Harshavardhan Bollepalli, BS College of Arts and Sciences Saint Louis University St. Louis, Missouri
Robert Evans, BS College of Arts and Sciences Saint Louis University St. Louis, Missouri
Seth Ludford, BS College of Arts and Sciences Saint Louis University St. Louis, Missouri
Angela Spencer, MLS Health Sciences Reference Librarian Assistant Professor Saint Louis University St. Louis, Missouri
Suma Chand, PhD Professor Department of Psychiatry and Behavioral Neuroscience Saint Louis University School of Medicine St. Louis, Missouri
Disclosures The authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
In response to resident complaints about long duty hours, a new rule has been implemented that states residents cannot work >16 hours per shift.30 This rule has been found to increase quality of life and prevent burnout.30
The amount of time spent on electronic medical records and documentation has been a major complaint from doctors and was identified as a factor contributing to burnout.45 It can act as a time drain that impedes the physician from providing optimal patient care and cause additional stress. This suggests the need for organizations to find solutions to minimize this strain.
A concerning issue reported as an institutional factor and associated with burnout is mistreatment through discrimination, harassment, and physical or verbal abuse. A recent study found 45% of general and vascular surgeons reported being mistreated in some fashion.57 The strategies reported as helpful for institutions to combat mistreatment include resilience training, improved mentorship, and implicit bias training.57
Burnout has been positively correlated with anxiety and depression.6 A recent study reported that 13% of orthopedic surgery residents screened positive for depression.44 Higher levels of burnout and depersonalization have been found to be closely associated with increased rates of suicidal ideation.17 In a study of vascular surgeons, 8% were found to report suicidal ideation, and this increased to 15% among vascular surgeons who had higher levels of depersonalization and emotional exhaustion,58 both of which are associated with burnout. In another study, surgery residents and fellows were found to have lower levels of personal achievement and higher levels of depersonalization, depressive symptoms, alcohol abuse, and suicidal ideation compared to attending physicians and the general population.54 These findings spell out the association between burnout and depressive symptoms among surgeons and emphasize the need for institutions to create a culture that supports the mental health needs of their physicians. Without access to supportive resources, residents resort to alternative methods that may be detrimental in the long run. In a recent study, 17% of residents admitted to using alcohol, including binge drinking, to cope with their stress.4
Burnout and depression are linked to physical health risks such as cardiovascular disease, diabetes, substance abuse, and male infertility.6 Exercise has been shown to be beneficial for stress reduction, which can lead to changes in metabolism, inflammation, coagulation, and autonomic function.6 One study of surgeons found aerobic exercise and strength training were associated with lower rates of burnout and a higher quality of life.59
