Elsevier

Surgery

Volume 130, Issue 4, October 2001, Pages 696-705
Surgery

Central Surgical Association
Burnout among American surgeons*

Presented at the 58th Annual Meeting of the Central Surgical Association, Tucson, Ariz, March 7-10, 2001.
https://doi.org/10.1067/msy.2001.116676Get rights and content

Abstract

Background. The long-term consequences of stress on the surgeon are unknown. One manifestation of stress is burnout. The purpose of this study was to measure the prevalence of burnout in actively practicing American surgeons. Methods. The Maslach Burnout Inventory and a questionnaire of our own design were sent to 1706 graduates of various University of Michigan surgical residencies (1222) and members of the Midwest Surgical Association (484). The response rate was 44%. Responses from 582 actively practicing surgeons were the sample used for analysis. Results. Thirty-two percent of actively practicing surgeons showed “high” levels of emotional exhaustion, 13% showed “high” levels of depersonalization, and 4% showed evidence for low personal accomplishment. Younger surgeons were more susceptible to burnout (r = −0.28, P <.01). Burnout was not related to caseload, practice setting, or percent of patients insured by a health maintenance organization. Important etiologic factors were a sense that work was “overwhelming” (r = 0.61, P <.01), a perceived imbalance between career, family, and personal growth (r = −0.56), P <.01), perceptions that career was unrewarding (r = −0.42, P <.01), and lack of autonomy or decision involvement (r = −0.39, P <.01). A strong association was noted between burnout elements and a desire to retire early (r = 0.50, P <.01). Conclusions. Burnout is an important problem for actively practicing American surgeons. These data could be used to modify existing surgical training curricula or as an aid to surgical leadership when negotiating about the surgical work environment. (Surgery 2001;130:696-705.)

Section snippets

Sample groups

A total of 1706 surveys were mailed to graduates of various University of Michigan surgical residencies (1222) or members of the Midwest Surgical Association (484). Seven hundred fifty-nine surveys were returned (44% response rate) of which 582 (77%) were from actively practicing surgeons. The latter group constitutes the sample used for analysis. Of retired surgeons, the mean age at retirement was 65.9 years. Of full-time academics, 56% were professors and 59% were tenured. Of respondents, 41%

Demographic variables

Table I presents a summary of demographic variables arranged according to type of surgical practice (private, full-time academic, private with academic affiliation) for actively practicing surgeons.

. Demographic variables

Empty CellType of practice
Demographic variablesPrivate practiceFull-time academicPrivate practice with academic affiliation
Age (y) (±SD)50 ± 1050 ± 1051 ± 10
No. of children (±SD)3 ± 13 ± 13 ± 1
Years in practice (±SD)18 ± 1018 ± 1019 ± 10
No. of cases/year (±SD)419 ± 367328 ± 198416 ± 296
No.

Discussion

The data in this article show that a substantial percentage of American surgeons have lost energy and enthusiasm for work. One third of actively participating surgeons scored high in the EE scale of an established burnout inventory, indicating that they “had nothing left to give.” When one considers the unique life and death nature of the surgical craft, these data should give rise to great concern. One sixth of the respondents had progressed to the next stage in the burnout continuum, DP,

Discussion

Dr Layton F. Rikkers (Madison, Wis). I think we should all be grateful to you for this excellent and timely study that has such important implications for all of us, especially our younger colleagues, and possibly most importantly for the residents in our training programs.

Somewhat surprising to you and in contradiction to your original hypothesis, burnout was significantly more common among younger surgeons. Actually, this finding is not particularly surprising to me. Compared with those of us

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  • Cited by (0)

    *

    Reprint requests: Darrell A. Campbell, Jr, MD, Department of Surgery, University of Michigan Health System, 2920F Taubman Center, 1500 East Medical Center Dr, Ann Arbor, MI 48109-0331.

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