a virtual MBI for dealing with stress, burnout, and improving dexterity among young neurosurgeons. Further research is warranted to validate these findings.
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Affiliation(s)
- Anand S Pandit
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Arisa Reka
- Department of Medicine, University College London, London, United Kingdom
| | - Hugo Layard Horsfall
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Hani J Marcus
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Female Surgeons for Obesity Treatment: a Snapshot Sampling in Academic Productivity : The Role of Women in Obesity Surgery. Obes Surg 2022; 32:1741-1747. [PMID: 35296967 DOI: 10.1007/s11695-022-05998-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
The proportion of females choosing a career in surgery is lower than that of males. Through the Obesity Surgery and SOARD journals of 2018-2020, the number of articles with female first/senior authors was identified and their characteristics were assessed. Almost 40% of the published papers were written by females, being mostly original and from University Hospitals, although the difference in the numbers between journals was prominent (p = 0.011). Articles with a female as first author had a female or male as senior, at a ratio 1:2, while less than 10% of female senior authors had a male as first. The number of females as corresponding authors in SOARD was significantly higher (p < 0.001). The findings of the present study underline the existing gender inequity in bariatric surgery.
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Stress Among Surgeons: Sources and Determinants. Indian J Surg 2022. [DOI: 10.1007/s12262-021-02832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Akl A, Mohiyaldeen I, Alshatti R, Alenezi O, Dougherty R, Al-Raihan A, Alotaibi S, Tadros N, Longenecker JC. The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals. Front Public Health 2022; 10:679834. [PMID: 35174119 PMCID: PMC8841660 DOI: 10.3389/fpubh.2022.679834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Workplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait. Methods This cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders. Results Prevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9–80.7%) and 14.0% (11.0–17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases. Conclusion The prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.
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Affiliation(s)
- Amr Akl
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Idrees Mohiyaldeen
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Rashed Alshatti
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Omer Alenezi
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Ryan Dougherty
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Abdullah Al-Raihan
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Salman Alotaibi
- Kuwait Ministry of Health, Rotating Internship Program, Kuwait City, Kuwait
| | - Nardine Tadros
- Faculty of Medicine, Department of Community Medicine and Behavioural Sciences, Kuwait University, Kuwait City, Kuwait
- Department of Quality and Accreditation, Kuwait Ministry of Health, Kuwait City, Kuwait
| | - Joseph C. Longenecker
- Faculty of Medicine, Department of Community Medicine and Behavioural Sciences, Kuwait University, Kuwait City, Kuwait
- Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
- *Correspondence: Joseph C. Longenecker
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Claeson AA, Schwab FJ, Gandhi AA, Skaggs DL. Power-assisted Pedicle Screw Technique Protects Against Risk of Surgeon Overuse Injury: A Comparative Electromyography Study of the Neck and Upper Extremity Muscle Groups in a Simulated Surgical Environment. Spine (Phila Pa 1976) 2022; 47:E86-E93. [PMID: 33973563 DOI: 10.1097/brs.0000000000004097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cadaveric. OBJECTIVE The aim of this study was to quantify the amplitude and duration of surgeons' muscle exertion from pedicle cannulation to screw placement using both manual and power-assisted tools in a simulated surgical environment using surface electromyography (EMG). SUMMARY OF BACKGROUND DATA A survey of Scoliosis Research Society members reported rates of neck pain, rotator cuff disease, lateral epicondylitis, and cervical radiculopathy at 3 ×, 5 ×, 10 ×, and 100 × greater than the general population. The use of power-assisted tools in spine surgery to facilitate pedicle cannulation through screw placement during open posterior fixation surgery may reduce torque on the upper limb and risk of overuse injury. METHODS Pedicle preparation and screw placement was performed from T4-L5 in four cadavers by two board-certified spine surgeons using both manual and power-assisted techniques. EMG recorded muscle activity from the flexor carpi radialis, extensor carpi radialis, biceps, triceps, deltoid, upper trapezius, and neck extensors. Muscle activity was reported as a percentage of the maximum voluntary exertion of each muscle group (%MVE) and muscle exertion was linked to low- (0-20% MVE), moderate- (20%-45% MVE), high- (45%-70% MVE) and highest- (70%-100% MVE) risk of overuse injury based on literature. RESULTS Use of power-assisted tools for pedicle cannulation through screw placement maintains average muscle exertion at low risk for overuse injury for every muscle group. Conversely with manual technique, the extensor carpi radialis, biceps, upper trapezius and neck extensors operate at levels of exertion that risk overuse injury for 50% to 92% of procedure time. Powerassisted tools reduce average muscle exertion of the biceps, triceps, and deltoid by upwards of 80%. CONCLUSION Power-assisted technique protects against risk of overuse injury. Elevated muscle exertion of the extensor carpi radialis, biceps, upper trapezius, and neck extensors during manual technique directly correlate with surgeons' self-reported diagnoses of lateral epicondylitis, rotator cuff disease, and cervical myelopathy.Level of Evidence: N/A.
