1
|
Clark M, Kerslake S, Bøe B, Hiemstra LA. Being a woman and an orthopaedic surgeon-A primer on the challenges we face. J ISAKOS 2024; 9:449-456. [PMID: 38777119 DOI: 10.1016/j.jisako.2024.05.008] [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: 02/15/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
A higher number of women are graduating from medical schools than men, yet orthopedic surgery continues to register the lowest proportion of female surgeons and residents of the surgical specialties. This trend is observed not only in North America but also globally. The presence of a more diverse workforce has been shown to lead to improved patient outcomes, enhanced efficiencies, and overall wellness within healthcare systems and would be of benefit to the orthopedic surgery profession. This primer aims to provide surgeons and leaders with evidence-based insights into diversity, equity, and equality, as well as define barriers and potential solutions pertaining to women in orthopedic surgery.
Collapse
Affiliation(s)
- Marcia Clark
- Department of Surgery, University of Calgary, North Tower Foothills Medicine Centre, 1403 29th St. NW, Calgary, Alberta, T2N 2T9, Canada.
| | - Sarah Kerslake
- Department of Surgery, University of Calgary, North Tower Foothills Medicine Centre, 1403 29th St. NW, Calgary, Alberta, T2N 2T9, Canada.
| | - Berte Bøe
- Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
| | - Laurie A Hiemstra
- Department of Surgery, University of Calgary, North Tower Foothills Medicine Centre, 1403 29th St. NW, Calgary, Alberta, T2N 2T9, Canada; Banff Sport Medicine Foundation, PO Box 1300, Banff, Alberta, T1L 1B3, Canada.
| |
Collapse
|
2
|
Vasireddi N, Vasireddi N, Shah AK, Moyal AJ, Gausden EB, Mclawhorn AS, Poelstra KA, Gould HP, Voos JE, Calcei JG. High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review. Clin Orthop Relat Res 2024; 482:659-671. [PMID: 37987688 PMCID: PMC10936985 DOI: 10.1097/corr.0000000000002904] [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] [Received: 05/29/2023] [Accepted: 09/29/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The Centers for Disease Control defines work-related musculoskeletal disorders as disorders of the nerves, muscles, tendons, joints, spinal discs, and cartilage that are caused or exacerbated by the environment or nature of work. Previous meta-analyses have characterized work-related musculoskeletal disorders among interventionists, general surgeons, and other surgical subspecialties, but prevalence estimates, prognosis, and ergonomic considerations vary by study and surgical specialty. QUESTIONS/PURPOSES (1) What is the career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons? (2) What is the treatment prevalence associated with work-related musculoskeletal disorders in orthopaedic surgeons? (3) What is the disability burden of work-related musculoskeletal disorders in orthopaedic surgeons? (4) What is the scope of orthopaedic surgical ergonomic assessments and interventions? METHODS A systematic review of English-language studies from PubMed, MEDLINE, Embase, and Scopus was performed in December 2022 and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that presented prevalence estimates of work-related musculoskeletal disorders or assessed surgical ergonomics in orthopaedic surgery were included. Reviews, case reports, gray literature (conference abstracts and preprints), and studies with mixed-surgeon (nonorthopaedic) populations were excluded. The search yielded 5603 abstracts; 24 survey-based studies with 4876 orthopaedic surgeons (mean age 48 years; 79% of surgeons were men) were included for an analysis of work-related musculoskeletal disorders, and 18 articles were included for a descriptive synthesis of ergonomic assessment. Quality assessment using the Joanna Briggs Institute Tool revealed that studies had a low to moderate risk of bias, largely because of self-reporting survey-based methodology. Because of considerable heterogeneity and risk of bias, prevalence outcomes were not pooled and instead are presented as ranges (mean I 2 = 91.3%). RESULTS The career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons ranged from 37% to 97%. By anatomic location, the prevalence of work-related musculoskeletal disorders in the head and neck ranged from 4% to 74%; back ranged from 9% to 77%; forearm, wrist, and