Time Out: The Impact of Physician Burnout on Patient Care Quality and Safety in Perioperative Medicine

The Magnitude of Anesthesiology Residents Burnout at Shahid Beheshti University of Medical Sciences: A Cross-Sectional Study

Background

Burnout is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, particularly prevalent among anesthesiology residents due to their demanding work environment.

Objectives

This study aimed to assess the prevalence of burnout and its associations with depression, sleep quality, and quality of life among anesthesiology residents at Shahid Beheshti University of Medical Sciences.

Methods

A cross-sectional study was conducted in 2023 with 51 anesthesiology residents. Validated Persian versions of standardized tools, including the Maslach Burnout Inventory (MBI), Patient Health Questionnaire-9 (PHQ-9), Epworth Sleepiness Scale (ESS), STOP-Bang test, and World Health Organization (WHO) Quality of Life (WHOQOL-BREF) Questionnaire, were used to measure burnout, depression, sleep quality, and quality of life. Descriptive statistics and correlation analyses explored associations between these variables.

Results

Burnout was highly prevalent: 41.2% of residents experienced severe emotional exhaustion, 66.7% exhibited high depersonalization, and 100% reported reduced personal accomplishment. Severe depression affected 17.65% of participants, correlating strongly with all burnout dimensions. Emotional exhaustion was significantly associated with increased daytime sleepiness (r = 0.470, P < 0.001), while burnout severity inversely impacted physical, psychological, and social quality of life. Emotional support emerged as a critical protective factor against burnout. Exploratory analyses revealed no significant gender differences in burnout, depression, or sleep quality, though small effect sizes suggested trends toward higher emotional exhaustion and depression among female residents.

Conclusions

The study highlights the alarming prevalence of burnout among anesthesiology residents, driven by occupational stress, sleep disturbances, and mental health challenges. These findings align with research in other high-stress specialties, such as emergency medicine and surgery, but also underscore unique stressors faced by anesthesiology residents. Targeted interventions, such as optimizing work conditions, enhancing emotional support, and addressing mental health and sleep issues, are urgently needed. Longitudinal and comparative studies are recommended to further explore burnout progression and develop specialty-specific strategies to improve resident well-being and patient care outcomes.

An integrated neurophenomenological framework for naturalistic assessment of work-related stressors in healthcare professionals: a pilot study in neuro-surgery

Work-related stress and burnout are pervasive challenges in healthcare, particularly in high-stakes specialties like neurosurgery. Neurosurgeons face unique demands, including prolonged cognitive and physical strain, emotionally charged patient interactions, and ethical dilemmas. These stressors significantly impact individual wellbeing, patient safety, and organizational efficiency. However, traditional stress assessment methods, such as self-reports and retrospective surveys, fail to capture the dynamic and context-specific nature of stress in real-world clinical environments. This paper introduces an integrated neurophenomenological framework for assessing stress in neurosurgeons, combining continuous physiological monitoring with real-time phenomenological assessments using experience sampling methods (ESM). Wearable devices enable the collection of granular physiological data-heart rate, heart rate variability, electrodermal activity, and skin temperature-while ESM provides real-time subjective insights, reducing recall biases. Synchronizing these data streams offers a holistic understanding of stress dynamics. A pilot study is introduced to discuss the feasibility of this approach. Participants engaged in ward-based and surgical tasks while their physiological data were continuously recorded. Structured interviews and psychometric tools complemented these measures, revealing context-specific stress responses: higher electrodermal activity during emotionally demanding ward shifts and elevated heart rate during physically intense surgical procedures. Discrepancies between physiological activation and subjective stress perception highlighted the importance of interoceptive awareness in modulating stress responses. This framework offers a replicable model for advancing stress research in healthcare. By integrating physiological and phenomenological data, it provides actionable insights into stress dynamics, paving the way for targeted interventions to enhance resilience and optimize patient care.

Voice EHR: introducing multimodal audio data for health

Introduction

Artificial intelligence (AI) models trained on audio data may have the potential to rapidly perform clinical tasks, enhancing medical decision-making and potentially improving outcomes through early detection. Existing technologies depend on limited datasets collected with expensive recording equipment in high-income countries, which challenges deployment in resource-constrained, high-volume settings where audio data may have a profound impact on health equity.

Methods

This report introduces a novel protocol for audio data collection and a corresponding application that captures health information through guided questions.

Results

To demonstrate the potential of Voice EHR as a biomarker of health, initial experiments on data quality and multiple case studies are presented in this report. Large language models (LLMs) were used to compare transcribed Voice EHR data with data (from the same patients) collected through conventional techniques like multiple choice questions. Information contained in the Voice EHR samples was consistently rated as equally or more relevant to a health evaluation.

Discussion

The HEAR application facilitates the collection of an audio electronic health record ("Voice EHR") that may contain complex biomarkers of health from conventional voice/respiratory features, speech patterns, and spoken language with semantic meaning and longitudinal context-potentially compensating for the typical limitations of unimodal clinical datasets.

