‘From bones to burnout, delving beyond the scalpel’: prioritizing surgeon wellness for optimal patient outcomes

Sir,

Orthopaedic surgeons face significant challenges in balancing their demanding professional responsibilities with their personal lives, which can often lead to burnout and poor well-being. Orthopaedic surgeons face a variety of multifaceted stressors which lead to burnout and have significant impacts on their well-being and the quality of patient care. Here, we present an overview of relevant literature and provide evidence-based recommendations for a comprehensive multidisciplinary approach to implement strategies to mitigate their effects.

Stressors include long work hours, high workload, job demands, work-home conflict, patient expectations, and administrative tasks; thus, leading to a high burnout rate.¹ COVID-19 pandemic has also had an impact on the mental health and well-being of orthopaedic surgeons.

Other stressors include financial pressures, malpractice concerns, conflicts with colleagues, pressure of making critical decisions and the potential for adverse outcomes.2 Additionally, high volume of patient care, the complexity of cases, the need to constantly update medical knowledge and skills and the emotional burden of dealing with patients who may have chronic pain or disability; contribute as ‘stress-risers’.³

One potential approach to improve the psychological well-being of orthopaedic surgeons is the adoption of mindfulness-based practices. This approach may have the potential to improve stress levels, job satisfaction, and psychological well-being.² Mindfulness-based practices can involve different techniques such as meditation, breathing exercises, and body awareness, and can be incorporated into daily routines to promote relaxation and emotional regulation. Prioritizing self-care activities such as getting adequate sleep, exercising regularly, and maintaining a balanced diet can help alleviate stress and promote overall well-being. In addition to mindfulness-based practices, orthopaedic surgeons should prioritize self-care, seek social support, and implement stress management strategies to maintain their physical and emotional health and optimize patient outcomes.³

Seeking social support is another valuable source of stress management. Connecting with colleagues and peers can reduce feelings of isolation and build a sense of camaraderie. The protective role of self-efficacy has been found to reduce burnout in nursing and other healthcare professions.⁴ Taking regular breaks throughout the day to rest and recharge can also help reduce stress levels. Meditation and deep breathing exercises, can help to reduce stress and promote a sense of calmness.⁵ Orthopaedic surgeons who are struggling with stress and anxiety may also benefit from seeking professional help. Cognitive-behavioural therapy has been found to be an effective treatment for anxiety and depression in healthcare professionals.⁶ Finally, leadership can play a crucial role in promoting a positive work environment, recognizing the contributions of orthopaedic surgeons, and implementing wellness programs to promote physician wellness. Leaders in the field should be proactive in supporting the well-being of orthopaedic surgeons to mitigate burnout and ensure the provision of high-quality care.⁷

In conclusion, orthopaedic surgeons face significant challenges in maintaining their well-being while providing high-quality care. By prioritizing self-care practices, seeking social support, taking regular breaks, practicing mindfulness techniques, and seeking professional help when needed, orthopaedic surgeons can reduce stress and improve their overall quality of life.

Additionally, leadership should play a proactive role in promoting physician wellness to mitigate burnout and ensure high-quality care provision.

REFERENCES

1. 1. Bhatia N, Bhojaraja VS, Stevanovic MV. Burnout in orthopaedic surgeons: a review. EFORT Open Rev. 2019;4(10):637-44.
2. 2. Turner KA, Chaudhry S, Crawford DC. The impact of mindfulness-based practices on orthopedic surgeons: a systematic review. J Patient Safety Quality Improvement. 2021;9(2):78-85.
3. 3. Birkenmaier C, Veit K, Mutschler W, Biberthaler P. Orthopaedic surgery and its impact on quality of life: a patient's perspective. J Clin Orthop Trauma. 2020;11(1):S8-13.
4. 4. Fida R, Laschinger HKS, Leiter MP. The protective role of self-efficacy against workplace incivility and burnout in nursing: A time-lagged study. Health Care Management Rev. 2020;45(2):151-60.
5. 5. Liu J, Gong Y, Wang X, Wei W, Tao N. Effectiveness of mindfulness-based stress reduction for nurses: a systematic review and meta-analysis. J Adv Nursing. 2020;76(5):1124-38.
6. 6. Liu S, Jiang Y, Wang W, Shi L. Cognitive-behavioral therapy for anxiety and depression in healthcare professionals: A systematic review and meta-analysis. J Psychiatr Res. 2021;138:98-108.
7. 7. Haughom BD, Schairer WW, Hellman MD, Yi PH, Levine BR, Sheth NP. Promoting physician wellness and mitigating burnout in orthopaedic surgery. J Am Academy Orthop Surgeons. 2019;27(23):e1073-9.