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Prevalence of Burnout among General Practitioners: A Systematic Review and Meta-Analysis. Br J Gen Pract 2021; 72:e316-e324. [PMID: 34990391 DOI: 10.3399/bjgp.2021.0441] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/09/2021] [Indexed: 12/16/2022] Open
Abstract
Background Burnout is a work-related syndrome documented to have negative consequences for general practitioners (GPs) and their patients. Our objective was to conduct a systematic review and meta-analysis of the literature to provide an estimate of how widespread this phenomenon is. AIM To review the existing literature concerning studies published up to December, 2020, on the prevalence of burnout amongst GPs in general practice, to determine GP burnout estimates worldwide. DESIGN AND SETTING Systematic literature search and meta-analysis. METHOD Searches of CINAHL Plus, Embase, MEDLINE, PsycINFO, and Scopus were conducted to identify published peer-reviewed quantitative empirical studies in English up to December, 2020, that have used the Maslach Burnout Inventory-Human Services Survey to establish the prevalence of burnout in practising GPs (i.e., excluding GPs in training). A random-effects model was employed. RESULTS Wide-ranging prevalence estimates (6% to 32%) for 22,177 GPs across 29 countries were reported for 60 studies included in this review. Mean burnout estimates were as follows: 16.43 (EE); 6.74 (DEP); and 29.28 (PA). Subgroup and meta-analyses documented that country-specific factors may be important determinants of the variation in GP burnout estimates. Moderate overall burnout cut-offs were found to be determinants of the variation in moderate overall burnout estimates. CONCLUSION Moderate to high GP burnout exist worldwide. However, substantial variations in how burnout is characterised and operationalised resulted in considerable heterogeneity in GP burnout prevalence estimates. This highlights the challenge of developing a uniform approach, and the importance of considering the GP's work context, to better characterise burnout.
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Moniz T, Pack R, Lingard L, Watling C. Voices from the Front Lines: An Analysis of Physicians' Reflective Narratives about Flaws with the 'System'. THE JOURNAL OF MEDICAL HUMANITIES 2021; 42:737-752. [PMID: 33822310 PMCID: PMC8021932 DOI: 10.1007/s10912-021-09690-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Physicians often express frustration with the 'system' in which they work. Over time, this frustration may put them at risk of burnout and disengagement, which may impact patient care. In this study, we aimed to understand the nature of the system flaws that physicians identified in their published narratives and to explore their self-representation as agents of change. We reviewed all reflective narratives published in four medical journals (NEJM, JAMA, CMAJ, Annals IM) between January 2015 and December 2017 (n = 282). By consensus, we identified those that addressed system flaws (n = 87). Using content and narrative analysis, we analyzed the types of flaws and the physicians' orientation to the flawed system. We identified seven recurring system flaws-five related to medical culture: failures of communication, erosive impact of the hidden curriculum, inadequate health advocacy, frenzied pace of work, and experience of stigma. Less frequently, physicians' narratives also exposed limited and disparate healthcare resources and restrictive institutional practices as impeding patient-centered care. Physicians expressed agency to create change foremost when writing about flaws related to medical culture. While physicians are challenged by system flaws, they strive to practice in ways that do not succumb to them. We saw tension between the elements outside the physician's control and those within it. This tension becomes a source of distress when the compromises that emerge from system flaws move physicians away from the values that define their professional identity.
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Affiliation(s)
- Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, 166 Bedford Hwy., McCain Centre, Room 305F, Halifax, Nova Scotia, B3M 2J6, Canada.
| | - Rachael Pack
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Lorelei Lingard
- Centre for Education Research & Innovation, and Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Chris Watling
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Bazargan-Hejazi S, Shirazi A, Wang A, Shlobin NA, Karunungan K, Shulman J, Marzio R, Ebrahim G, Shay W, Slavin S. Contribution of a positive psychology-based conceptual framework in reducing physician burnout and improving well-being: a systematic review. BMC MEDICAL EDUCATION 2021; 21:593. [PMID: 34823509 PMCID: PMC8620251 DOI: 10.1186/s12909-021-03021-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. METHODS Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). RESULTS Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. CONCLUSION Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.
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Affiliation(s)
- Shahrzad Bazargan-Hejazi
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA.
