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March 7, 2018

The Problem of Burnout Among Surgeons

Author Affiliations
  • 1Department of Medicine and Surgery, University of North Carolina, Chapel Hill
  • 2Department of Surgery, Mayo Clinic, Rochester, Minnesota
JAMA Surg. Published online March 7, 2018. doi:10.1001/jamasurg.2018.0047

Today the world of medicine in general, and of surgery in particular, is faced with a problem that is severely affecting both trainees and practicing physicians: burnout. In 1974, the American psychologist Herbert Freudenberger coined the term burnout to describe “the consequences of severe or prolonged stress and anxiety experienced by people working in the healing professions.”1(p160) Several years later, Maslach and Jackson defined burnout as “a syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do people work of some kind.”2(p99) Burnout is often complicated by disruptive behaviors, such as depression, substance abuse, interpersonal conflicts, and even suicidal ideation. In a survey of 7905 surgeons performed in 2010 and funded by the American College of Surgeons, Shanafelt and colleagues3 found that 6.3% reported some element of suicidal ideation during the prior 12 months; only 26% of these surgeons sought psychiatric care, while the remainder were afraid to seek help, because they thought that it could affect their medical license. Unfortunately, the rate of burnout among surgeons is much greater than among the general population (53% vs 28%), and represents a major increase compared with several years ago, when it was closer to 40%.4 Based on the analysis by Maslach and Jackson,2 the following 3 aspects of burnout have emerged: emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment.

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