Burnout
J.Sales-Llopis
Neurosurgery Service, Alicante University General Hospital, Alicante Spain.
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Neurosurgery is a rewarding career choice, but numerous challenges and stressors can lead to lower levels of satisfaction and dangerously increased levels of burnout 1).
Burnout is a negative workplace syndrome of emotional exhaustion, cynicism, and perceived professional inefficacy that risks the patient-provider relationship, patient care, and physician well-being. Noticeable methodological differences in studies on trainee and attending burnout contribute to a wide range of neurosurgery burnout estimates and yield significant knowledge gaps. The environment may have a greater impact on trainee burnout than demographics. Wellness programs should emphasize solidarity 2)
Burnout in neurosurgeons
Definition
Risk factors
Clinical features
Burnout is defined by lethargy, pessimism, constant complaining, and indifference due to excessive work, study, and activity.
It is composed of 3 different subdimensions, namely emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA).
Differential diagnosis
Surveys
Complications
Ignored or unaddressed job burnout can have significant consequences, including:
Excessive stress
Sadness, anger, or irritability
Alcohol or substance misuse
Heart disease
High blood pressure
Type 2 diabetes
Vulnerability to illnesses
Only more severe (i.e., clinical) manifestations of burnout are linked to creativity.
Prevention
Effective leadership is imperative and clinically has been shown to improve team efficacy, patient outcomes, and staff engagement, as well as reduce physician burnout and medical errors. But despite the demonstrated benefit of effective leadership on improving clinical outcomes and reducing burnout, there is a lack of formal leadership training in residency programs 3).
Management
Systematic reviews
Clinical experience suggests that curbing physician burnout requires a combination of workplace redesigns, positive leadership behaviors, and resilience training that teaches practical applications from the fields of resilience, emotional intelligence, positive psychology, and relationship systems 4).
COVID-19 Pandemic
Palliative care physician
Over one-third of palliative medicine, physicians meet burnout criteria. The provision of enhanced organizational and colleague support is paramount in both the current and future pandemics 5).