hand ranged from 12% to 54%; elbow ranged from 3% to 28%; shoulder ranged from 3% to 34%; hip and thigh ranged from 1% to 10%; knee and lower leg ranged from 1% to 31%; and foot and ankle ranged from 4% to 25%. Of orthopaedic surgeons reporting work-related musculoskeletal disorders, 9% to 33% had a leave of absence, practice restriction or modification, or early retirement, and 27% to 83% received some form of treatment. Orthopaedic surgeons experienced biomechanical, cardiovascular, neuromuscular, and metabolic stress during procedures. Interventions to improve orthopaedic surgical ergonomics have been limited, but have included robotic assistance, proper visualization aids, appropriate use of power tools, and safely minimizing lead apron use. In hip and knee arthroplasty, robotic assistance was the most effective in improving posture and reducing caloric expenditure. In spine surgery, proper use of surgical loupes was the most effective in improving posture. CONCLUSION Although the reported ranges of our main findings were wide, even on the low end of the reported ranges, work-related musculoskeletal disability among orthopaedic surgeons appears to be a substantial concern. We recommend that orthopaedic residency training programs incorporate surgical ergonomics or work injury lectures, workshops, and film review (alongside existing film review of surgical skills) into their curricula. We suggest hospitals engage in shared decision-making with surgeons through anonymous needs assessment surveys to implement wellness programs specific to surgeons' musculoskeletal needs. We urge institutions to assess surgeon ergonomics during routine quality assessment of novel surgical instruments and workflows. LEVEL OF EVIDENCE Level III, prognostic study.
Collapse
Affiliation(s)
- Nikhil Vasireddi
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | | | - Aakash K. Shah
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew J. Moyal
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | | | | | - Kornelis A. Poelstra
- The Robotic Spine Institute of New Jersey, Jersey City, NJ, USA
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | | | - James E. Voos
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | - Jacob G. Calcei
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| |
Collapse
|
3
|
Davis ME, Ishmael C, Fram B, Light JJ, Obremskey WT, Cannada LK. Finding Your Job in Orthopaedic Trauma: A Survey Revealing the Cold Hard Facts. J Orthop Trauma 2024; 38:e120-e125. [PMID: 38117574 DOI: 10.1097/bot.0000000000002744] [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] [Accepted: 12/13/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVES Finding a first job after fellowship can be stressful due to the uncertainty about which resources to use, including fellowship program directors, residency faculty, and other sources. There are more than 90 orthopaedic trauma fellows seeking jobs annually. We surveyed orthopaedic trauma fellows to determine the job search process. METHODS DESIGN An anonymous 37-question survey. SETTING Online Survey. PATIENT SELECTION CRITERIA Orthopaedic trauma fellows from the 5 fellowship-cycle years of 2016-2021. OUTCOME MEASURES AND COMPARISONS The primary questions were related to the job search process, current job, and work details. The secondary questions addressed job satisfaction. Data analysis was performed using STATA 17. RESULTS There were 159 responses (40%). Most of the respondents completed a fellowship at an academic program (84%). Many (50%) took an academic job and 24% were hospital employed. Sixteen percent had a job secured before fellowship and 49% went on 2-3 interviews. Word of mouth was the top resource for finding a job (53%) compared with fellowship program director (46%) and residency faculty (33%). While 82% reported ending up in their first-choice job, 34% of respondents felt they "settled." The number of trauma cases was important (62%), ranked above compensation (52%) as a factor affecting job choice. Surgeons who needed to supplement their practice (46%) did so with primary and revision total joints (37%). CONCLUSIONS Jobs were most often found by word of mouth. Most fellows landed their first job choice, but still a third of respondents reporting settling on a job. Case volume played a significant role in factors affecting job choice.
