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Assessing Burnout and Professional Fulfillment in Breast Surgery: Results From a National Survey of the American Society of Breast Surgeons

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Physician burnout is a well-recognized problem in health care that has a negative impact on professional well-being and quality of patient care. Rates of burnout in breast surgery are not well-defined. This study sought to understand the degree of burnout among breast surgeons and to identify factors that influence professional fulfillment.

Methods

All U.S. members of the American Society of Breast Surgeons with a valid email address were surveyed in October 2017. The results were anonymous, and the participants were blinded to the study hypothesis. The survey included 30 questions (16-item Professional Fulfillment Index [PFI] and 14-item demographics/practice patterns). Multivariable linear regressions were performed to assess overall burnout and high professional fulfillment.

Results

Of the 2568 surveys delivered, 708 surveys were initiated, and 660 were completed. Among breast surgeons, 270 (41.3%) expressed burnout, whereas 281 (42.5%) reported high professional fulfillment. In the multivariable analysis, years in practice was inversely associated with burnout and positively correlated with professional fulfillment. Working more than 60 h per week was positively associated with burnout, and having more than 50% of practice dedicated to breast surgery correlated positively with fulfillment.

Conclusion

Approximately 4 of 10 breast surgeons have symptoms of burnout, whereas 4 of 10 surgeons report high professional fulfillment. Specific clinical practice conditions largely influence rates of burnout and professional fulfillment. The contributing factors identified in the study analysis may be useful in identifying breast surgeons at higher risk for burnout. The study findings also help to inform the design of interventions focused on the clinical practice environment to promote professional fulfillment and sustainability.

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References

  1. Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L, et al. A brief instrument to assess both burnout and professional fulfillment in physicians: reliability and validity, including correlation with self-reported medical errors, in a sample of resident and practicing physicians. Acad Psychiatry. 2018;42:11–24.

    Article  PubMed  Google Scholar 

  2. Back AL, Steinhauser KE, Kamal AH, Jackson VA. Why burnout is so hard to fix. J Oncol Pract. 2017;13:348–51.

    Article  PubMed  Google Scholar 

  3. Hlubocky FJ, Back AL, Shanafelt TD. Addressing burnout in oncology: why cancer care clinicians are at risk, what individuals can do, and how organizations can respond. Am Soc Clin Oncol Educ Book. 2016;35:271–9.

    Article  PubMed  Google Scholar 

  4. Shanafelt TD, Gradishar WJ, Kosty M, Satele D, Chew H, Horn L, et al. Burnout and career satisfaction among US oncologists. J Clin Oncol. 2014;32:678–86.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714–21.

    Article  PubMed  Google Scholar 

  6. Shanafelt TD, Balch CM, Dyrbye L, Bechamps G, Russell T, Satele D, et al. Special report: suicidal ideation among American surgeons. Arch Surg. 2011;146:54–62.

    Article  PubMed  Google Scholar 

  7. Oreskovich MR, Kaups KL, Balch CM, Hanks JB, Satele D, Sloan J, et al. Prevalence of alcohol use disorders among American surgeons. Arch Surg. 2012;147:168–74.

    Article  PubMed  Google Scholar 

  8. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis. JAMA Intern Med. 2018;178:1317–30.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shanafelt TD1, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, et al. Burnout and medical errors among American surgeons. Ann Surg. 2010;251:995–1000.

  10. Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91:422–31.

    Article  PubMed  Google Scholar 

  11. Sinsky CA, Dyrbye LN, West CP, Satele D, Tutty M, Shanafelt TD. Professional satisfaction and the career plans of US physicians. Mayo Clin Proc. 2017;92:1625–35.

    Article  PubMed  Google Scholar 

  12. Hamidi MS, Bohman B, Sandborg C, Smith-Coggins R, de Vries P, Albert MS, et al. Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study. BMC Health Serv Res. 2018;18:851.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90:1600–13.

    Article  PubMed  Google Scholar 

  14. Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, West CP. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91:836–48.

    Article  PubMed  Google Scholar 

  15. Kuerer HM, Eberlein TJ, Pollock RE, Huschka M, Baile WF, Morrow M, et al. Career satisfaction, practice patterns, and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology. Ann Surg Oncol. 2007;14:3043–53.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. Balch CM, Shanafelt TD, Sloan JA, Satele DV, Freischlag JA. Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. Ann Surg. 2011;254:558–68.

    Article  PubMed  Google Scholar 

  18. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397–422.

    Article  CAS  PubMed  Google Scholar 

  19. Shanafelt T, Chung H, White H, Lyckholm LJ. Shaping your career to maximize personal satisfaction in the practice of oncology. J Clin Oncol. 2006;24:4020–6.