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Anaheed Shirazi
- Department of Psychiatry, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Andrew Wang
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Nathan A Shlobin
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Krystal Karunungan
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Joshua Shulman
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Robert Marzio
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Gul Ebrahim
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - William Shay
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Stuart Slavin
- Accreditation Council for Graduate Medical Education, Chicago, USA
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Yao H, Wang P, Tang YL, Liu Y, Liu T, Liu H, Chen Y, Jiang F, Zhu J. Burnout and job satisfaction of psychiatrists in China: a nationwide survey. BMC Psychiatry 2021; 21:593. [PMID: 34819029 PMCID: PMC8612106 DOI: 10.1186/s12888-021-03568-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite a significant shortage of psychiatrists in China, an ever-increasing number of psychiatrists in China are experiencing burnout and job dissatisfaction and considering leaving their jobs. Yet, to our knowledge, there have been no nationwide studies to date that examined both burnout and job dissatisfaction of psychiatrists in China. Therefore, this study evaluated burnout and job dissatisfaction of psychiatrists in China, and identified relevant characteristics. METHODS We conducted a nationwide, cross-sectional survey in March 2019. Psychiatrists from all tertiary psychiatric hospitals in China were invited to participate. The Maslach Burnout Inventory-Human Service Survey and the short version of the Minnesota Satisfaction Questionnaire were used to measure burnout and job satisfaction. Data on socio-demographic and occupational characteristics were collected. Multivariate logistic regression was conducted to identify socio-demographic and occupational characteristics associated with burnout and job satisfaction. RESULTS In total, 4520 psychiatrists from tertiary psychiatric hospitals in China completed the questionnaire. Overall, 38.4% of respondents met the criteria for burnout and 35.6% were dissatisfied with their jobs. Being male, more years of practice, having no leadership role, and longer working hours per week were significantly associated with burnout and job dissatisfaction. Lower monthly pay was significantly associated with job dissatisfaction but not burnout. Moreover, burnout was significantly associated with job dissatisfaction. CONCLUSIONS Our data suggest a high rate of burnout and job dissatisfaction among psychiatrists in China. In order to preserve and strengthen the mental health workforce, proactive measures are urgently needed to mitigate burnout and job dissatisfaction among psychiatrists in China.
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Affiliation(s)
- Hao Yao
- grid.16821.3c0000 0004 0368 8293Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Peicheng Wang
- grid.12527.330000 0001 0662 3178Vanke School of Public Health, Tsinghua University, Beijing, 100084 China ,grid.12527.330000 0001 0662 3178School of Medicine, Tsinghua University, Beijing, 100084 China
| | - Yi-Lang Tang
- grid.414026.50000 0004 0419 4084Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA 30033 USA ,grid.189967.80000 0001 0941 6502Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30329 USA
| | - Yuanli Liu
- grid.506261.60000 0001 0706 7839School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 China
| | - Tingfang Liu
- grid.12527.330000 0001 0662 3178Institute for Hospital Management of Tsinghua University, Beijing, 100091 China
| | - Huanzhong Liu
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000 China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yanhua Chen
- grid.12527.330000 0001 0662 3178Vanke School of Public Health, Tsinghua University, Beijing, 100084 China ,grid.12527.330000 0001 0662 3178School of Medicine, Tsinghua University, Beijing, 100084 China
| | - Feng Jiang
- grid.16821.3c0000 0004 0368 8293School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China.
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Mir H, Downes K, Chen AF, Grewal R, Kelly DM, Lee MJ, Leucht P, Dulai SK. Physician wellness in orthopaedic surgery : a multinational survey study. Bone Jt Open 2021; 2:932-939. [PMID: 34766825 PMCID: PMC8636297 DOI: 10.1302/2633-1462.211.bjo-2021-0153] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIMS Physician burnout and its consequences have been recognized as increasingly prevalent and important issues for both organizations and individuals involved in healthcare delivery. The purpose of this study was to describe and compare the patterns of self-reported wellness in orthopaedic surgeons and trainees from multiple nations with varying health systems. METHODS A cross-sectional survey of 774 orthopaedic surgeons and trainees in five countries (Australia, Canada, New Zealand, UK, and USA) was conducted in 2019. Respondents were asked to complete the Mayo Clinic Well-Being Index and the Stanford Professional Fulfillment Index in addition to 31 personal/demographic questions and 27 employment-related questions via an anonymous online survey. RESULTS A total of 684 participants from five countries (Australia (n = 74), Canada (n = 90), New Zealand (n = 69), UK (n = 105), and USA (n = 346)) completed both of the risk assessment questionnaires (Mayo and Stanford). Of these, 42.8% (n = 293) were trainees and 57.2% (n = 391) were attending surgeons. On the Mayo Clinic Well-Being Index, 58.6% of the overall sample reported feeling burned out (n = 401). Significant differences were found between nations with regards to the proportion categorized as being at risk for poor outcomes (27.5% for New Zealand (19/69) vs 54.4% for Canada (49/90) ; p = 0.001). On the Stanford Professional Fulfillment Index, 38.9% of the respondents were classified as being burned out (266/684). Prevalence of burnout ranged from 27% for Australia (20/74 up to 47.8% for Canadian respondents (43/90; p = 0.010). Younger age groups (20 to 29: RR 2.52 (95% confidence interval (CI) 1.39 to 4.58; p = 0.002); 30 to 39: RR 2.40 (95% CI 1.36 to 4.24; p = 0.003); 40 to 49: RR 2.30 (95% CI 1.35 to 3.9; p = 0.002)) and trainee status (RR 1.53 (95% CI 1.15 to 2.03 p = 0.004)) were independently associated with increased relative risk of having a 'at-risk' or 'burnout' score. CONCLUSIONS The rate of self-reported burnout and risk for poor outcomes among orthopaedic surgeons and trainees varies between countries but remains unacceptably high throughout. Both individual and health system characteristics contribute to physician wellness and should be considered in the development of strategies to improve surgeon wellbeing. Level of Evidence: III Cite this article: Bone Jt Open 2021;2(11):932-939.