Collapse
Affiliation(s)
- Max E Davis
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - Chad Ishmael
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD
| | - Brianna Fram
- Department of Orthopaedics & Rehabilitation, Orthotrauma, Yale School of Medicine, New Haven, CT
| | - Jonathan J Light
- Eastern Virginia Medical School, School of Medicine, Norfolk, VA
| | - William T Obremskey
- Department of Orthopaedic Surgery, Vanderbilt University, Nashville, TN; and
| | - Lisa K Cannada
- Novant Health Orthopaedic Fracture Clinic, University of North Carolina School of Medicine, Charlotte Campus, Charlotte, NC
| |
Collapse
|
4
|
Jella TK, Patel VR, Cwalina TB, Schmidt JE, Lawler EA, Vallier HA. What Factors Are Associated With Early Career Attrition Among Orthopaedic Surgeons in the United States? Clin Orthop Relat Res 2023; 481:1895-1903. [PMID: 36881550 PMCID: PMC10499099 DOI: 10.1097/corr.0000000000002625] [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] [Received: 10/11/2022] [Revised: 01/15/2023] [Accepted: 02/15/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The attrition of medical personnel in the United States healthcare system has been an ongoing concern among physicians and policymakers alike. Prior studies have shown that reasons for leaving clinical practice vary widely and may range from professional dissatisfaction or disability to the pursuit of alternative career opportunities. Whereas attrition among older personnel has often been understood as a natural phenomenon, attrition among early-career surgeons may pose a host of additional challenges from an individual and societal perspective. QUESTIONS/PURPOSES (1) What percentage of orthopaedic surgeons experience early-career attrition, defined as leaving active clinical practice within the first 10 years after completion of training? (2) What are the surgeon and practice characteristics associated with early-career attrition? METHODS In this retrospective analysis drawn from a large database, we used the 2014 Physician Compare National Downloadable File (PC-NDF), a registry of all healthcare professionals in the United States participating in Medicare. A total of 18,107 orthopaedic surgeons were identified, 4853 of whom were within the first 10 years of training completion. The PC-NDF registry was chosen because it has a high degree of granularity, national representativeness, independent validation through the Medicare claims adjudication and enrollment process, and the ability to longitudinally monitor the entry and exit of surgeons from active clinical practice. The primary outcome of early-career attrition was defined by three conditions, all of which had to be simultaneously satisfied ("condition one" AND "condition two" AND "condition three"). The first condition was presence in the Q1 2014 PC-NDF dataset and absence from the same dataset the following year (Q1 2015 PC-NDF). The second condition was consistent absence from the PC-NDF dataset for the following 6 years (Q1 2016, Q1 2017, Q1 2018, Q1 2019, Q1 2020, and Q1 2021), and the third condition was absence from the Centers for Medicare and Medicaid Services Opt-Out registry, which tracks clinicians who have formally discontinued enrollment in the Medicare program. Of the 18,107 orthopaedic surgeons identified in the dataset, 5% (938) were women, 33% (6045) were subspecialty-trained, 77% (13,949) practiced in groups of 10 or more, 24% (4405) practiced in the Midwest, 87% (15,816) practiced in urban areas, and 22% (3887) practiced at academic centers. Surgeons not enrolled in the Medicare program are not represented in this study cohort. A multivariable logistic regression model with adjusted odds ratios and 95% confidence intervals was constructed to investigate characteristics associated with early-career attrition. RESULTS Among the 4853 early-career orthopaedic surgeons identified in the dataset, 2% (78) were determined to experience attrition between the first quarter 2014 and the same point in 2015. After controlling for potential confounding variables such as years since training completion, practice size, and geographic region, we found that women were more likely than men to experience early-career attrition (adjusted OR 2.8 [95% CI 1.5 to 5.0]; p = 0.006]), as were academic orthopaedic surgeons compared with private practitioners (adjusted OR 1.7 [95% CI 1.02 to 3.0]; p = 0.04), while general orthopaedic surgeons were less likely to experience attrition than subspecialists (adjusted OR 0.5 [95% CI 0.3 to 0.8]; p = 0.01). CONCLUSION A small but important proportion of orthopaedic surgeons leave the specialty during the first 10 years of practice. Factors most-strongly associated with this attrition were academic affiliation, being a woman, and clinical subspecialization. CLINICAL RELEVANCE Based on these findings, academic orthopaedic practices might consider expanding the role of routine exit interviews to identify instances in which early-career surgeons face illness, disability, burnout, or any other forms of severe personal hardships. If attrition occurs because of such factors, these individuals could benefit from connection to well-vetted coaching or counseling services. Professional societies might be well positioned to conduct detailed surveys to assess the precise reasons for early attrition and characterize any inequities in workforce retention across a diverse range of demographic subgroups. Future studies should also determine whether orthopaedics is an outlier, or whether 2% attrition is similar to the proportion in the overall medical profession.
