Surgeon Burnout: Defining, Identifying, and Addressing the New Reality

Abstract

Surgeon wellness is a multidimensional commitment that encompasses occupational, mental, physical, emotional, and social domains. Loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; excessive administrative burdens; poor work–life balance; and frustrations with medical record and order entry systems have all been associated with burnout. Described as a syndrome of emotional exhaustion, depersonalization, and loss of a sense of personal accomplishment, burnout can have myriad untoward consequences. The strong link between surgeons' personal and professional identities can lead to a perfect storm of burnout, depression, compromised patient safety and quality of care, physician job loss and career dissatisfaction, substance abuse, damage to personal relationships, and suicide. The alarming scope of this problem cannot be confined to a single specialty or practice setting and is expected to increase without much needed changes to surgeon work practices and work environments. A heightened focus on wellness in the workplace with attention to improving workflow, scheduling, collaboration, and resource allocation is a welcome step taken by several institutions and championed by professional societies. Much more research is needed to reliably gauge the overall effectiveness of these approaches, further address the nuances of burnout as it applies specifically to surgeons, and ensure that members of the surgical workforce remain at their peak throughout the duration of their careers.

The COVID-19 reset: lessons from the pandemic on Burnout and the Practice of Surgery

“…A surgical community with declining health and wellbeing threatens the provision of safe, high-quality, and patient-centered care. Surgeon wellness is described as "a multi-dimensional commitment that encompasses occupational, mental, physical, emotional, and social domains" [2]. According to Maslach and colleagues, the most commonly cited definition of Burnout is the "triad of emotional exhaustion (overextension), depersonalization (negative, callous, and detached responses to others), and reduced personal accomplishment (feelings of competence and achievement in one's work) [3].…”

“…Expanding on the definition by Maslach et al, Burnout refers not only to a decline in wellness but more precisely the culmination of failed wellness and mental wellbeing. Factors associated with Burnout include loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; excessive administrative burdens; frustrations with medical record systems, and poor work-life balance [2].…”

Burnout and work-life balance in neurosurgery: Current state and opportunities

“…Around 2000, dialog and investigation expanded to include broader populations such as health care workers. [ 40 ]…”

“…[ 6 , 25 , 26 , 35 , 46 ] Among surgical specialties, burnout has been reported in general surgery, gynecology surgery, neurosurgery, ophthalmology, orthopedic surgery, otolaryngology, plastic surgery, and urology. [ 2 , 3 , 9 , 24 , 39 , 40 , 46 , 48 ]…”

“…[ 28 ] In fact, national burnout rates among physicians have been reported to be >50%. [ 40 , 46 ] Neurosurgeons are not immune to burnout, as reported rates in the specialty have ranged from 27% to 57%. [ 24 , 29 ] Several facets of the job such as the acuity of neurosurgical patients, possibility of devastating neurological complications, and medicolegal concerns make neurosurgeons particularly prone to burnout.…”