    Article  PubMed  Google Scholar 

  20. Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169:990–5.

    Article  PubMed  Google Scholar 

  21. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377–85.

    Article  PubMed  Google Scholar 

  22. Shanafelt TD1, Dyrbye LN2, Sinsky C3, Hasan O3, Satele D4, Sloan J4, West CP5. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91:836–48.

  23. Kawamura Y, Takayashiki A, Ito M, Maeno T, Seo E, Maeno T. Stress factors associated with burnout among attending physicians: a cross-sectional study. J Clin Med Res. 2018;10:226–32.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Teixeira-Poit SM, Halpern MT, Kane HL, Keating M, Olmsted M. Factors influencing professional life satisfaction among neurologists. BMC Health Serv Res. 2017;17:409.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chipp C, Dewane S, Brems C, Johnson ME, Warner TD, Roberts LW. “If only someone had told me…”: lessons from rural providers. J Rural Health. 2011;27:122–30.

  26. Vick B. Analyzing rural versus urban differences in career dissatisfaction and plans to leave among Pennsylvanian physicians. J Rural Health. 2016;32:164–75.

    Article  PubMed  Google Scholar 

  27. Thommasen HV, Lavanchy M, Connelly I, Berkowitz J, Grzybowski S. Mental health, job satisfaction, and intention to relocate: opinions of physicians in rural British Columbia. Can Fam Physician. 2001;47:737–44.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Blechter B, Jiang N, Cleland C, Berry C, Ogedegbe O, Shelley D. Correlates of burnout in small independent primary care practices in an urban setting. J Am Board Fam Med. 2018;31:529–36.

    Article  PubMed  Google Scholar 

  29. Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, et al. Burnout and medical errors among American surgeons. Ann Surg. 2010;251:995–1000.

    Article  PubMed  Google Scholar 

  30. Tawfik DS, Profit J, Morgenthaler TI, Satele DV, Sinsky CA, Dyrbye LN, et al. Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical errors. Mayo Clin Proc. 2018;93:1571–80.

    Article  PubMed  Google Scholar 

  31. Salyers MP, Bonfils KA, Luther L, Firmin RL, White DA, Adams EL, Rollins AL. The relationship between professional burnout and quality and safety in healthcare: a meta-analysis. J Gen Intern Med. 2017;32:475–82.

    Article  PubMed  Google Scholar 

  32. Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg. 2009;144:371–6.

    Article  PubMed  Google Scholar 

  33. Ruotsalainen JH, Verbeek JH, Marine A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2015:CD002892.

  34. Montgomery A. The inevitability of physician burnout: implications for interventions. Burnout Res. 2014;1:50–6.

    Article  Google Scholar 

  35. Shanafelt T, Goh J, Sinsky C. The business case for investing in physician well-being. JAMA Intern Med. 2017;177:1826–32.

    Article  PubMed  Google Scholar 

  36. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388:2272–81.

    Article  PubMed  Google Scholar 

  37. Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med. 2017;177:195–205.

    Article  PubMed  Google Scholar 

  38. Linzer M, Levine R, Meltzer D, Poplau S, Warde C, West CP. 10 Bold steps to prevent burnout in general internal medicine. J Gen Intern Med. 2014;29:18–20.

    Article  PubMed  Google Scholar 

  39. Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92:129–46.

    Article  PubMed  Google Scholar 

  40. Dzau VJ, Kirch DG, Nasca TJ. To care is human: collectively confronting the clinician burnout crisis. N Engl J Med. 2018;378:312–4.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

The authors would like to acknowledge the American Society of Breast Surgeons Research Committee for their support and help in the completion of this project.

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Authors and Affiliations

  1. Department of Surgery, Beth Israel Deaconess Medical Center, 300 Brookline Avenue, Boston, MA, 02215, USA

    Jennifer Q. Zhang MD, Luis Riba MD, Leo Magrini BSc, Aaron Fleishman MPH, Promise Ukandu BSc, Amulya Alapati MBBS & Ted A. James MD, MS, FACS

  2. Department of Medicine, Stanford University, Stanford, CA, USA

    Tait Shanafelt MD

  3. BreastCare Center, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Ted A. James MD, MS, FACS

Authors
  1. Jennifer Q. Zhang MD
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  2. Luis Riba MD
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Correspondence to Ted A. James MD, MS, FACS.

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Zhang, J.Q., Riba, L., Magrini, L. et al. Assessing Burnout and Professional Fulfillment in Breast Surgery: Results From a National Survey of the American Society of Breast Surgeons. Ann Surg Oncol 26, 3089–3098 (2019). https://doi.org/10.1245/s10434-019-07532-3

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