We aim to investigate the prevalence of posttraumatic stress disorder (PTSD), physician burnout (PBO), and work–life balance (WLB) among surgical residents, fellows, and attendings to illustrate the trends in surgeon wellness. A cross-sectional national survey of surgical residents, fellows, and attendings was conducted screening for PTSD, PBO, and WLB. The prevalence of screening positive for PTSD was more than two times that of the general population at all levels of experience, and more than half have an unhealthy WLB. The prevalence of PTSD, PBO, and unhealthy WLB declined with increasing level of experience (P < 0.001). One deviation in this trend was a lower prevalence of PBO among surgical fellows compared with residents and attendings (P < 0.001). Surgeon wellness improved with increasing level of experience. The incorporation of wellness programs into surgical residencies is essential to the professional development of young surgeons to cultivate healthy lasting habits for a well-balanced career and life.
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References
1.
McClaffertyH., BrownO.W.Section on Integrative Medicine; Committee on Practice And Ambulatory Medicine; Section on Integrative Medicine. Physician health and wellness.Pediatrics2014; 134: 830–5.
2.
WallaceJ.E., LemaireJ.Physician well being and quality of patient care: an exploratory study of the missing link.Psychol Health Med2009; 14: 545–52.
3.
WallaceJ.E., LemaireJ.B., GhaliW.A.Physician wellness: a missing quality indicator.Lancet2009; 374: 1714–21.
4.
GreeneJ.Employee wellness proves its worth.Trustee2011; 64: 8–12.
JosephB., PanditV., HadeedG.Unveiling posttraumatic stress disorder in trauma surgeons: a national survey.J Trauma Acute Care Surg2014; 77: 148–54; discussion 154.
8.
ShanafeltT.D., HasanO., DyrbyeL.N.Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014.Mayo Clin Proc2015; 90: 1600–13.
9.
BodenheimerT., SinskyC.From triple to quadruple aim: care of the patient requires care of the provider.Ann Fam Med2014; 12: 573–6.
10.
ShanafeltT.D., BalchC.M., DyrbyeL.Special report: suicidal ideation among American surgeons.Arch Surg2011; 146: 54–62.
11.
ShanafeltT.D., OreskovichM.R., DyrbyeL.N.Avoiding burnout: the personal health habits and wellness practices of US surgeons.Ann Surg2012; 255: 625–33.
12.
BalchC.M., FreischlagJ.A., ShanafeltT.D.Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences.Arch Surg2009; 144: 371–6.
13.
RegehrC., GlancyD., PittsA.Interventions to reduce the consequences of stress in physicians: a review and meta-analysis.J Nerv Ment Dis2014; 202: 353–9.
14.
AndreasenN.What is post-traumatic stress disorder?Dialogues Clin Neurosci2011; 13: 240–3.
15.
RomaniM., AshkarK.Burnout among physicians.Libyan J Med2014; 9: 1–6.
16.
RobertsA.L., DohrenwendB.P., AielloA.E.The stressor criterion for posttraumatic stress disorder: does it matter?J Clin Psychiatry2012; 73: e264–70.
17.
ShanafeltT.D., BooneS., TanL.Burnout and satisfaction with work-life balance among us physicians relative to the general us population.Arch Intern Med2012; 172: 1377–85.
18.
WangT.Work-life balance: hopeless endeavor or rather, a true privlege?Front Pediatr2015; 3: 99.
19.
LemaireJ.B., WallaceJ.E.How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study.BMC Health Serv Res2014; 14: 616.
20.
WestC.P., DyrbyeL.N., SloanJ.A.Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.J Gen Intern Med2009; 24: 1318–21.
21.
FreedyJ., SteenkampM.M., MagruderK.M.Post-traumatic stress disorder screening test performance in civilian primary care.Fam Pract2010; 27: 615–24.
22.
PrinsA., OuimetteP., KimerlingR.The primary care PTSD screen (PC-PTSD): devevlopment and operating characteristics.Prim Care Psychiatr2003; 9: 9–14.
23.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th Ed.Arlington, VA: American Psychiatric Publishing, Inc., 2013.
24.
JenningsM.L., SlavinS.J.Resident wellness matters: optimizing resident education and wellness through the learning environment.Acad Med2015; 90: 1246–50.
25.
LefebvreD.C.Perspective: resident physician wellness: a new hope.Acad Med2012; 87: 598–602.
26.
LinzerM., PoplauS., BabbottS.Worklife and wellness in academic general internal medicine: results from a national survey.J Gen Intern Med2016; 31: 1004–10.
27.
ParkA.E., SuttonE.R., HenifordB.T.Minimally invasive surgery fellowship graduates: their demographics, practice patterns, and contributions.Surgery2015; 158: 1462–7.
28.
LinzerM., VisserM.R., OortF.J.Predicting and preventing physician burnout: results from the United States and The Netherlands.Am J Med2001; 111: 170–5.
29.
PantenburgB., LuppaM., KonigH.H.Burnout among young physicians and its association with physicians’ wishes to leave: results of a survey in Saxony, Germany.J Occup Med Toxicol2016; 11: 2.
30.
KesslerR.C., ChiuW.T., DemlerO.Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.Arch Gen Psychiatry2005; 62: 617–27.
31.
GostlowH., VegaC.V., MarlowN.Do surgeons react?: a retrospective analysis of surgeons’ response to harassment of a colleague during simulated operating theatre scenarios.Ann Surg2018; 268: 277–81.
32.
LuuS., PatelP., St-MartinL.Waking up the next morning: surgeons’ emotional reactions to adverse events.Med Educ2012; 46: 1179–88.
33.
DyrbyeL.N., BurkeS.E., HardemanR.R.Association of clinical specialty with symptoms of burnout and career choice regret among us resident physicians.J Am Med Assoc2018; 320: 1114–30.
34.
LakeJ.The integrative management of PTSD: a review of conventional and CAM approaches used to prevent and treat PTSD with emphasis on military personnel.Adv Integr Med2015; 2: 13–23.
35.
SmedsM.R., ThrushC.R., McDanielF.K.Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination.J Surg Res2017; 217: 217–25.
36.
PompiliM., InnamoratiM., NarcisoV.Burnout, hopelessness and suicide risk in medical doctors.Clin Ter2010; 161: 511–14.
37.
WurmW., VogelK., HollA.Depression-burnout overlap in physicians.PLoS One2016; 11: e0149913.
38.
Bentley-KumarK., JacksonT., HollandD.Trauma patients: I can't get no (patient) satisfaction?Am J Surg2016; 212: 1256–60.
39.
SwensenS., KabcenellA., ShanafeltT.Physician-organization collaboration reduces physician burnout and promotes engagement: the Mayo clinic experience.J Healthc Manag2016; 61: 105–27.
40.
BerwickD.M., NolanT.W., WhittingtonJ.The triple aim: care, health, and cost.Health Aff2008; 27: 759–69.
41.
JacksonT.N., PearcyC.P., KhorgamiZ.The physician attrition crisis: a cross-sectional survey of the risk factors for reduced job satisfaction among US surgeons.World J Surg2018; 42: 1285–92.
42.
GazelleG., LiebschutzJ.M., RiessH.Physician burnout: coaching a way out.J Gen Intern Med2015; 30: 508–13.
43.
GoldhagenB.E., KingsolverK., StinnettS.S.Stress and burnout in residents: impact of mindfulness-based resilience training.Adv Med Educ Pract2015; 6: 525–32.
