Clinical Faceoff: Physician Burnout—Fact, Fantasy, or the Fourth Component of the Triple Aim?

Abstract

We are pleased to present to readers of Clinical Orthopaedics and Related Research 1 another installment of Clinical Faceoff, a regular feature. This section is a pointcounterpoint discussion between recognized experts in their fields on a controversial topic.

Wrestling With the Invincibility Myth: Exploring Physicians’ Resistance to Wellness and Resilience-Building Interventions

“…Burnout is caused by a complex interaction of individual, systemic, and professional values-aligning with evidence from organizational psychology that wellness initiatives and resilience-building interventions must address not only the individual and the system but also professional values that may drive the external pressures and the internal angst that fuel burnout. 4,52 Arguments that both the professional culture and the organizational environment significantly contribute to burnout and that individuals experiencing it need to accept their role in addressing it are both valid. There is, however, a precarious line between advocating for personal responsibility and blaming individual physicians for the burnout crisis; reconceptualizing the meaning and intention behind individual accountability may be one way to traverse it.…”

Gendered Innovations in Orthopaedic Science: Burn and Crash

“…Regardless of the gender of the surgeon, burnout has serious implications both for surgeons and for their patients. Authors more qualified than I offer sound strategies to treat burnout throughout the orthopaedic career [1,2,[4][5][6][12][13][14]. However, as physicians we should appreciate the value of early diagnosis for effective treatment.…”

Your Best Life: Resiliency Builder: Delivering Orthopaedic Care Abroad

“…A lthough burnout affects physicians in all medical disciplines, orthopaedic surgeons can be particularly at risk, with prevalence rates up to 60% higher than their general surgeon counterparts [1]. Previous columns have catalogued the direct effects of burnout including depression, substance abuse, decreased work performance, and the potential for damaging relationships with loved ones [1,9,13,15]. The high rates of burnout have been related to excessive administrative tasks [14], loss of autonomy to choose treatment strategies, feelings of insignificance, and the sense that patients are treated as litigation risks, as opposed to opportunities to deliver compassionate healing to a person in need [15].…”

“…Previous columns have catalogued the direct effects of burnout including depression, substance abuse, decreased work performance, and the potential for damaging relationships with loved ones [1,9,13,15]. The high rates of burnout have been related to excessive administrative tasks [14], loss of autonomy to choose treatment strategies, feelings of insignificance, and the sense that patients are treated as litigation risks, as opposed to opportunities to deliver compassionate healing to a person in need [15]. We have highlighted some means of counteracting this trend, including the practice of mindfulness, taming the scourge of perfection, and focusing on maintaining intimate relationships.…”