2017 HSC Section 2 - Practice Management

Otolaryngology–Head and Neck Surgery 146(2)

these findings. One recent study found that 23.4% of surgeons felt that their commitment to childrearing slowed their career advancement. 25 Perhaps lacking sense of control and flexibility as childrearing encroaches upon professional demands and ambition increases the likelihood of burnout in this population. Our study suffers from a few limitations. First, the 49% response rate, although comparable to similar published studies, 5,25 opens the possibility of response bias. It may also have decreased the power of our study to detect other correlations between burnout and the risk factors of interest. Additional selection bias may have been introduced by lim- iting our survey to alumni, who may have a tendency to embellish their survey responses so as to not appear inferior to their former faculty mentors. Third is the self-reported nature of the gathered data, which may not reflect each par- ticipant’s actual behavior. Last, the cross-sectional design of the survey prohibits our ability to determine cause-and- effect relationships and the potential direction of causality. Despite these limitations, we believe that the data presented here may serve to further enhance our understanding of the complex interplay of factors (both personal and profes- sional) leading to physician burnout. Further study is needed to determine where best to direct efforts to reduce the incidence of burnout in physicians. Conclusion Most practicing otolaryngologists surveyed experience low levels of burnout. Factors directly correlating with burnout include number of hours worked per week and number of children in the home. Inverse relationships were noted between burnout and age, the number of years in practice, and number of years married. There was no significant cor- relation between practice setting and burnout. As these study results were obtained through a survey of graduates of a single otolaryngology program, they cannot be extrapo- lated to represent the experience of all US otolaryngologists. However, these findings may help practicing otolaryngolo- gists understand and target potentially modifiable personal and professional factors that contribute to burnout. Aaron M. Fletcher , preparation of manuscript, interpretation of data; Nitin Pagedar , preparation of manuscript, statistical analysis, interpretation of data; Richard J. H. Smith , preparation of manu- script, study design, interpretation of data. Disclosures Competing interests: None. Sponsorships: University of Iowa Hospitals and Clinics Department of Otolaryngology. Funding source: Departmental funding. Author Contributions

2. Gabbe SG, Melville J, Mandel L, Walker E. Burnout in chairs of obstetrics and gynecology: diagnosis, treatment, and preven- tion. Am J Obstet Gynecol . 2002;186:601-612. 3. Cruz OA, Pole CJ, Thomas SM. Burnout in chairs of academic departments of ophthalmology. Ophthalmology . 2007;114:2350- 2355. 4. Shanafelt TD, West CP, Sloan JA, et al. Career fit and burn- out among academic faculty. Arch Intern Med . 2009;169: 990-995. 5. Golub JS, Weiss PS, Ramesh AK, Ossoff RH, Johns MM III. Burnout in residents of otolaryngology–head and neck surgery: a national inquiry into the health of residency training. Acad Med . 2007;82:596-601. 6. Hill JD, Smith RJ. Monitoring stress levels in postgraduate medical training. Laryngoscope . 2009;119:75-78. 7. Golub JS, Johns MM III, Weiss PS, Ramesh AK, Ossoff RH. Burnout in academic faculty of otolaryngology–head and neck surgery. Laryngoscope . 2008;118:1951-1956. 8. Johns MM III, Ossoff RH. Burnout in academic chairs of oto- laryngology: head and neck surgery. Laryngoscope . 2005;115: 2056-2061. 9. Contag SP, Golub JS, Teknos TN, et al. Professional burnout among microvascular and reconstructive free-flap head and neck surgeons in the United States. Arch Otolaryngol Head Neck Surg . 2010;136:950-956. 10. Maslach C, Leiter MP. Maslach Burnout Inventory Manual . Palo Alto, CA: Consulting Psychologists Press; 1996. 11. Balch CM, Shanafelt TD, Sloan J, Satele DV, Kuerer HM. Burnout and career satisfaction among surgical oncologists compared with other surgical specialties. Ann Surg Oncol . 2011;18:16-25. 12. West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med . 2009;24:1318-1321. 13. Balch CM, Shanafelt TD. Burnout among surgeons: whether specialty makes a difference. Arch Surg . 2011;146:385-386. 14. Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg . 2010; 251:995-1000. 15. Mingote Adan JC, Moreno Jimenez B, Galvez Herrer M. Burnout and the health of the medical professionals: review and preventive options. Med Clin (Barc) . 2004;123:265-270. 16. Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg . 2009;144:371-376. 17. Prins JT, van der Heijden FM, Hoekstra-Weebers JE, et al. Burnout, engagement and resident physicians’ self-reported errors. Psychol Health Med . 2009;14:654-666. 18. Rosenstein AH, Mudge-Riley M. The impact of stress and burnout on physician satisfaction and behaviors. Physician Exec . 2010;36:16-18, 20, 22-23. 19. Johnson JT, Wagner RL, Rueger RM, Goepfert H. Professional burnout among head and neck surgeons: results of a survey. Head Neck . 1993;15:557-560. 20. Shanafelt T, Balch C, Bechamps G, et al. Burnout and career satis- faction among American surgeons. Ann Surg . 2009;250:463-471.

References

1. Campbell DA Jr, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery . 2001;130:696-705.

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