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Affiliation(s)
- Hassan Mir
- Florida Orthopedic Institute, Tampa, Florida, USA
| | | | - Antonia F Chen
- Department of Orthopaedics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ruby Grewal
- Roth McFarlane Hand and Upper Limb Cente, University of Western Ontario, London, Canada
| | - Derek M Kelly
- Campbell Clinic Orthopaedics, Memphis, Tennessee, USA
| | - Michael J Lee
- Department of Orthopaedics, University of Chicago, Chicago, Illinois, USA
| | - Philipp Leucht
- Ortho Surgery & Cell Biology, NYU Langone Health, New York, New York, USA
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Huang R, Hewitt DB, Cheung EO, Agarwal G, Etkin CD, Smink DS, Shanafelt TD, Bilimoria KY, Hu YY. Burnout Phenotypes Among U.S. General Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2021; 78:1814-1824. [PMID: 33935019 DOI: 10.1016/j.jsurg.2021.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/10/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Although well-established metrics exist to measure workplace burnout, researchers disagree about how to categorize individuals based on assessed symptoms. Using a person-centered approach, this study identifies classes of burnout symptomatology in a large sample of general surgery residents in the United States. DESIGN, SETTING, PARTICIPANTS A survey was administered following the 2018 American Board of Surgery In-Training Examination (ABSITE) to study wellness among U.S. general surgery residents. Latent class models identified distinct classes of residents based on their responses to the emotional exhaustion and depersonalization questions of the modified abbreviated Maslach Burnout Inventory (aMBI). Classes were assigned representative names, and the characteristics of their members and residency programs were compared. RESULTS The survey was completed by 7415 surgery residents from 263 residency programs nationwide (99.3% response rate). Five burnout classes were found: Burned Out (unfavorable score on all six items, 9.8% of total), Fully Engaged (favorable score on all six items, 23.1%), Fatigued (favorable on all items except frequent fatigue, 32.2%), Overextended (frequent fatigue and burnout from work, 16.7%), and Disengaged (weekly symptoms of fatigue and callousness, 18.1%). Within the more symptomatic classes (Burned Out, Overextended, and Disengaged), men manifested more depersonalization symptoms, whereas women reported more emotional exhaustion symptoms. Burned Out residents were characterized by reports of mistreatment (abuse, sexual harassment, and gender-, racial-, or pregnancy and/or childcare-based discrimination), duty hour violations, dissatisfaction with duty hour regulations or time for rest, and low ABSITE scores. CONCLUSIONS Burnout is multifaceted, with complex and variable presentations. Latent class modeling categorizes general surgery residents based on their burnout symptomatology. Organizations should tailor their efforts to address the unique manifestations of each class as well as shared drivers.
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Affiliation(s)
- Reiping Huang
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - D Brock Hewitt
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Division of Surgical Oncology, Ohio State University Wexner Medical Center, Arthur G James Cancer Hospital, Columbus, Ohio
| | - Elaine O Cheung
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Gaurava Agarwal
- Department of Psychiatry, Northwestern University, Chicago, Illinois
| | - Caryn D Etkin
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Douglas S Smink
- Brigham & Women's Faulkner Hospital, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Tait D Shanafelt
- Division of Hematology, Stanford School of Medicine, Stanford University, Stanford, California; Stanford Medicine WellMD Center, Stanford, California
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; American College of Surgeons, Chicago, Illinois
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Alabi RO, Hietanen P, Elmusrati M, Youssef O, Almangush A, Mäkitie AA. Mitigating Burnout in an Oncological Unit: A Scoping Review. Front Public Health 2021; 9:677915. [PMID: 34660505 PMCID: PMC8517258 DOI: 10.3389/fpubh.2021.677915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to provide a scoping review on how to address and mitigate burnout in the profession of clinical oncology. Also, it examines how artificial intelligence (AI) can mitigate burnout in oncology. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science, for articles that examine how to address burnout in oncology. Results: A total of 17 studies were found to examine how burnout in oncology can be mitigated. These interventions were either targeted at individuals (oncologists) or organizations where the oncologists work. The organizational interventions include educational (psychosocial and mindfulness-based course), art therapies and entertainment, team-based training, group meetings, motivational package and reward, effective leadership and policy change, and staff support. The individual interventions include equipping the oncologists with adequate training that include-communication skills, well-being and stress management, burnout education, financial independence, relaxation, self-efficacy, resilience, hobby adoption, and work-life balance for the oncologists. Similarly, AI is thought to be poised to offer the potential to mitigate burnout in oncology by enhancing the productivity and performance of the oncologists, reduce the workload and provide job satisfaction, and foster teamwork between the caregivers of patients with cancer. Discussion: Burnout is common among oncologists and can be elicited from different types of situations encountered in the process of caring for patients with cancer. Therefore, for these interventions to achieve the touted benefits, combinatorial strategies that combine other interventions may be viable for mitigating burnout in oncology. With the potential of AI to mitigate burnout, it is important for healthcare providers to facilitate its use in daily clinical practices. Conclusion: These combinatorial interventions can ensure job satisfaction, a supportive working environment, job retention for oncologists, and improved patient care. These interventions could be integrated systematically into routine cancer care for a positive impact on quality care, patient satisfaction, the overall success of the oncological ward, and the health organizations at large.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | | | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Omar Youssef
