Physician burnout has long been recognized as a diagnosable and perhaps even treatable condition. While burnout existed Pre Covid-19, the pandemic may have precipitated burned out physicians’ leaving the workforce.
Historically, physician health has not been taught in the traditional medical school curriculum; however, over my 30 years of post-undergraduate education and training, physician wellness has become a topic of interest. Given the national shortage of physicians, longer life expectancy and perhaps longer career, it is imperative that neurosurgeons have a strategy to maintain career interest over decades. The neurosurgical career is a marathon, not a sprint!
Although burnout was first described in 1974 by Freudenberger, development of the Maslach Burnout Inventory (MBI) led to a wider recognition of the incidence and prevalence of burnout. Burnout is defined by three main characteristics: EE (emotionally exhaustion), DP (depersonalization) and PA (lack of personal achievement). In the neurosurgical world, burnout is a real entity, affecting both residents and attendings in both private practice and academic settings. A meta-analysis of the literature regarding neurosurgical burnout revealed that neurosurgeons exhibit the highest rates of burnout (51.1% prevalence in attendings vs. 45.4% prevalence in residents) amongst all physicians.
As is the case with many diseases processes, prevention is key. As neurosurgeons, we need to adequately address our physical, mental and spiritual health regularly. These three aspects of health are inter-related. Dedicating time to the pursuit of physical activity is important for both physical and mental health. As we age, the body reveals evidence of degenerative changes; the best defense against this is to maintain strength and flexibility proactively by engaging in an active lifestyle. Maintaining mental agility by pursuing a new hobby or maintaining lifelong passions is equally important. Finally, having some sort of belief system by which you approach your life is beneficial.
It has been shown that lack of PA is most closely linked to neurosurgical burnout. I would argue that our profession allows us daily opportunities for emotional renewal, connection and personal achievement. Daily, neurosurgeons confront issues related to the quantity and quality of life; we are forced to define the human experience and experience our collective humanity. All it requires is having the mindfulness, aka, presence of mind, to connect with those before us, whether it is our patients or colleagues.
With 2024, AANS Neurosurgeon is launching a monthly feature, “Beating Burnout.” We will feature contributors from diverse backgrounds and perspectives to empower the neurosurgical community with techniques to diagnose, treat and hopefully prevent this malady; it is difficult for a treating physician to be suffering simultaneously.
