Surgeon burnout: It is time to make solutions a priority

urnout was first described by Dr. Herbert Freudenberger in 1980 and was originally defined as a state of mental and physical exhaustion caused by one's professional life. 1 Over the years, burnout has unfortunately become a term we have become too familiar with.This is likely not too surprising for many of us, especially over the past "pandemic year," as growing pressures from increasing administrative and clinical demands, surgical backlog pressures, greater dependence on electronic medical records, pandemicinduced necessity to have back-to-back breakless meetings via Zoom/WebEx platforms, to list a few, have all continued to chip away at the already reduced "me and/or family" time.On the bright side, however, the pandemic has widened our eyes to realize what is truly important in our lives -this will be different for each of us.Finding that inner happiness and "sweet spot" balance between work and play is key to wellness; this wellness will breed success both at work and at home.Physician burnout is one of the most important medical realizations of the past decade, with a five-fold increase in the number of peer-reviewed articles published evaluating it compared to the last decade.It impacts us all either directly or indirectly and, as many authors would argue, up to 45% of people reading this supplement would test positive for burnout -a staggering number!As surgeons, we are consistently subjected to high levels of stress in our day-to-day work and often face uncertainties in our practice.We are exposed to extremes of emotions as we care for our patients, ranging from solitude, sense of failure, and frustration when the patient's illness progresses, feelings of powerlessness against illness and associated losses, and absolute success on the other end of the spectrum.Many reports have highlighted our inherent risk for experiencing mental disorders, substance abuse, suicide, and impairment in functioning. 2Despite this, we are also statistically the least likely group to openly discuss these feelings.Could it be because we somehow feel that our feelings and vulnerability may betray our code as "surgeons"?Hopefully, that type of false magical thinking no longer prevails in 2021.None of us are immune.Physicians experiencing burnout are at higher risk of making poor decisions, displaying hostile attitudes toward patients, making medical errors, having difficult relationships with coworkers, and experiencing ailments such as major depression, anxiety, sleep disturbance, and substance abuse. 3Often, these lead to marital problems, early retirement, and sadly, sometimes suicide.The impact is therefore not only personal but also affect the remaining 60-70% of the group by leading to loss and significant workload and work force gaps.Much of the data evaluating physician burnout comes from several key population-based and survey-based studies.The seminal publication came in 2011 from Mayo clinic, with a followup re-evaluation in 2014. 4They showed an approximate 10% increase in overall burnout rates among U.S. physicians compared to the general population.A closer look revealed that urologists demonstrated some of the highest rates of burnout, leading the pack in the top-tertile of all physicians and surgeons in the U.S. in both surveys.A followup survey by Medscape in 2019 unfortunately put urologists at the top of the pack again with respect to burnout among all physician groups in the U.S., with a rate of 54% compared to the average across all specialties of 44%.The American Urological Association took these findings very seriously and showed, through a directed survey to all its constituents, that burnout rates were closer to 40%, and not nearly as high as previously reported.Although this important revelation was somewhat reassuring that as urologists, we were not the most burned out among our surgical compatriots, it still left us with many questions and food for thought that we needed to do better.Having over

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