Joy of Practice for Surgeons

Two recent issues of the New England Journal of Medicine caught my attention: January 25 and March 1, 2018. Both issues included thoughtful and provocative discussions of physician burnout and its sequelae. In the January issue, Wright and Katz discuss the negative impact of electronic health records (EHRs) on patient care and physician satisfaction. Over half of US physicians report symptoms of burnout, such as emotional exhaustion, depersonalization or a poor sense of accomplishment. While primary care seems to be at highest risk, surgeons are heavily affected. Burnout is associated with higher rates of depression, suicidal thoughts and substance abuse. It can be measured and it can be reduced by supporting team-based models of care, monitoring regulatory burdens on our faculty and taking other steps to restore the “joy of practice.” In that same issue, Dzau et al. note that burnout has serious consequences, notably a real human cost as well as various health system problems. The authors report that mental illness has reached a crisis level in our practitioners – and, hence the National Academy of Medicine, has launched an Action Collaboration on Clinician Well-Being and Resilience. The four central goals are: increase the visibility of clinician stress and burnout, understand the challenges inherent in clinician well-being, identify evidence-based solutions and monitor the effectiveness of such solutions. We clearly have seen the effects of overwork, inefficiency and mental turmoil in our department. The March 1 issue of the NEJM features a thought-provoking and courageous perspective article by our own Dr. Michael Weinstein, one of our superb trauma surgeons. In this article entitled “Out of the Straitjacket,” Dr. Weinstein describes his training, hard work, descent into deep depression and multi-pronged recovery. He is very involved with our educational and clinical missions, and his messages of recovery, appreciating life, mindfulness and self-care merit our unwavering support. He ends his article with the comment “I believe that by deploying tools for reflection and self-care and working together in a brave and disciplined way, we can remove our restraints and isolation – both figurative and literal.” We all should assist the Action Collaborative on Clinical Well-Being and Resilience as it seeks to address these critical issues. Please enjoy the various articles which compose this issue and keep up with our news on Facebook.com/JeffersonSurgery and Twitter@JEFFsurgery in between issues