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Burnout, The Greatest Threat to Surgeons’ Quality of Life

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Aug 5, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    Burnout has probably always been a part of doctors’ lives, and that’s still true today. A calm and collected life for physicians, with reduced stress and anxiety, is the exception rather than the rule. Some doctors, such as surgeons, are even more challenged than others.

    The numbers that paint this picture of crisis are staggering. Moreover, what do these numbers tell us about how modern society treats the ones who devote their lives to the task of caring for others? And furthermore, when these people are neglected and drained, are they actually able to care for others properly?

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    Being a Doctor is No Easy Task

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    The life of a doctor is undoubtedly taxing. Part of the difficulty is due to the fact that doctors’ lives so complex, with hundreds of contributing factors at play.

    Sadly, across the whole world, burnout is a norm within this career path. From working long hours and dealing with huge workloads to facing life-and-death situations, the long-term effects of these factors are evident. For example, up to 40% of doctors in the U.S. experience symptoms of emotional, physical and psychological burnout. Unfortunately, this sometimes even leads to suicide. And this trend is often as prevalent among young doctors as older ones.

    As one physician put it: “The relentless pressures of day-to-day work, the loss of a patient, the sense of inadequacy and isolation, the fear of making mistakes and exhaustion destroy whatever bravado, humor and compassion a young physician may have. Empathy for patients and the ability to see both colleagues and nurses as partners rather than competitors are diminished as residents work in survival mode.”

    Surgeons – The Heavyweights of the Medical Profession

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    Some doctors are taxed harder than others. Take surgeons, for example. Surgeons and stress go hand-in-hand. According to a list compiled a few years ago, being a surgeon was considered the 4th most stressful job, preceded by those of firefighters, big CEOs and taxi drivers.

    What’s more, surgeons are even more likely to experience burnout, depression and suicidal ideation than their counterparts in other sectors of healthcare. This greatly reduces their satisfaction with work, and can consequently complicate patient safety and quality of patient care, and contribute to an increase in medical errors.

    In particular, it is the heavy decision which surgeons need to make, which contribute to their feeling exhausted. The environment of the operating room, where every moment counts, the requirement to be able to memorize big amounts of relevant patient data and the lack of absolute control over a situation, all of these contribute to surgeons constantly being stretched to their limits.

    The surgical profession places high demands on its cadres
    Yet, being a surgeon and, generally speaking, a doctor, comes with a certain type of personality and code of conduct. As stated by the industry group Support 4 Doctors: “The very traits that are necessary for good patient care may not be good for the doctor’s health.”

    This is because doctors are required to remain calm, competent and as objective as possible in situations of extreme stress. Doctors need to retain control, yet they also need to be highly self-critical and constantly assess their decisions and face the consequences of these. Yet, as has been demonstrated, such an extremely self-critical mode of functioning can be the cause of deep depression. The most motivated, conscientious and dedicated surgeons are the ones that usually suffer the most.

    Surgeons’ needs are often disregarded
    For example, as research at the Imperial College London shows, surgeons often suffer emotionally when surgical complications occur. Despite that, surgeons in the survey also reported that institutional support in such situations was inadequate.

    “Given the potential impact on patients as well as on surgeons, additional support and mentoring should be seriously considered by the surgical community and by those involved in the management of surgical services.”

    So what can be done?

    Who Cares for the Caretakers?
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    Patient care and well-being are every doctor’s priority. Yet, these are tightly linked to doctors’ own well-being. And the failure of doctors to care for themselves is in a sense the failure of society and governments to care for them adequately. And how should surgeons continue to perform at their best, when instead of being supported, the culture they work in is psychologically oppressive?

    How do surgeons cope with stress?
    Various coping strategies have been observed in surgeons trying to deal with burnout. ‘Stress, burnout, and maladaptive coping: strategies for surgeon well-being‘, deals both with ineffectual coping strategies of surgeons as well as with such that actually work. According to one study from Canada, the three most prevalent surgeon coping strategies were:

    • Keeping stress to oneself,
    • Concentrating on what to do next, and
    • Going on as if nothing happened
    However, the report offers a number of helpful coping strategies. These emphasize changes in workplace environment and reaching out to colleagues, changes in personal attitude and more broadly – on the level of organizational management.

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    Technology can also help to relieve stress
    Introducing innovative healthcare technology for better patient care is also a way to reduce the potential for surgical complications. Such technology reduces the time for a surgery and helps surgeons make better decisions, relieving them of part of the pressure that comes with surgical procedures.

    As Igor Movrin, MD, an assistant professor at the University Medical Center Maribor reports:

    “By using ADORA there is no need to wait for a non-sterile nurse to become available. I have fast and reliable access to patient information on the spot and there is no need to leave the sterile field and risk a surgical site infection.”

    All of this, in turn, translates into less stress and less burnout for surgeons. It contributes to psychological and physical health, creates satisfaction with one’s job and helps reduce frictions in other areas of life, which are all too often neglected. The implications of using such technology in the operating room are enormous. And more and more surgeons are reporting that they experience more peace of mind due to such technological innovations.

    These and other approaches are necessary if surgeons’ and healthcare professions in general should experience less burnout. And, as one article put it, addressing these issues is a group effort, though doctors may not be quite used to that yet.

    How do You Experience Your Profession?

    As a surgeon, do you consider your profession stressful? Do you agree that burnout is a prevailing and serious issue in your field? In what ways do you think this can change?

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