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Orthopedic surgeons are no strangers to the challenges and pressures inherent in their profession. Nonetheless, recent studies have shown that orthopedic surgeons are particularly susceptible to physician burnout by specialty. In this article, we will explore why orthopedic surgeons are more prone to experiencing burnout and discuss potential solutions to address this significant challenge.
What is burnout in healthcare?
Burnout definition is a state of chronic workplace stress that can harm your well-being and the quality of care you provide. Feelings of emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment characterize it. Untreated burnout can escalate to depression and suicidal behaviors.
There is a higher correlation between burnout and healthcare workers due to the demanding nature of their work and the high stakes associated with it. The seeds of burnout often take root during the rigorous residency period where prioritizing high performance tends to overshadow self-care and work-life balance.
Why do orthopedic surgeons experience a higher prevalence of burnout?
The rates of orthopedic surgeon burnout have been reported1 as high as 40% to 60%. Among all surgical subspecialties, orthopedic surgeons tragically have the highest prevalence of death by suicide. They accounted for 28.2% of surgeon suicides between the years 2003 and 2017.
These alarming statistics shed light on the significant challenges these surgeons encounter and the urgent need to address burnout and the mental health and well-being of orthopedic surgeons.
In pursuit of excellence, numerous orthopedic surgeons define their medical identity based on the ideals of perfection and persistent efficiency, often at any cost. The following factors might contribute to the higher prevalence of burnout within this subspecialty:
Intense Workload
Your role involves managing a heavy caseload, performing complex surgeries, managing consultations, and overseeing post-operative care. The demanding nature of the profession, combined with long work hours and emergency cases, can lead to physical and mental exhaustion.
High-Stress Environment
Orthopedic surgeries require precision and critical decision-making under pressure. The complexity and potential risks of surgical procedures contribute to the high-stress environment you navigate daily.
Administrative Burdens
Increasing administrative tasks, such as documentation, compliance, charting, and paperwork, can take time away from patient care and add to your workload.
Patient Complexity and Expectations
You often treat patients with complex conditions, chronic pain, and lengthy recovery periods. Balancing patient expectations, managing complications, and ensuring positive outcomes can be emotionally challenging and a sense of guilt might arise when faced with complications.
Feeling Underappreciated
Despite the emphasis on teamwork and collective efforts, the prevailing medical culture often shifts blame disproportionately to the surgeon when complications or problems arise.
Organizational Inefficiency
Insufficient staff support, poor communication, and operational inefficiencies (inadequate resources, lengthy wait times, or bad patient screening) can hinder your ability to do what you’re qualified to do, leading to decreased career satisfaction.
Burnout gets worse if support doesn’t get sought. According to Medscape2, 44% of orthopedists don’t consider looking for professional help, and another 45% are not being helped but consider asking for it.
Those who did seek help for their mental health concerns often faced judgment from supervisors and the risk of peers disclosing their issues to others, intensifying the challenges of combating burnout.
How Burnout Affects Patient Care?
Burnout not only takes a toll on you as a surgeon but also affects the care of your patients. It's essential to recognize how this can happen:
Medical Errors
Burnout impairs cognitive function, attention, and decision-making abilities. When you're exhausted and overwhelmed, you're more prone to making errors that can compromise patient safety and surgical outcomes.
Reduced Compassion
Burnout can diminish your empathetic qualities, affecting your interactions with patients. Depersonalization may creep in, leading to a decline in the quality of communication with the patient and patient satisfaction.
Decreased Focus and Productivity
Burnout diminishes your ability to concentrate and pay attention to detail, impacting your ability to provide focused and efficient patient care. This can result in longer surgical times, increased complications, and reduced overall productivity.
Potential Solutions to Coping with Burnout
Before you despair, recognizing burnout symptoms and burnout signs is the first step towards addressing it and reclaiming your passion for your work.
Although not all responsibility falls on your shoulders, recovery from burnout requires a proactive approach, so here are potential solutions to consider:
Prioritize Self-Care
Make self-care a priority by incorporating exercise, adequate sleep, and healthy nutrition into your routine. Taking breaks, pursuing hobbies, and maintaining a healthy work-life balance can help you recharge and rejuvenate.
Set Boundaries
Learn to set clear boundaries between work and personal life. Create dedicated time for relaxation, leisure activities, and spending time with loved ones. Protect your time as much as possible to maintain a sense of balance.
Seek Support
Despite any perceived stigma, don't hesitate to reach out to colleagues, mentors, or support groups. Sharing experiences can be immensely beneficial. Consider confidential counseling or therapy to address and manage the emotional demands associated with your work.
Practice Mindfulness
Incorporate mindfulness techniques, such as meditation or deep breathing exercises, into your daily routine. These practices can help reduce stress, enhance focus, and promote emotional well-being.
Use Preoperative Planning System
Simplifying processes, minimizing errors, and reducing administrative burdens, preoperative planning systems optimize workflow. By freeing up time and contributing to a healthier work environment, these systems alleviate stress and create space for a more balanced professional life.
Organizational Change
Taking charge of your health is essential, but it's important to acknowledge that the overall system itself has its flaws.
Implementing organizational-level changes is crucial like eliminating unnecessary obligations, establishing protected work hours for peer discussions, improving workflow, addressing inefficiencies, increasing staff, and leading by example.
Healthcare organizations possess the power to cultivate a culture centered on the wellness of surgeons. By prioritizing your well-being, organizations can effectively reduce the costs of burnout in healthcare associated with medical errors and staff turnover.
Remember, prioritizing your well-being is not only beneficial for you but also for the patients who rely on your expertise and care.
References
1 - Jennings, J. M., Gold, P. A., Nellans, K., & Boraiah, S. (2022). Orthopaedic surgeons have a high prevalence of burnout, depression, and suicide: review of factors which contribute or reduce further harm. Journal of the American Academy of Orthopaedic Surgeons
2 - Koval, Mary Lyn (2023) Orthopedist Lifestyle, Happiness & Burnout Report 2023. Medscape