Collapse
Affiliation(s)
- Tarun K. Jella
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vishal R. Patel
- Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Thomas B. Cwalina
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Ericka A. Lawler
- Department of Orthopedics and Rehabilitation, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | | |
Collapse
|
5
|
Aggarwal VK, Gold PA, Sonn KA, Frisch NB, Cohen-Rosenblum AR. What a Junior-Senior Partnership Should Look Like Today: A Young Arthroplasty Group Committee Editorial. J Arthroplasty 2023; 38:1629-1631. [PMID: 37236283 DOI: 10.1016/j.arth.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Affiliation(s)
- Vinay K Aggarwal
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
| | - Peter A Gold
- Panorama Orthopedics & Spine Center, Golden, Colorado
| | - Kevin A Sonn
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | | | | |
Collapse
|
6
|
Hamdan M, Haddad BI, Alshrouf MA, Al-Ani A, Alisi MS, Hammad Y, Alelaumi A, Al Hawamdeh H, Halaweh AA, Alshabatat L, Kawasmi S. Burnout, grit and resilience among Jordanian orthopedic surgeons: a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:593. [PMID: 37605179 PMCID: PMC10464497 DOI: 10.1186/s12909-023-04572-y] [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: 02/09/2023] [Accepted: 08/06/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Burnout is a serious issue that affects physicians more than the general population; however, those with higher levels of grit and resilience have been shown to experience lower levels of burnout. The primary aim was to determine the prevalence of burnout among Jordanian orthopedic surgeons, explore its risk factors, and investigate the relationship between burnout and grit and resilience. METHODS We conducted a questionnaire-based cross-sectional study targeting a total of 180 orthopedic surgeons attending the yearly Jordanian National Orthopedic Conference (JNOC). Non-random sampling (i.e., convenience) was utilized to recruit participants. The abbreviated Maslach Burnout Inventory, short grit scale, and Connor-Davidson Resilience Scale were used. Scores were examined using the Mann-Whitney U, Kruskal-Wallis H, and Spearman's rho tests, of which results were corrected using the Bonferroni method. RESULTS Among 135 respondents, 62.2% were specialists and 37.8% were residents. About 52.0% practiced in public hospitals. Approximately 69.0% worked for more than 50 h weekly. The prevalence of burnout among all participants was 45.2% with more frequency among residents (66.7%). Burnout and the participants' grit and resilience showed an inverse relationship (ρ = -0.441 and ρ = -0.312, respectively). Age (ρ = 0.337), number of children (ρ = 0.245), and years of experience (ρ = 0.331) were positively correlated with grit. The median score for grit was higher in physicians who had or are having their residency outside Jordan (p < 0.001). Age (ρ = 0.233) and years of experience (ρ = 0.269) were positively correlated with resilience. CONCLUSION Jordanian orthopedic surgeons face significant rates of burnout. Institutional efforts should be taken to detect and prevent burnout in addition to enhancing the grit and resilience among orthopedic professionals.
