In their study in this issue of JAMA Surgery, Hewitt et al1 have compared definitions and thresholds of burnout in general surgery residents, providing important insights into strategies to measure physician burnout. The study offers multiple strengths: a large and representative sample (N = 6956), an excellent survey response rate (85.6%), the use of a validated gold standard measure of burnout, and exploration of prevalence based on inconsistencies in the literature. The authors have asserted that the Maslach Burnout Inventory is scored and interpreted inconsistently in the literature regarding the time frame and number of symptoms needed for a respondent to be classified as having burnout. In fact, much of the recent prevalence research has required an elevation (using defined cutoffs) in only 1 of 3 dimensions (emotional exhaustion, depersonalization, or a decreased sense of personal accomplishment) for an individual to be considered burnt out.2,3 Such an approach may not capture burnout as a complex and dynamic construct.
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Danhauer SC, Files K, Freischlag JA. Broadening the Discussion on Physician Burnout. JAMA Surg. Published online September 09, 2020. doi:10.1001/jamasurg.2020.3364
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