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland.,University of Turku, Institute of Biomedicine, Pathology, Turku, Finland
| | - Antti A Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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Abstract
STUDY DESIGN Cross-sectional survey study. OBJECTIVE To evaluate the prevalence of burnout, assess the personal and professional characteristics associated with burnout in spine surgeons and determine their quality of life. SUMMARY OF BACKGROUND DATA Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and decreased sense of accomplishment that leads to decreased effectiveness at work. To date, there has been a lack of information on the prevalence of burnout among spine surgeons worldwide and the risk factors associated with this condition. METHODS An electronic survey with members of AO Spine was performed in May 2018. The survey evaluated demographic variables, practice characteristics, burnout, and quality of life. Maslach Burnout Inventory (MBI) and EuroQol 5-dimensions (EQ5D) were used to evaluate burnout and quality of life, respectively. RESULTS A total of 818 surgeons from 86 countries completed the survey. The prevalence of burnout was 30.6%. In the multiple linear model, emotional fatigue was independently associated with younger age (B = -0.17, CI95% = -0.26 to -0.07, P < 0.0001), and longer working hours per week (B = -2.71, CI95% = -4.34 to -1.07, P = 0.001); depersonalization was independently associated with younger age (B = -0.13, CI95% = -0.19 to -0.07, P < 0.0001), practicing outside Latin America (LA) (B = 0.71, CI95% = 0.41-1.01, P < 0.0001) and currently being a fellow (B = 0.54, CI95% = 0.06-1.02, P = 0.02); and higher scores of personal fulfilment was associated with practicing in LA (B = -1.27, CI95% = -1.69 to -0.85, P < 0.0001). CONCLUSION Burnout is a common condition among spine surgeons worldwide. There is a significant association between burnout scores and decreased general quality of life. These results highlight the need to develop interventional programs to better identify, prevent, and manage this condition among practicing spine surgeons.Level of Evidence: 4.
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Abstract
Physician fatigue, also known as burnout, is a highly prevalent but often underrecognized result of workplace stressors. The consequences of burnout can include poor work-life integration, isolation, depression, and suicide. As a result, an organization may experience high physician turnover, patient safety issues, malpractice suits, and financial losses. Physicians should be encouraged to play a role in their wellness by taking mental time away from work, pursuing hobbies, attending wellness programs, and ensuring quality time with family. Ultimately, it is an organization that must acknowledge physician burnout, identify risk factors, and invest in targeted interventions to prevent this immense threat to their stability.
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Affiliation(s)
- Asyia Ahmad
- Division of Gastroenterology, Drexel University College of Medicine/Tower Health Medical Group, Philadelphia, PA, USA.
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Scott L, Lim R, Foxcroft L, Lum PA. How can surgical programs use peer support programs in times of crisis? Can Urol Assoc J 2021; 15:S36-S39. [PMID: 34406930 DOI: 10.5489/cuaj.7302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Leslie Scott
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Rodrick Lim
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Laura Foxcroft
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - P Andrea Lum
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Walker HR, Evans E, Nirula R, Hyngstrom J, Matsen C, Nelson E, Pickron B, Zurbuchen E, Morrow EH. "I need to have a fulfilling job": A qualitative study of surgeon well-being and professional fulfillment. Am J Surg 2021; 223:6-11. [PMID: 34332744 DOI: 10.1016/j.amjsurg.2021.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/25/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Burnout, often regarded as an individual failing, rather than a systemic one, negatively impacts quality of care, patient safety and healthcare costs. Focusing on improving well-being can help mitigate burnout. This study examined protective factors that promote well-being and professional fulfillment in surgeons. METHODS Using a purposive sample, 32 semi-structured 30-60-min interviews were conducted with surgeons of varying sub-specialties and rank. Abductive exploratory analysis was used to code and interpret interview transcripts and to build a conceptual model of surgeon well-being. RESULTS Emergent protective factors were placed into one of three levels of implementation: individual, team-level, and institutional (figure). Individual factors for well-being included autonomy and adequate time to pursue non-clinical endeavors. Team-level factors consisted of adaptability, boundaries, and cohesion. Institutional factors related to diversifying performance evaluations and celebrating and recognizing individual value and contributions. CONCLUSIONS The conceptual model developed from the results of this study highlights factors important to surgeons' professional well-being. This model can be used to guide quality improvement efforts.