Collapse
Affiliation(s)
- Mohammad Hamdan
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Bassem I Haddad
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | | | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | - Mohammed S Alisi
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Yazan Hammad
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Ahmad Alelaumi
- Department of Orthopedics and Spine Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Hashem Al Hawamdeh
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Ahmad Abu Halaweh
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Lara Alshabatat
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Sanad Kawasmi
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| |
Collapse
|
7
|
Minichiello V, Webber S. Resident Physician Perspectives on Mindfulness Education in Residency: A Multispecialty Qualitative Assessment of Clinical Care Impact. J Grad Med Educ 2023; 15:356-364. [PMID: 37363667 PMCID: PMC10286909 DOI: 10.4300/jgme-d-22-00492.1] [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] [Received: 06/25/2022] [Revised: 10/18/2022] [Accepted: 03/27/2023] [Indexed: 06/28/2023] Open
Abstract
Background Mindfulness training positively influences residents personally and professionally. Routine integration into residency may be impacted by limited understanding of the ways in which mindfulness training enhances clinical care. Objective We explored residents' direct experience and personal application of mindfulness in their clinical work following 10 hours of mindfulness training. Methods Mindfulness training sessions were facilitated between 2017 and 2019 for 5 groups of residents: pediatrics, ophthalmology, postgraduate year (PGY)-1 anesthesiology, and 2 different years of PGY-1 family medicine residents. Training was integrated into resident protected didactic time and attendance was expected, although not mandated, with the exception of pediatrics, in which the department mandated the training. Qualitative evaluation was conducted using a voluntary, semi-structured, de-identified phone interview within 2 months post-training. Reviewers independently coded the transcripts and then dialogued to reach consensus around emergent themes. Results Thirty-six of 72 residents (50%) who participated in the training completed interviews. Themes were similar across specialties. All residents acknowledged the potential usefulness of mindfulness training during residency. Six residents (17%) reported they had not applied the mindfulness training to their daily work by the end of the course. There were 4 emergent themes related to clinical application of mindfulness training: integrating brief moments of mindfulness practice, self-awareness, relational presence with patients, and maintaining perspective during clinical encounters and residency training as a whole. Conclusions After completing a 10-hour mindfulness training program, residents reported enhanced perspective-taking and relationship-building with themselves and their patients in clinical settings across medical and procedural specialties.
Collapse
Affiliation(s)
- Vincent Minichiello
- All authors are with the University of Wisconsin-Madison School of Medicine and Public Health
- Vincent Minichiello, MD, is Family Physician, Assistant Professor, and Director, Academic Integrative Health Fellowship, Department of Family Medicine and Community Health
| | - Sarah Webber
- All authors are with the University of Wisconsin-Madison School of Medicine and Public Health
- Sarah Webber, MD, is a Pediatric Hospitalist, Associate Professor, and Division of Hospital Medicine and Pediatric Sedation Provider, Department of Pediatrics
| |
Collapse
|
8
|
Schmerler J, Solon L, Harris AB, Best MJ, LaPorte D. Publication Trends in Research on Mental Health and Mental Illness in Orthopaedic Surgery: A Systematic Review. JBJS Rev 2023; 11:01874474-202306000-00014. [PMID: 37327350 DOI: 10.2106/jbjs.rvw.23.00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Mental health conditions affect tens of millions of Americans. In recent years, particularly with the advent of the coronavirus disease 2019 pandemic, there has been a burst of interest in mental health and mental illness among orthopaedic surgical patients. The mental health of orthopaedic surgeons themselves has also come into focus, with high reported rates of burnout and depression. The aim of this article was to evaluate trends in publication on mental health and mental illness in