Epidemic of Burnout Among Physicians, Especially Surgeons, Is Increasing

MedicalResearch.com Interview with:

Francesca M Dimou, MD Research Fellow University of Texas Medical Branch Galveston, TX

Dr. Francesca Dimou

Francesca M Dimou, MD
Research Fellow University of Texas Medical Branch
Galveston, TX

MedicalResearch.com: What is the background for this study?

Dr. Dimou: Burnout is a syndrome defined by emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Over the past decade the problem of physician and surgeon burnout has come to the forefront. The demands on physicians at academic healthcare institutions are expanding rapidly and include increasing regulation, increased demands on clinical productivity, difficulty funding research efforts, medicolegal liability, inefficient systems, loss of autonomy, rising student debt, and difficulty balancing professional and personal lives. This challenges the wellbeing of everyone in the organization, including the physicians and the patients they treat.

MedicalResearch.com: What are the main findings?

Dr. Dimou: Our systematic review identified a significant number of studies reporting on surgeon burnout with rates exceeding 50% in some surgical specialties. Even more striking, is that the incidence of burnout among surgeons is increasing steadily and the consequences of burnout impact all aspects of their professional and personal lives. Review of the literature demonstrates that surgeons meeting criteria for burnout had an increased probability of committing and reporting medical errors, increased depression, and increased suicidal ideation. Most importantly, despite the strong data highlighting that magnitude, acuity, and consequences of the burnout problem, we could not find definitive, reproducible intervention programs for surgeons dealing with burnout, nor could we identify prevention programs.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Dimou:    The epidemic of burnout among physicians, and surgeons in particular is increasing. The unique surgical culture adds additional challenges. Surgeons are perfectly capable of “running on empty”, continuing to see patients and meet other expectations long after they are completely drained and exhausted. In fact, their ability to do this is a core component of their medical education and training. The surgical environment is one that discourages “weakness”; it is an environment that teaches surgeons to feel guilty if they take care of themselves. There are many system and culture issues in surgery and medicine that need to be addressed. The article highlights the need to design interventions to both help physicians who are already burned out as well as develop interventions to improve physician wellbeing at the individual level while working to make needed changes in the system as a whole.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Dimou:    Research has already significantly raised awareness around burnout and its consequences. The next step is to identify intervention and prevention programs for physicians to promote physician wellbeing and resiliency – teaching surgeons to respond to their stressful environment in a way that promotes their wellbeing. Several programs throughout the country are beginning to promote physician wellbeing, such as the Balance in Life Program at Stanford and the Physician Well-being Program at Mayo Clinic. Such programs need to be designed and studied systematically to identify effective, reproducible, and scalable interventions to allow for widespread adoptability.

MedicalResearch.com: Is there anything else you would like to add?

Dr. Dimou:    A career in surgery can be an unparalleled privilege. Being a surgeon truly gives you the ability to change someone’s life and a surgical career will always require time, hard work, and sacrifices; we teach surgeons to operate and teach them to take care of patients, but we don’t teach them to respond to their environment effectively. The ramifications of continuing on the current path are potentially profound. If we do not change the system and create a surgical culture that promotes wellbeing we are at the risk of losing not only our current surgeon workforce, but also the best and brightest of the next generation. Systematic efforts to improve physician wellbeing at the individual level and change surgical culture to support this change are essential. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Surgeon Burnout: A Systematic Review
Dimou, Francesca M. et al.
Journal of the American College of Surgeons , Volume 0 , Issue 0 ,
Published Online:March 25, 2016

DOI: http://dx.doi.org/10.1016/j.jamcollsurg.2016.03.022

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Last Updated on March 31, 2016 by Marie Benz MD FAAD