While physician burnout has been well-documented over the years, surgeons may be facing a hidden, more acute set of workplace stressors.
According to “Behind the Mask,” a new report by devicemaker Johnson & Johnson, which analyzed emotional, physical and mental exhaustion among surgeons across three specialties, more than 40% of surgeons have considered leaving the field altogether.
The study evaluated responses from more than 1,500 surgeons across five countries. Only 36% of surgeons rate their mental health as positive, and told researchers that the stress often follows them home.
The origins of this stress can be traced to the constant pursuit of perfection that is deeply embedded in surgical practice, Angela Chaudhari, MD, vice chief of staff and chief of gynecology and gynecologic surgery at Northwestern Memorial Hospital in Chicago, told Becker’s.
Dr. Chaudhari built out a peer-support network in response to the high stress and burnout she witnessed among colleagues in her department.
“I was very worried about my colleagues who experienced adverse events and complications, with surgeries and deliveries in my particular case,” she said. Dr. Chaudhari now serves as the director of the P2P Network at Northwestern Medicine, where her goal is to “support [surgeons] using techniques of stress first aid and peer support after adverse events, complications, near misses.”
The network also increasingly supports physicians with stress related to litigation and peer review.
“I like to call them the occupational hazards of the job,” she said. “Even when we do our very, very best, people are sick and sometimes bad things happen. We really are trying to support our clinicians through that difficult work that they do every day.”
When it comes to surgical complications, surgeons are often discouraged from discussing the case outside of a clinical analysis and review for safety purposes — which can compound the existing feelings of shame or distress already associated with errors in a high-stakes field.
“Having a complication feels very personal for a surgeon. It’s not something that they necessarily want to broadcast or share,” Dr. Chaudhari said. While complications might be reviewed with team members to determine what could have been done differently, that conversation rarely revolves around the impact on the surgeon’s mental state.
“Oftentimes what’s missed in that conversation is that the provider who’s had that complication is taking it very personally,” she said. “In addition to really wanting to care for their patient, they’re just feeling very down on themselves about what happened.”
Through the P2P Network, team members or supervisors of an affected surgeon can connect them with a network of volunteer peer supporters across the health system that will then reach out to them to check in on their wellbeing and initiate a conversation.
“And that conversation is not meant to rehash an event, or figure out what they did wrong,” Dr. Chaudhari said. “But it really is a conversation geared towards understanding how they’re coping with it and how they’re moving past it to be able to take really quality care of future patients.”
Dr. Chaudhari said that the program has seen high engagement, and, even for those who choose not to connect with the network after a complication, its existence alone serves to comfort physicians dealing with high-stress events,
“I think what really embodies the program is even when people don’t engage…They’ll actually say ‘I think I’m doing OK. I already talked to a couple of colleagues and I feel like I’m coping well, but I really love that this program exists. I really love that someone is thinking about the fact that all of this happened,'” Dr. Chaudhari said.
Programs like this may be essential tools in the battle against early retirements, burnout and other factors contributing to the ongoing shortage of physicians in the U.S.
“If you really look at engagement and surgeon burnout rates, that is correlated to bad outcomes for future patients. If you have a doc who can’t cope with an event that happened a few months ago and is actively burned out, that may impact your future patients and what those complication rates look like,” Dr. Chaudhari said. “It’s just really highlighting this culture of perfectionism that’s coveted in our surgical world, and recognizing that surgeons are human too, that complications can happen. That’s why I think programs like ours are so important to help support people through some of that.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.