orthopaedic surgery. METHODS Web of Science and PubMed were queried to conduct a systematic review. Studies that discussed orthopaedic surgery and mental illnesses or mental health topics over 2001 to 2022 were included. Publications were analyzed by article-, author-, and topic-level characteristics. RESULTS A total of 416 studies were analyzed after application of inclusion and exclusion criteria. Publication volume increased dramatically, demonstrating quadratic growth over 2001 to 2022 (p < 0.001). Eighty-eight percent of studies focused on patients and 10% on surgeons, with studies about patients more likely to focus on mental illness and those about surgeons more likely to focus on mental health (p < 0.001). Twenty percent of publications had a female senior author, and 5 authors collectively accounted for 10% of all publications. Eight journals published more than 10 publications, accounting for 35% of all publications. The most productive subspecialties were arthroplasty (135, 30%), general orthopaedics (87, 21%), and spine (69, 17%). Mental illnesses that were least represented included schizophrenia, bipolar disorder, eating disorders, attention-deficit/hyperactivity disorder, and personality disorders (1% or less of total publications each). CONCLUSION This analysis showed a dramatically increasing trend in publications on mental health and mental illness in orthopaedic surgery. A high concentration of publications came from a subset of journals and senior authors, and women were overrepresented as senior authors relative to their representation in the field. The results of this analysis identified gaps in the literature, including underrepresented subspecialties, understudied mental illnesses, and study of orthopaedic surgeon mental health, and thus highlighted areas for future investigation. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- Jessica Schmerler
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | | | | |
Collapse
|
9
|
Hiemstra LA, Kerslake S, Fritz JA, Clark M, Temple-Oberle C, Boynton E, Lafave M. Rates of Burnout in Female Orthopaedic Surgeons Correlate with Barriers to Gender Equity. J Bone Joint Surg Am 2023:00004623-990000000-00787. [PMID: 37083849 DOI: 10.2106/jbjs.22.01319] [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: 04/22/2023]
Abstract
BACKGROUND The primary purpose of this study was to investigate the relationships between career burnout and the barriers to gender equity identified by Canadian female orthopaedic surgeons. A secondary purpose was to assess relationships between the demographic characteristics of the female surgeons and career burnout and job satisfaction. METHODS An electronic survey was distributed to 330 Canadian female orthopaedic surgeons. Demographic variables including age, stage and years in practice, practice setting, and marital status were collated. The survey included the Gender Bias Scale (GBS) questionnaire and 2 questions each about career burnout and job satisfaction. The Pearson r correlation coefficient evaluated the relationships among the higher- and lower-order factors of the GBS, burnout, and job satisfaction. Spearman rank correlation coefficient assessed relationships among burnout, job satisfaction, and demographic variables. RESULTS Survey responses were received from 218 (66.1%) of the 330 surgeons. A total of 110 surgeons (50.5%) agreed or strongly agreed that they felt career burnout (median score = 4). Burnout was positively correlated with the GBS higher-order factors of Male Privilege (r = 0.215, p < 0.01), Devaluation (r = 0.166, p < 0.05), and Disproportionate Constraints (r = 0.152, p < 0.05). Job satisfaction (median = 4) was reported by 168 surgeons (77.1%), and 66.1% were also satisfied or very satisfied with their role in the workplace (median = 4). Burnout was significantly negatively correlated with surgeon age and job satisfaction. CONCLUSIONS Half of the female orthopaedic surgeons reported symptoms of career burnout. Significant relationships were evident between burnout and barriers to gender equity. Identification of the relationships between gender-equity barriers and burnout presents an opportunity to modify organizational systems to dismantle barriers and reduce this occupational syndrome. CLINICAL RELEVANCE Given the relationships between gender inequity and career burnout in this study of female orthopaedic surgeons, actions to dismantle gender barriers and address systemic biases are necessary at all career stages to reduce burnout.
