Surgeon Wellness and Burnout

Abstract

Physician wellness and burnout have been an increasing source of debate, while physician depression and suicide continue to be on the rise. The Pediatric Orthopedic Society of North American has been on the forefront of addressing these issues throughout the creation of a Physician Wellness Task Force, membership surveys, and a pre-course at the annual meeting directly addressing this topic. However, physician members of POSNA still report a burnout rate of almost forty percent. Despite hard questions being asked, there continues to be significant debate about how best to address physician burnout and focus on physician wellness.
 Key Concepts:
 
 Occupational burnout is the constellation of emotional exhaustion, depersonalization, and a perceived lack of personal accomplishment.
 Physician burnout can lead to increased complications and medical errors.
 Physician burnout requires a multi-faceted approach to prevent and treat, including both personal and institutional strategies.
 POSNA continues to develop and implement strategies to help their members prevent burnout and focus on wellness.

A Comprehensive Umbrella Review for Understanding Burnout in Orthopaedic Surgery

“…We deemed 16 reviews to be relevant for inclusion, of which eight were systematic reviews 6,8,[15][16][17][18][19][20] and eight were narrative reviews (Figure 1). 3,[21][22][23][24][25][26][27] Copyright © 2023 JPOSNA® www.jposna.org…”

“…6,16,17,19,20 About half the reviews conducted quality assessments, 8,[17][18][19] with only one using it to inform study inclusion. 8 Narrative Reviews Narrative reviews were conducted between 2016 and 2022; 3,[21][22][23][24][25][26][27] we present the results of these reviews in Appendix 3. We highlight the results of the systematic reviews in the subsequent sections because, unlike narrative reviews, they aim to present all of the available literature on a topic.…”

System-Level Interventions for Addressing Burnout and Improving Professional Wellness for Orthopaedic Surgeons

“…1,12,13 Surgeon burnout, which can manifest as dysfunctional relationships, alcohol and substance use, depression, and suicide, ultimately impacts the physician-patient relationship and contributes to decreased patient satisfaction. 1,3,4,6,14 Physician retention, productivity, and quality of care also decrease, 2,4,14 with conservative estimates indicating that physician burnout costs the United States approximately $4.6 billion annually. 15 High rates of burnout-along with its detrimental personal, professional, and financial implications-highlight the urgent need to intervene.…”

“…16,17 Commonly, mindfulness-based interventions, as well as counselling and relaxation sessions, have been recommended. 2,4,6,7,14,16 However, burnout is increasingly recognized as a system-level problem resulting from excessive workloads, administrative burdens, inadequate job resources, and lack of work-life balance. 18,19 Therefore, clinicians, researchers, national medical associations, and community organizations are advocating for organizational and workflow interventions to address burnout.…”

“…18,19 Therefore, clinicians, researchers, national medical associations, and community organizations are advocating for organizational and workflow interventions to address burnout. 3,5,6,[12][13][14]17,[20][21][22][23] In this paper, we aim to summarize system-level interventions, including evidence-based organizational strategies and approaches suggested by national medical associations, to better equip institutions in their efforts to address burnout in orthopaedic surgery. We also aim to summarize the recommendations outlined in landmark burnout guidelines, such as those published by the World Health Organization (WHO) and the National Academy of Medicine (NAM).…”