Articles

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis[1]. Etheridge JC, et al. J Am Coll Surg. 2023 Jan 1;236(1):253-265. Epub 2022 Dec 15.

Burnout is described as a syndrome characterized by exhaustion, cynicism, and reduced self efficacy (person’s belief in their ability to complete a task or achieve a goal). Burnout is further defined in the context of 3 key dimensions that drive a syndrome that develops in response to chronic stressors: emotional exhaustion, depersonalization, and feeling incompetent (or lacking self-confidence). The consequences of burnout are numerous and include: negative affect on patient care, increased absenteeism (and presenteeism), decreased productivity, increased errors, and decreased satisfaction. Depending on the study, burnout in surgeons is estimated at 35-50% in attending surgeons and up to 70% in trainees. Addressing burnout is not only a practical necessity, it is a moral imperative.6 The ACS and ACGME (amongst others) have issued calls to action and implemented programs to mitigate burnout. Data on burnout trajectory (or how has burnout changed over time) for surgeons is lacking.

This metanalysis represents 103 studies with over 63,000 surgeons from 1996-2021. Forty-one percent met criteria for burnout. Trainees had a higher incidence than faculty (46% vs 36%). The authors conclude that there is no evidence for the claim of rising burnout. Instead, increased awareness of surgeon burnout may lead to perceptions of a growing epidemic. Indeed, there was consistent suggestion in the analysis that components of burnout, especially emotional exhaustion, are on the decline. The authors are careful to state that surgeon burnout remains worrisome, and at the current rate of decline it would require “several decades” for the US to reach European burnout rates (< 19%). Importantly, the authors stress that “Burnout is not simply a failure of resilience at the individual level, it stems from mismatch between job demands and available resources”.

Addressing Surgeon Burnout Through a Multi-level Approach: A National Call to Action[2]. Golisch KB, et al. Curr Trauma Rep. 2023 Jan 17;1-12. Online ahead of print.

Surgeons have one of the highest rates of burnout in medicine (42%). Although some studies suggest a stagnant or declining rate of surgeon burnout, others do not and the US Surgeon General recently released a report sounding an alarm on health care worker burnout. As the root causes of burnout are multi-factorial and complex, the authors advocate for a novel conceptual model to address burnout at the individual, institutional, and national level.

This paper is a “Call to Action” to mitigate surgeon burnout and presents a comprehensive overview of burnout, including key factors and effects. By analyzing 35 recent papers (2017-2022) the authors develop a strategy to classify and implement solutions to improve well-being using a 3-layer approach. At the individual level; emotional intelligence, mindfulness, and resilience is taught. At the institutional level; initiative, mentoring, and support is stressed. Finally, nationally, policies, opportunities, and leadership are discussed. Each of these areas has an easily digestible 2-3 paragraph section with informative and meaningful content for those wishing to further explore.