Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study

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Abstract

Background

Surgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.

Methods

This cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).

Results

A total of 142 surgeons reported having contracted COVID-19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID-19 status; however, the greater the perceived impact of COVID-19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.

Conclusions

These findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self-care in surgeon training and the provision of accessible and confidential support for practising surgeons.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00268-021-06351-6.

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Most cited references 28

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Burnout and medical errors among American surgeons.

Tait Shanafelt, Charles Balch, Gerald Bechamps … (2010)

To evaluate the relationship between burnout and perceived major medical errors among American surgeons. Despite efforts to improve patient safety, medical errors by physicians remain a common cause of morbidity and mortality. Members of the American College of Surgeons were sent an anonymous, cross-sectional survey in June 2008. The survey included self-assessment of major medical errors, a validated depression screening tool, and standardized assessments of burnout and quality of life (QOL). Of 7905 participating surgeons, 700 (8.9%) reported concern they had made a major medical error in the last 3 months. Over 70% of surgeons attributed the error to individual rather than system level factors. Reporting an error during the last 3 months had a large, statistically significant adverse relationship with mental QOL, all 3 domains of burnout (emotional exhaustion, depersonalization, and personal accomplishment) and symptoms of depression. Each one point increase in depersonalization (scale range, 0-33) was associated with an 11% increase in the likelihood of reporting an error while each one point increase in emotional exhaustion (scale range, 0-54) was associated with a 5% increase. Burnout and depression remained independent predictors of reporting a recent major medical error on multivariate analysis that controlled for other personal and professional factors. The frequency of overnight call, practice setting, method of compensation, and number of hours worked were not associated with errors on multivariate analysis. Major medical errors reported by surgeons are strongly related to a surgeon's degree of burnout and their mental QOL. Studies are needed to determine how to reduce surgeon distress and how to support surgeons when medical errors occur.

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Is Open Access

The prevention and handling of the missing data

Hyun Ki Kang (2013)

Even in a well-designed and controlled study, missing data occurs in almost all research. Missing data can reduce the statistical power of a study and can produce biased estimates, leading to invalid conclusions. This manuscript reviews the problems and types of missing data, along with the techniques for handling missing data. The mechanisms by which missing data occurs are illustrated, and the methods for handling the missing data are discussed. The paper concludes with recommendations for the handling of missing data.

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Burnout and career satisfaction among American surgeons.

Gerald J Bechamps, Paul Novotny, Daniel Satele … (2009)

To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout. : Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons. Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments. Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon. Burnout is common among American surgeons and is the single greatest predictor of surgeons' satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

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Author and article information

Contributors

Dileep N. Lobo:

ORCID: http://orcid.org/0000-0003-1187-5796

Dileep.Lobo@nottingham.ac.uk

Journal

Journal ID (nlm-ta): World J Surg

Journal ID (iso-abbrev): World J Surg

Title: World Journal of Surgery

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0364-2313

ISSN (Electronic): 1432-2323

Publication date (Electronic): 26 October 2021

Publication date PMC-release: 26 October 2021

Pages: 1-9

Affiliations

[1 ]GRID grid.4563.4, ISNI 0000 0004 1936 8868, Centre for Organisational Health and Development, School of Medicine, , University of Nottingham, ; Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB UK

[2 ]GRID grid.415598.4, ISNI 0000 0004 0641 4263, East Midlands Surgical Academic Network, , Queen’s Medical Centre, ; Nottingham, NG7 2UH UK

[3 ]GRID grid.415598.4, ISNI 0000 0004 0641 4263, Gastrointestinal Surgery, , Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen’s Medical Centre, ; Nottingham, NG7 2UH UK

[4 ]GRID grid.415598.4, ISNI 0000 0004 0641 4263, MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, , University of Nottingham, Queen’s Medical Centre, ; Nottingham, NG7 2UH UK

Author information

Dileep N. Lobo http://orcid.org/0000-0003-1187-5796

Article

Publisher ID: 6351

DOI: 10.1007/s00268-021-06351-6

PMC ID: 8547303

PubMed ID: 34704146

SO-VID: bcd6a224-5dd8-48c7-ac11-faad561ca6aa

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 7 October 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;

Award ID: MR/K00414X/1

Funded by: FundRef http://dx.doi.org/10.13039/501100000341, Arthritis Research UK;

Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study

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Abstract

Background

Methods

Results

Conclusions

Supplementary Information

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Novel Coronavirus Disease COVID-19

Most cited references 28

Burnout and medical errors among American surgeons.

The prevention and handling of the missing data

Burnout and career satisfaction among American surgeons.

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