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Burnout in orthopedic surgeons - 29/01/20

Doi : 10.1016/j.otsr.2019.04.029 
Vincent Travers
 Clinique les Lauriers, 147, avenue Jean-Giono, 83600 Fréjus, France 

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Abstract

Burnout corresponds to a state of exhaustion (emotional, physical, mental) that can result in complete psychological and/or physical breakdown. Burnout is a result of how our society has evolved. A recent phenomenon, it affects all strata of society, all corporations, and all countries. Physicians are not immune to it, whether they are in public or private practice and whether they are residents in training or seasoned practitioners. The orthopedic world is particularly affected because of multiple risk factors such as sustained work demands, increased malpractice lawsuits, patients no longer placing physicians on a pedestal, greater bureaucratic demands from hospitals and large practices, institutional control policies, reduced autonomy and aggressive media. This is a highly topical issue, hence this study. We sought to answer the following questions: What is burnout? Burnout has three components: emotional exhaustion, depersonalization, loss of personal accomplishment. Its manifestations are psychological, emotional and also physical. Six psychosocial risk factors have been described. The most relevant to our specialty are the intensity and complexity of the work, and the substantial emotional requirements. What is the frequency of burnout and the risk factors in the medical field? Burnout affects the healthcare sector, especially surgeons with a mean of 40% rate. All age groups, all types of practices and all countries are impacted. The mean suicide rate among surgeons (13.3%) is double that of the general population. The primary risk factors are physical and emotional overload, growing bureaucracy, the burden of malpractice lawsuits and regulatory bodies. How does burnout impact orthopedic and trauma surgery specifically? The burnout rate has been reported to be 30% to 40%, and greater than 50% in residents. The stress level is graded at more than 8/10 in 31% of us, with 40% of practitioners deeming this current stress level unacceptable. Administrative factors and the regulatory burden are said to be the most difficult to handle; consequently, orthopedic surgeons feel the best when they are operating. How can burnout be prevented and treated? The main elements of individual and collective prevention appear to be stress management seminars where surgeons can share their experiences, hear from others in the same situation and adjust their practices. We believe the priority should be placed on managing the work time and number of patients.

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Keywords : Burn out, Orthopedics, Work-related stress


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