Combating Stress and Burnout in Surgical Practice: A Review

Johns Hopkins Medical Institutions, Department of Surgery, 1515 Orleans St. Cancer Research Building II, Room 507, Baltimore, MD 21231, USA.
Advances in Surgery 09/2010; 44(1):29-47. DOI: 10.1016/j.yasu.2010.05.018
Source: PubMed


The practice of surgery offers the potential for tremendous personal and professional satisfaction. Few careers provide the opportunity to have such a profound effect on the lives of others and to derive meaning from work. Surgeons choose this arduous task to change the lives of individuals facing serious health problems, to experience the joy of facilitating healing, and to help support those patients for whom medicine does not yet have curative treatments. Despite its virtues, a career in surgery brings with it significant challenges, which can lead to substantial personal distress for the individual surgeons and their family. By identifying the priorities of their personal and professional life, surgeons can identify values, choose the optimal practice type, manage the stressors unique to that career path, determine the optimal personal work-life balance, and nurture their personal wellness. Being proactive is better than reacting to burnout after it has damaged one's professional life or personal wellness. Studies like the ACS survey can benefit surgeons going through a personal crisis by helping them to know that they are not alone and that many of their colleagues face similar issues. It is important that surgeons do not make the mistake of thinking: "I must not be tough enough," or "no one could possibly experience what I am going through." The available evidence suggests that those surgeons most dedicated to their profession and their patient may very well be most susceptible to burnout. Silence on career distress, as a strategy, simply does not work among professionals whose careers, well-being, and level of patient care may be in jeopardy. Additional research in these areas is needed to elucidate evidence-based interventions to address physician distress at both the individual and organizational level to benefit the individual surgeon and the patient they care for. Surgeons must also be able to recognize how and when their personal distress affects the quality of care they provide (both in the delivery of care and in the emotional support of patients and their families). There is no single formula for achieving a satisfying career in surgery. All surgeons deal with stressful times in their personal and professional life and must cultivate habits of personal renewal, emotional self-awareness, connection with colleagues, adequate support systems, and the ability to find meaning in work to combat these challenges. As surgeons, we also need to set an example of good health to our patients and future generations of surgeons. To provide the best care for our patients, we need to be alert, interested in our work, and ready to provide for our patient's needs. Maintaining these values and healthy habits is the work of a lifetime.

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    • "The specific job resources we focus on are social support, feedback, and leadership because they have also been found to be important for employees and influence their working conditions, which may then also relate to their performance (Bakker et al., 2003). In healthcare , cultivating job resources can help HCP deal with stressful situations by facilitating habits of personal renewal, emotional self-awareness, connections with colleagues , adequate social support systems, and meaningfulness in working to overcome these challenges at work (Balch & Shanafelt, 2011). Values such as assertiveness, competitiveness, desirability for achievement, and overselling themselves (Hofstede, 1983, 2001) are more predominant in a masculine culture (US scored 36/50 and NL scored 3/50 on masculinity vs. femininity index). "
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    ABSTRACT: We explore how job demands and job resources are related to job crafting, and how this, in turn, is related to performance in two samples of American (US; N = 70) and Dutch (NL; N = 144) health care professionals (HCP). A cross-sectional, cross-cultural design revealed that US HCP have higher job demands and reduce them more than NL HCP, who have higher and seek more job resources. Specifically, job demands positively related to seeking resources; job resources positively related to seeking challenges and seeking resources but negatively to reducing demands. While reducing demands negatively related to task and contextual performance, seeking resources positively related to task and creative performance. This study expands scientific and practical knowledge on employee proactive organizational behavior.
    Full-text · Article · Oct 2015 · Journal of Personnel Psychology
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    • "During 2009, a working group collaboratively designed a preventive intervention process called APEP (Ajuda Preventiva en l'Esgotament Profesional), or " Helping to Prevent Professional Exhaustion " , oriented towards secondary prevention of the syndrome. They took into account not only the prior experience of members of both preventive groups, but also some existing studies of similar interventions [16] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31]. "

    Full-text · Article · Jan 2013 · Health
    • "On the contrary, the increase of the stress of the doctor, of the anesthesiologist, or nurse affects the efficiency and outcome in a negative way. In particular, the doctors must constantly balance their private life with work, since they work for many hours (Balch & Shanafelt, 2011), in addition to retain control over the patient's safety and fulfill their role of leadership requested by the specialty (Majmudar, Jain, Chaudry, & Schwartz, 2010). Anesthesiologists on the other hand, in view of process efficiency, must express a series of nonemerging factors, which do not concern skills, strictly speaking (i.e., ''nontechnical skills'': task management, team working, situation awareness, and decision makingEisenach, 2009), but they are affected by organizational and cultural influences (Helmreich, 2000). "
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    ABSTRACT: This paper focuses on efficiency as a central theme of the Italian health care reforms, combining macrolevel policies with microlevel (i.e., operating room) perceptions of the concept. According to the phenomenographic approach, this analysis investigates how the components of a surgical team (22 semistructured interviews) experience efficiency in their daily workflows. The main findings show that the concept of efficiency is multidimensional. According to participants' perspective, several categories of efficiency collected in an outcome space emphasize an holistic view of efficiency driving health policies and strategies. SOCIAL IMPLICATIONS: The suggestion of further relationships between perspectives and other constructs (i.e., quality, safety, patient focus, process) at micro and macro level could enhance the impact of health reforms. A qualitative approach conducted at microlevel help to recognize the phenomenon (of efficiency), engaging the individual conception that practitioners have of the health efficiency.
    No preview · Article · Dec 2012 · Advances in Health Care Management
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