Wednesday, April 22, 2009

Stress and Burnout Among Surgeons – an Article Review

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

There is an interesting article on stress and burnout in surgeons in this months issue of Archives of Surgery.  The authors state the goals of their article is to raise awareness of burnout and to encourage surgeons to “be proactive in their personal health habits.”  I will admit I sometimes struggle with trying to keep my life in balance so that I won’t become a “burned out” surgeon/human.  So I read these articles and look for that “magic cloak” that would protect me.  It’s not there.  It takes work and vigilance to prevent becoming a burned out cynic.

Their definition of “burnout”
Burnout is a form of personal distress that appears in a markedly more common fashion among physicians compared with depression, substance abuse, and suicide.
As a clinical syndrome, burnout is characterized by emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment.
It is a syndrome that primarily affects individuals such as physicians, nurses, and social workers, whose work involves constant demands and intense interactions with people who have great physical and emotional needs.
Just as with “burned-out” individuals in any other profession, we need to be aware of the following symptoms:
treating patients and colleagues as objects rather than human beings
feeling emotionally depleted
physical exhaustion
 poor judgment
feelings of ineffectiveness
a sense of depersonalization in relationships with coworkers or patients
The authors make the point that burnout in physicians/surgeons not only affect them personally, but can adversely affect patient safety, the quality of care we give to patients, and may contribute to medical errors.  This in turn (the increase medical errors and the decreased patient satisfaction) can then increase the threat of malpractice litigation. 
The increased stress/distress often lead to broken marriages, substance abuse, poor health, etc.
The article points out many of the contributing causes, including a lack of autonomy, imbalance between personal and professional life, excessive administrative tasks, long work hours, financial issues (overhead, poor insurance reimbursement, etc), and isolation from colleagues.
The article points out (and I would agree) that prevention is better than treatment of “burnout.”
Although recovery from burnout is possible, prevention is a better strategy.
Physicians who actively nurture and protect their personal and professional well-being on all levels—physical, emotional, psychological, and spiritual—are more likely to prevent burnout or at least to mitigate its consequences. 
The importance of mentorship cannot be underestimated

I limited my office hours so I could try to find a balance between being a “wife” and being a “physician/surgeon.”  This affects the finances and not always in a good way.  Being in solo practice can be isolating, even though it gives me the “freedom” to set my hours and not feel “guilty about not pulling my weight.”  I covet my daily walks with my dog.

Stress and Burnout Among Surgeons: Understanding and Managing the Syndrome and Avoiding the Adverse Consequences;  Arch Surg. 2009;144(4):371-376; Charles M. Balch, MD; Julie A. Freischlag, MD; Tait D. Shanafelt, MD

Related Blog Posts
Doctors With Depression (September 24, 2009)


Jabulani said...

Very interesting article.
I would like to add from my perspective, that burnout occurs in stay-home moms too! There is a need for them to cultivate "outside-of-the-home" interests, so they can refocus and regroup! Either that or just have loads of coffee meetings/lunches/nights' out with girlfriends to remind them they are humans, not just moms!!

Chrysalis said...

It's so important to protect your own well being. No one is going to look out for you, but you. I'm glad you guard that area. Those walks are healing in many ways.