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Affiliation(s)
| | - Ethan Evans
- University of Utah Health, Resiliency Center, United States.
| | - Raminder Nirula
- University of Utah School of Medicine, Department of Surgery, United States.
| | - John Hyngstrom
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Cindy Matsen
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Edward Nelson
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Bartley Pickron
- University of Utah School of Medicine, Department of Surgery, United States.
| | | | - Ellen H Morrow
- University of Utah Health, Resiliency Center, United States; University of Utah School of Medicine, Department of Surgery, United States.
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Siddaiah-Subramanya M, To H, Haigh C. The psychosocial impact of surgical complications on the operating surgeon: A scoping review. Ann Med Surg (Lond) 2021; 67:102530. [PMID: 34276982 PMCID: PMC8267492 DOI: 10.1016/j.amsu.2021.102530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 06/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Aim Surgical complications are common, and their management is an integral part of surgical care. The impact on the surgeon, the “second victim” is significant, particularly in terms of psychological health. The aim of this review is to describe the nature of psychosocial consequences of surgical complications on the surgeons involved. Method Following scoping review protocols, we set out to identify the evidence-base for psychosocial consequences on the operating surgeon, predominantly general surgeons, following surgical complications. Results This scoping review identified 19 articles, mainly survey and interview based (n = 8), with all but one article from first world countries. Seven articles reported on negative emotions or depressive behavioural responses. All original studies reported on difficulty in coping (37.5%), and a range of behaviours. There was little evidence for support structures or active interventions to aid the surgeon post complication. Conclusions The review suggests that the psychosocial impact, following a complication, is variable but affects every surgeon irrespective of the level of impact on the patient. The main variables differentiating impact are severity, and outcome of the complication and seniority of the surgeon. Reported emotions and behaviours were generally negative and persist across the surgeon's journey towards recovery. Surgeons who manage stress well exhibit largely constructive behaviours and actively work to recover. Identification of variables underpinning complications, and affected surgeons is paramount, as is the provision of services to support recovery. Efforts should be made to proactively prevent complications, via education, awareness and to formalise support processes. Surgical complications negatively impact the operating surgeon (the second victim). Negative emotions and behaviours manifested may persist throughout surgeon’s career. Surgeons’ reaction can negatively influence social and professional relationships. Range of factors affect coping and recovery, and the support sought tend not to focus on psychosocial aspects of coping. Need to develop management resources for surgeons to manage the psychosocial impact.
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Affiliation(s)
- Manjunath Siddaiah-Subramanya
- Department of Upper GI Surgery, Queen Elizabeth Hospital, Birmingham, UK.,University of Melbourne, Melbourne, Australia
| | - Henry To
- University of Melbourne, Melbourne, Australia.,Department of General Surgery, Northern Hospital Epping, Melbourne, Australia
| | - Catherine Haigh
- Monash Rural Health Gippsland, Monash University, Traralgon, Australia
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Mackel CE, Nelton EB, Reynolds RM, Fox WC, Spiotta AM, Stippler M. A Scoping Review of Burnout in Neurosurgery. Neurosurgery 2021; 88:942-954. [PMID: 33471896 DOI: 10.1093/neuros/nyaa564] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/04/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Burnout is a negative workplace syndrome of emotional exhaustion, cynicism, and perceived professional inefficacy that risks the patient-provider relationship, patient care, and physician well-being. OBJECTIVE To assimilate the neurosurgical burnout literature in order to classify burnout among domestic and international neurosurgeons and trainees, identify contributory factors, and appraise the impact of wellness programs. METHODS A scoping review identified the available literature, which was reviewed for key factors related to burnout among neurosurgeons. Two researchers queried PubMed, Embase, Google Scholar, Cochrane, and Web of Science for articles on burnout in neurosurgery and reduced 1610 results to 32 articles. RESULTS A total of 32 studies examined burnout in neurosurgery. A total of 26 studies examined prevalence and 8 studies detailed impact of wellness programs. All were published after 2011. Burnout prevalence was measured mostly through the Maslach Burnout Inventory (n = 21). In 4 studies, participants defined their own understanding of "burnout." Domestically, burnout prevalence was 11.2% to 67% among residents and 15% to 57% among attendings. Among trainees, poor operative experience, poor faculty relationships, and social stressors were burnout risks but not age, sex, or marital status. Among attendings, the literature identified financial or legal concerns, lack of intellectual stimulation, and poor work-life balance as risks. The impact of wellness programs on trainees is unclear but group exercises may offer the most benefit. CONCLUSION Noticeable methodological differences in studies on trainee and attending burnout contribute to a wide range of neurosurgery burnout estimates and yield significant knowledge gaps. Environment may have greater impact on trainee burnout than demographics. Wellness programs should emphasize solidarity.