Collapse
Affiliation(s)
- Laurie A Hiemstra
- Banff Sport Medicine Foundation, Banff, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Marcia Clark
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Claire Temple-Oberle
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Alberta, Canada
| | - Erin Boynton
- Department of Oncology, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Alberta, Canada
| | - Mark Lafave
- Department of Health and Physical Education, Mount Royal University, Calgary, Alberta, Canada
| |
Collapse
|
10
|
Sinclair MK, Chhabra AB. Recruiting, Supporting and Retaining Diversity in Hand Surgery. Hand Clin 2023; 39:33-42. [PMID: 36402524 DOI: 10.1016/j.hcl.2022.08.003] [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] [Indexed: 11/17/2022]
Abstract
All surgical fields that lead to a career in Hand Surgery have a stark lack of diversity of sex/gender and race, at every level of the workforce, from trainees to practicing physicians. Despite consistent statistics in publications on lack of diversity in surgical fields, a guide to effective recruitment and retention is lacking. Although we recognize that a strategy cannot be applied in all practices, this article provides actionable items to consider in the commitment and work toward a more just and equitable practice of Hand Surgery.
Collapse
Affiliation(s)
- Micah K Sinclair
- Department of Orthopaedic Surgery & Musculoskeletal Medicine, Children's Mercy Hospital, University of Missouri Kansas City, University of Kansas Medical Center, 2401 Gillham Road, Kansas City, MO 64108, USA.
| | - A Bobby Chhabra
- Department of Orthopaedic Surgery, Hand Surgery, University of Virginia Health, PO Box 800159, Charlottesville, VA 22908-0159, USA
| |
Collapse
|
11
|
Burnout und Abhängigkeit bei ärztlichem Personal zeitlos und während der COVID-19-Pandemie am Beispiel der Chirurgie und Anästhesie. DIE CHIRURGIE 2022; 93:1063-1071. [PMID: 35737018 PMCID: PMC9219363 DOI: 10.1007/s00104-022-01675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 12/02/2022]
Abstract
Hintergrund Die COVID-19(„coronavirus disease 2019“)-Pandemie wirkt sich auf die psychische Gesundheit und das berufliche Verhalten von Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen aus und scheint einen Einfluss auf die Substanzabhängigkeit zu haben. Fragestellung Welche Gründe gibt es für das Auftreten einer Substanzabhängigkeit und einem Burnout bei Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen zeitlos und während der COVID-19-Pandemie und welche Verbesserungsmaßnahmen könnten im klinischen Alltag helfen? Material und Methoden Es wurde eine Literaturrecherche in Form einer systematischen Übersicht („systematic review“) zu Studien und Übersichtsarbeiten durchgeführt, die für das Thema relevant sind. Ergebnisse Im Laufe der Jahre hat sich gezeigt, dass Chirurgen bzw. Chirurginnen und Anästhesisten bzw. Anästhesistinnen aufgrund ihres direkten Zugangs zu Medikamenten in der Klinik und der arbeitsbezogenen Stressbelastung zur Drogenabhängigkeit neigen. Insbesondere Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen schienen eine erhöhte Neigung zur Suchterkrankungen und ein erhöhtes Burnout-Risiko in der Pandemie vorzuweisen. Schlussfolgerungen Präventive Maßnahmen zugunsten besserer Arbeitsbedingungen in der Chirurgie und Anästhesie und eine bessere Drogenkontrolle (nicht nur wegen der Ausgabe, sondern auch wegen der richtigen Drogentests) sowie mehr Therapie- und Wiedereingliederungsprogramme unter psychiatrischer Begleitung und in Zusammenarbeit mit einem multidisziplinären Team sind sinnvoll.
Collapse
|
12
|
Kim JM. Individual First, Professional Second: Commentary on an article by Matthew K. Stein, MD, et al.: "Objects in Mirror Are Closer Than They Appear: Symptoms of Depression and Suicidality in Orthopaedic Surgeons". J Bone Joint Surg Am 2022; 104:1037. [PMID: 35648070 DOI: 10.2106/jbjs.22.00320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|