Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues

Abstract

Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness "goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life." The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.

Orthopaedic Surgeon Mental Health During the COVID-19 Pandemic

“…2,8,9 Suicidal ideation in orthopaedic surgery (3.8%) was lower than previously published reports in surgery (7%). 10 Psychological distress in orthopaedic surgery was lower than previously published reports (19%-33%) with no participants scoring for tentative diagnosis of depression. 11,12 Regarding burnout, 20% of individuals endorsed emotional exhaustion (I feel burned out from my work) and 16% reported depersonalization (I have become more callous toward people since I took this job).…”

“…20 One trial of subject-focused mindfulness and resilience intervention with biweekly sessions found that the intervention group had reduced depersonalization and emotional exhaustion after 1 year. 10 Implementing these strategies during a pandemic will prove challenging and further studies providing evidence of efficacy should be performed.…”

The dual degree orthopedic surgeon: A survey of the trends, motivations, and perceived value of the master of business administration degree

“…15 As these initiatives and pressures have increased administrative workload and decreased reimbursement to physicians and facilities, physician burnout has increased, with cost savings becoming a necessary goal. [16][17][18][19][20] The future uncertainties in healthcare and rising administration challenges may be why most respondents obtained the degree within the past decade (66.6%). This study highlights that orthopedic surgeons are actively taking on additional administrative responsibilities with the addition of an MBA.…”

Physician wellness in orthopaedic surgery

“… 2 - 4 , 10 , 17 Within orthopaedic surgery, burnout has been reported to occur at alarming rates in multiple practice settings (40% to 60%), and has been found to be more prevalent in trainees and early career surgeons than in older surgeons. 18 - 32 …”