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Affiliation(s)
- Charles E Mackel
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Emmalin B Nelton
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Renée M Reynolds
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | | | - Alejandro M Spiotta
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina
| | - Martina Stippler
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Drudi LM, Nishath T, Ma X, Mouawad NJ, O'Banion LA, Shalhub S. The impact of the COVID-19 pandemic on wellness among vascular surgeons. Semin Vasc Surg 2021; 34:43-50. [PMID: 34144747 PMCID: PMC9710729 DOI: 10.1053/j.semvascsurg.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 12/14/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed significant strain on the health and welfare of all health care professionals, including vascular surgeons. This review summarizes the implications of the pandemic on the health and wellness of surgeons and trainees, with a particular focus on those in vascular surgery (VS). A literature review was completed using common resource databases. We provide a brief history of burnout in VS and explore burnout and wellness in VS during this unprecedented pandemic. We then offer recommendations to address mental health needs by the VS workforce and highlight opportunities to address the gaps in the literature. The impact of COVID-19 on the professional and personal lives of surgeons and trainees in VS is notable. More than half of vascular surgeons reported some degree of anxiety. Factors associated with anxiety and burnout include COVID-19 exposure, moral injury, practice changes, and financial impacts. Trainees appeared to have more active coping strategies with dampened rates of anxiety compared to those in practice. Women appear to be disproportionately affected by the pandemic, with higher rates of anxiety and burnout. Groups underrepresented in medicine seemed to have more resilience when it came to burnout, but struggled with other inequities in the health care environment, such as structural racism and isolation. Strategies for addressing burnout include mindfulness practices, exercise, and peer and institutional support. The COVID-19 pandemic has had a substantial mental health impact on the VS workforce globally, as shifts were made in patient care, surgical practice, and work-home life concerns.
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Affiliation(s)
- Laura M. Drudi
- Division of Vascular Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Thamanna Nishath
- Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
| | - Xiya Ma
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Leigh Ann O'Banion
- Division of Vascular and Endovascular Surgery, University of California San Francisco–Fresno, Fresno, CA
| | - Sherene Shalhub
- Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356410, Seattle, WA, 98195,Corresponding author
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Chan EP, Stringer LS, Forster A, Meeks WD, Fang R, Franc-Guimond J, Sener A. Burnout in Canadian urology: Cohort analysis from the 2018 Canadian Urological Association census. Can Urol Assoc J 2021; 15:S5-S15. [PMID: 34406924 PMCID: PMC8418235 DOI: 10.5489/cuaj.7232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Physician burnout is associated with medical error, patient dissatisfaction, and poorer physician health. Urologists have reported high levels of burnout and poor work-life integration compared with other physicians. Burnout rates among Canadian urologists has not been previously investigated. We aimed to establish the prevalence of Canadian urologist burnout and associated factors. METHODS In the 2018 Canadian Urological Association census, the Maslach Burnout Inventory questions were assigned to all respondents. Responses from 105 practicing urologists were weighted by region and age group to represent 609 urologists in Canada. Burnout was defined as scoring high on the scales of emotional exhaustion or depersonalization. Demographic and practice variables were assessed to establish factors associated with burnout. Comparisons were made to the results of the 2016 American Urological Association census. RESULTS Overall, 31.8% of respondents met the criteria for burnout. There was no effect of subspecialty practice or practice setting on burnout. On univariate analysis, rates of burnout were highest among urologists under financial strain (50.8%), female urologists (45.3%), and early-to-mid-career urologists (37.7-41.8%). Factors associated with demanding practices and poor work-life integration were predictive of burnout. A total of 12.2% of urologists reported seeking burnout resources and 54.0% wished there were better resources available. CONCLUSIONS Urologist burnout in Canada is lower than reported in other countries, but contributing factors are similar. Urologists who report demanding clinical practices (particularly in early-to-mid career), poor work-life integration, financial strain, and female gender may benefit from directed intervention for prevention and management of burnout. Burnout resources for Canadian urologists require further development.
