Burnout, mental health and ‘wellness’ in obstetricians and gynaecologists: Why these issues should matter to our patients – and our profession

Abstract

Healthy doctors understand us better, make good decisions, and offer us the best chance of good health. 1 In October of 2017, the World Medical Association updated and amended its 'physician's pledge' -the Declaration of Geneva 2 -to include a new affirmation: 'I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.' This was a major addition to a time-honoured set of principles, significant enough to prompt worldwide attention in both the medical and lay press. 3 An argument could be made, though, that such a public call for doctors to attend to their own health was long overdue. For many years now the evidence has been clear that factors such as burnout, untreated mental health problems, and other illnesses in doctors impart considerable risk to patients. 4 Burnout, in particular, is an issue for our specialty. Burnout is a well-recognised constellation of emotional responses: a loss of enthusiasm for work, feelings of cynicism and depersonalisation, and a reduced sense of personal accomplishment. 5 The 2018 Medscape Physician burnout and depression survey found that obstetrics and gynaecology specialists reported among the highest rates of burnout with a prevalence of 46% in respondents. 6 Among

The impact of COVID-19 on O&G trainees; where are we now?

“…Stressors such as recurrent and prolonged selfisolation, taking time off as a carer, having family members affected, delayed milestone professional exams, a drastic reduction in operative workload and the uncertainty about training progression are some of many reasons leading to prolonged mental health sequalae. Failure to ensure HCP's well-being can lead to burnout, poor patient care (Robson and Cukierman, 2019), more medical errors and higher absenteeism (Shanafelt et al, 2010). Furthermore, O&G historically is a profession with a high burnout rate, and this is likely to worsen due to COVID-19 pandemic (Bourne et al, 2019;RCOG 2020a).…”

Well‐being, obstetrics and gynaecology and COVID‐19: Leaving no trainee behind

“…This can still be conducted by training supervisors over videoconferencing to identify trainees exposed to potentially traumatic situations caused either by this pandemic or through the course of routine work and dissect these to increase awareness of limitations, identify abnormal stress responses and come up with strategies to overcome them. This aims to ‘normalise vulnerability’ and enable learning unique lessons during this pandemic 13 …”

“…9 showed that HCPs during pandemics suffered higher levels of 10,11 have caused uneven clinical experience, case log deficits, and uncertainty regarding training progression. 12 Failure to ensure HCPs' well-being can lead to burnout, poorer patient care, 13 more medical errors, 14 and higher absenteeism. 8,15 We describe our efforts to maintain trainees' mental well-being in our university-affiliated teaching hospital in Singapore.…”

“…This aims to 'normalise vulnerability' and enable learning unique lessons during this pandemic. 13 F I G U R E 1 A graph demonstrating the decrease in surgical cases in our department from January to June 2020 as compared to January to June 2019. [Colour figure can be viewed at wileyonlinelibrary.com]…”

A qualitative analysis of adding kindness into the ISBAR handover tool

“…[4][5] This prevalence has been attributed in part to the nature of obstetric care, which requires immediate attention to clinical emergencies, prolonged and complex surgical procedures, litigation threat and lengthy shifts. [6][7] Performance anxiety also plays a role, with junior doctors expressing fears regarding public criticism as a contributory factor. 8 Nowhere is the junior doctor more likely to face such criticism than in the setting of acute service clinical handover.…”