Robert E. Nugent’s research while affiliated with Stratford University and other places

Burnout among physicians is a syndrome of emotional exhaustion, de-personalization, and reduced sense of personal accomplishment that can negatively affect personal relationships, physician well-being, and patient outcomes. Although burnout rates of up to 50% to 60% among orthopedic surgeons have been reported, no studies have evaluated burnout among orthopedic generalists and subspecialists. The primary goal of this study was to examine the prevalence of burnout among orthopedic disciplines. We conducted a multicenter study from March 2019 through December 2019 involving 149 orthopedists. An abbreviated Maslach Burnout Inventory-Human Services Survey was used to measure burnout. Demographic information, personal characteristics, professional characteristics, family life and spousal support, and depression were also assessed. The mean rate of burnout among all respondents was 62%, whereas 16.77% screened positive for depression. Subspecialties with the highest rates of burnout were oncology (100%), sports medicine (68%), and trauma (63%). Similarly, trauma (50.00%), oncology (40.00%), and general orthopedics (20.00%) had the highest positive depression screening rates. In contrast, shoulder and elbow (50%), pediatric (52%), and foot and ankle (54%) specialists had the lowest rates of burnout, whereas shoulder and elbow (0.00%), spine (0.00%), and sports medicine (6.50%) specialists had the lowest rates of positive depression screening. Older age, higher debt load, and oncology subspecialty were associated with increased burnout risk. This study sought to determine burnout rates within each orthopedic discipline, with a secondary aim of disclosing contributing factors. Trauma and oncology had the highest rates of burnout and positive depression screening. Because this study represents a small orthopedic cohort, larger studies are needed to appropriately manage burnout in the future. [Orthopedics. 20XX;XX(X):xx-xx.].

Category Other Introduction/Purpose Burnout affects physicians in a multitude of ways, resulting in low levels of personal accomplishment (PA), depersonalization (DP), and high emotional exhaustion (EE). Overall, burnout has a direct impact on physician well-being and can negatively impact personal relationships, contribute to drug or alcohol use, and result in reduced outcomes in the work field. Although orthopaedic surgeon burnout rates of up to 50-60% have been reported, there have been no studies comparing burnout rates by orthopaedic subspecialty. The primary goal of this study is to examine the prevalence of burnout amongst orthopedic generalists and subspecialists. Given that a multitude of factors may contribute to burnout, a secondary goal is to identify trends in demographic data that may contribute to burnout. Methods This was a multicenter, cross-sectional study conducted from March 2019 through December 2019 involving 149 orthopaedic surgeons with all orthopaedic subspecialties represented. The survey utilized an abbreviated 12-item Maslach Burnout Inventory - Human Services Survey (aMBI-HSS) to assess burnout. The aMBI-HSS consisted of three subcategories; PA, DP, and EE, each of which represented their own burnout score. Depression was also assessed in order to identify any correlation to increased burnout. Finally, independent factors, including demographics, personal characteristics, professional characteristics, and family life/spousal support were collected to assess how they contributed to burnout. Univariate and bivariate regression was performed to identify independent variables for multivariate regression analysis. Three separate generalized linear regressions were then performed to assess which independent factors led to an increase or decrease in the EE, DP, or PA burnout scores. Results Mean burnout amongst all respondents was 62.29%, with 16.7% screening positive for depression. Oncology (100%), Sports Medicine (67.70%), and Trauma (62.50%) were the three specialties with highest burnout. In contrast, lowest burnout rates were seen in Shoulder and Elbow (50.0%), Pediatrics (51.6%), and Foot and Ankle (53.8%). Trauma (50.0%), Oncology (40.0%), and General (20.0%) had the highest rates of depression, while Shoulder and Elbow (0.00%), Spine (0.00%), and Sports Medicine (6.5%) had the lowest rates of depression. Independent factors associated with increased risk of burnout included Oncology subspecialty, older age, and increased debt. Contrarily, independent factors associated with decreased burnout were more years in practice, more hours worked per week, more time spent with family and close friends, work environment satisfaction, and home life satisfaction. Conclusion Burnout is a growing problem amongst physicians. This study sought to determine which orthopaedic subspecialties had the highest rates of burnout and depression, while identifying any secondary contributing factors. Our study found that orthopaedic Trauma and Oncology had the highest rates of burnout and depression. Additionally, older age and higher debt load contributed to an increased rate of burnout and depression. As this is only a small representation of the orthopaedic surgical community, larger studies are necessary to help further understand burnout and elucidate effective treatment options for orthopaedic surgeons.

Background Three-fourths of Americans are sexually active and studies show a correlation between sexual activity and good health. Rotator cuff tears and subsequent repairs can cause significant disruption in daily living including sexual activity. Orthopedic surgeons rarely discuss sexual activity with patients. Therefore, patients have little information about expectations, restrictions, and return to sexual activity. The primary goal of this study is to evaluate patient improvement in sexual activity following arthroscopic rotator cuff repair and evaluate factors that affect sexual activity. Methods An anonymous 20-item multiple-choice survey was sent to patients greater than six-months following arthroscopic rotator cuff repair performed by seven fellowship trained orthopedic shoulder and elbow surgeons between March 2018 and May 2019. The survey assessed preoperative and postoperative sexual activity, and included questions regarding frequency, pain, positioning, and postoperative injury. Results A total of 88 patients met inclusion criteria and completed the survey. Preoperatively, 65% of patients admitted that their shoulder interfered with the quality and/or frequency of their sexual activity, most commonly secondary to inability to weight bear on the affected arm (31%). Postoperatively, the majority of patients (79%) found it easier to engage in sexual activity, with 35% of patients attributing this to less pain. At six weeks postoperative, 72% of patients returned to sexual activity. The overall trend demonstrated a statistically significant (p<0.001) increase in sexual activity frequency as one progressed from their operative date. Interestingly, 31% of patients removed their sling to engage in sexual activity following surgery, with 7% admitting to aggravating their shoulder or causing significant pain. Conclusion Prior to arthroscopic rotator cuff repair, most patients experience limitations in the quality and/or frequency of their sexual activity secondary to their shoulder. Following surgery, the majority of patients will more easily engage in sexual activity by 6 weeks, with increasing frequency as time progresses from surgery. Many patients are non-compliant with sling wear during sexual activity and 7% will aggravate their shoulder.