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Affiliation(s)
- Ernest P. Chan
- Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Leandra S. Stringer
- Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Adam Forster
- Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - William D. Meeks
- Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland, United States
| | - Raymond Fang
- Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland, United States
| | - Julie Franc-Guimond
- Department of Surgery, Division of Pediatric Urology, University of Montreal, QC, Canada
| | - Alp Sener
- Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Milder MJ, Roser SM, Austin TM, Abramowicz S. Does Burnout Exist in Academic Oral and Maxillofacial Surgery in the United States? J Oral Maxillofac Surg 2021; 79:1602-1610. [PMID: 33984289 DOI: 10.1016/j.joms.2021.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Information regarding burnout in academic oral and maxillofacial surgeons (OMSs) in the United States (US) does not exist. The purpose of this project was to answer the following question: "Does burnout exist in academic OMSs in the United States?" MATERIALS AND METHODS A 15-question anonymous survey was created based on Expanded Physician Well-Being Index (WBI, MedEd Web Solutions). The survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons (AACMS) consisting of demographics, professional obligations, wellness indicators (burnout, emotional hardening, depression, anxiety, fatigue, overwhelmed), and overall quality-of-life statements. Responses were quantified according to a scaled scoring system specific for WBI. Multivariable logistic regression was then used to create a predictive model of being "at risk" of burnout. RESULTS Surveys were sent to 180 active AACMS fellows; 110 completed the questionnaire (61.1%). One hundred eight active fellows met inclusion criteria. Majority were males between the ages of 41 and 50. About a quarter spent more than 20 years in an academic setting. Activities concentrated on patient care, teaching, and/or administrative duties. More than half of respondents felt emotionally hardened, anxious/irritable, and/or overwhelmed. About a third had adequate time for personal and family life. Most felt that their work was meaningful. Using WBI, the average score was 2.21, meaning that as a whole oral-maxillofacial surgery academicians are not considered at risk for burnout. Risk factors for burnout were age >40 years old, female gender, patient care more than 55 hours per week, call more than 10 times per month, and majority of time spent on teaching responsibilities. CONCLUSIONS According to WBI, OMSs as a group are not at risk for burnout. Certain traits (age, gender, more than 55 weekly hours and/or more than 10 call shifts per month, high percentage of time teaching responsibilities) are at higher risk for burnout.
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Affiliation(s)
- Megan J Milder
- Oral and Maxillofacial Surgery Resident-in-Training, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Steven M Roser
- DeLos Hill Chair and Professor of Surgery and Chief of Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA
| | - Thomas M Austin
- Associate Professor of Anesthesiology and Pediatrics, Department of Anesthesia, Emory University School of Medicine; Director of Operative Services, Children's Healthcare of Atlanta, Atlanta, GA
| | - Shelly Abramowicz
- Associate Professor of Surgery and Pediatrics, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA; Chief, Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA.
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50
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Cagnazzo C, Filippi R, Zucchetti G, Cenna R, Taverniti C, Guarrera ASE, Stabile S, Federici I, Monti M, Pirondi S, Testoni S, Fagioli F. Clinical research and burnout syndrome in Italy - only a physicians' affair? Trials 2021; 22:205. [PMID: 33712055 PMCID: PMC7953807 DOI: 10.1186/s13063-021-05158-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 02/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background The burnout phenomenon has been extensively investigated among health care professionals, particularly focusing on physicians and nurses. However, literature concerning burnout in clinical research is poor and often neglects the other professional categories involved. Methods In March 2019, all members of Italian Group of Clinical Research Coordinator were invited to participate to a web survey, consisting of three sections: general information and workload; Maslach Burnout Inventory (MBI) test; subjective perception of oneself’s work stress and possible causes. Results The majority of respondents felt a form of distress. The main source was contract type (31.2%), followed by workload (20.5%) and lack of skills recognition (17.8%). Results from MBI test confirmed the interviewees’ subjective perception: an intermediate level of emotional exhaustion (19.1 points) and a very high sense of reduced professional achievement (26.8 points) were observed. Both depersonalization and sense of reduced professional achievement showed weak to moderate correlations with emotional exhaustion. Emotional exhaustion was associated with contract type with high significance. Conclusion It is necessary to act on those qualitative factors that are greatly increasing the level of perceived stress, jeopardizing the quality of clinical research coordinators work and significantly amplifying the phenomenon of migration towards the private sector. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05158-z.
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Affiliation(s)
- Celeste Cagnazzo
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy. .,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy. .,Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.
| | - Roberto Filippi
- Oncologia Medica 1, AOU Città della Salute e della Scienza, Presidio Molinette, Turin, Italy
| | - Giulia Zucchetti
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Rosita Cenna
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Cristiana Taverniti
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Oncologia Medica 1, AOU Città della Salute e della Scienza, Presidio Molinette, Turin, Italy
| | - Agata Sue Ellen Guarrera
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Terapie Cellulari e Medicina Trasfusionale, AOU Careggi, Florence, Italy
| | - Stefano Stabile
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,SC Oncologia Falck, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Irene Federici
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Clinica di Ematologia, AOU Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy
| | - Manuela Monti
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Biostatistics and Clinical Trials Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, FC, Italy
| | - Sara Pirondi
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,UOSD Oncologia, AUSL Modena Area Sud Ospedale di Sassuolo (MO), Modena, Italy
| | - Sara Testoni
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Biostatistics and Clinical Trials Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, FC, Italy
| | - Franca Fagioli
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
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