A Call for Action to Prevent Imposter Syndrome and Burn-Out Among Medical Oncologists

Burnout and imposter syndrome (IS) are commonly reported among oncologists at all career stages, irrespective of age, sex, or training level. Many professionals in the field reported feeling unsupported, highlighting the urgent need for coordinated efforts by institutions and professional organizations to strengthen the well-being infrastructure. As more oncologists consider leaving the profession or transitioning to other careers, the importance of thoughtful workforce planning and retention strategies has become increasingly apparent. Resilience, though a core trait in cancer physicians, is not sufficient. Addressing IS and burnout requires a broad cultural shift, one that fosters mentorship, implements supportive workplace policies, and prioritizes physician health. The future of oncology depends not only on scientific breakthroughs but also on the sustainability and well-being of those delivering care. Therefore, it is time to act.

Are Doctors Putting Their Health Last?

The increasing demands of patient care and the high-stress environment of the medical field significantly impact doctors' physical and mental health. Studies show that physicians face a higher risk of burnout, which leads to emotional exhaustion, reduced sense of accomplishment, and even severe mental health issues such as depression and suicide. This burnout not only affects individual doctors but also significantly compromises patient safety and contributes to a shortage in the physician workforce. To address these challenges, it is crucial for doctors to prioritize their own health and well-being. This can be achieved through proactive measures such as ensuring adequate rest, reducing administrative burdens, and fostering a supportive environment that encourages open discussion about mental health issues. Hospitals should also implement regular duty rotations, improve doctor-patient ratios, and provide necessary resources to support physician health. Ultimately, promoting a culture where doctors' well-being is valued is essential for a healthier and more effective healthcare system.

Effect of heatwaves on daily hospital admissions in Portugal, 2000-18: an observational study

BACKGROUND

Climate change has increased the frequency, intensity, and duration of heatwaves, posing a serious threat to public health. Although the link between high temperatures and premature mortality has been extensively studied, the comprehensive quantification of heatwave effects on morbidity remains underexplored.

METHODS

In this observational study, we assessed the relationship between heatwaves and daily hospital admissions at a county level in Portugal. We considered all major diagnostic categories and age groups (<18 years, 18-64 years, and ≥65 years), over a 19-year period from 2000 to 2018, during the extended summer season, defined as May 1, to Sept 30. We did a comprehensive geospatial analysis, integrating over 12 million hospital admission records with heatwave events indexed by the Excess Heat Factor (EHF), covering all 278 mainland counties. We obtained data from the Hospital Morbidity Database and E-OBS daily gridded meteorological data for Europe from 1950 to present derived from in-situ observations. To estimate the effect of heatwaves on hospital admissions, we applied negative binomial regression models at both national and county levels.

FINDINGS

We found a statistically significant overall increase in daily hospital admissions during heatwave days (incidence rate ratio 1·189 [95% CI 1·179-1·198]; p<0·0001). All age groups were affected, with children younger than 18 years being the most affected (21·7% [20·6-22·7] increase in admissions; p<0·0001), followed by the working-age (19·7% [18·7-20·7]; p<0·0001) and elderly individuals (17·2% [16·2-18·2]; p<0·0001). All 25 major disease diagnostic categories showed significant increases in hospital admissions, particularly burns (34·3% [28·7-40·1]; p<0·0001), multiple significant trauma (26·8% [22·2-31·6]; p<0·0001), and infectious and parasitic diseases (25·4% [23·5-27·3]; p<0·0001). We also found notable increases in endocrine, nutritional, and metabolic diseases (25·1% [23·4-26·8]; p<0·0001), mental diseases and disorders (23·0% [21·1-24·8]; p<0·0001), respiratory diseases (22·4% [21·2-23·6]; p<0·0001), and circulatory system disorders (15·8% [14·7-16·9]; p<0·0001).

INTERPRETATION

Our results provide statistically significant evidence of the association between heatwaves and increased hospitalisations across all age groups and for all major causes of disease. To our knowledge, this is the first study to estimate the full extent of heatwaves' impact on hospitalisations using the EHF index over a 19-year period, encompassing an entire country, and spanning 25 disease categories during multiple heatwave events. Our data offer crucial information to guide policy makers in effectively and efficiently allocating resources to address the profound health-care consequences resulting from climate change.

FUNDING

None.

Wellness and burnout in cardiac surgery: not black and white

PURPOSE OF REVIEW

Despite a growing emphasis on burnout in medicine, there remains a paucity of data in cardiac surgery. Herein, we summarize recent data on cardiac surgeon well being and identify factors for consideration in future burnout inquiries and management.

RECENT FINDINGS

Overall, 70-90% of cardiothoracic surgeons report job satisfaction in the United States. However, 35-60% still endorse burnout symptoms, and the specialty reports some of the highest rates of depression (35-40%) and suicidal ideation (7%). Such negative experiences are greater among early-stage and female surgeons and may be addressed through targeted, program-specific wellness policies. Canada's single-payer healthcare system might exacerbate surgeon burnout due to lower financial compensation and job autonomy.

SUMMARY

Cardiothoracic surgeons appear simultaneously burnt out and professionally fulfilled. They report a high incidence of depression and clock in the most hours, yet the majority would choose this specialty again. These findings reveal a more nuanced state of well being than previously appreciated and speak to ambiguities in how burnout is conceived and measured. A broader examination across surgical and social contexts highlights the hierarchical nature of burnout factors and potential ways forward. Collectively, these insights can inform assessments of burnout in Canadian cardiac surgery that remain absent to date.