Is Your Doctor Happy or Burnt-Out?

Is your doctor happy? This is something that may have never crossed your mind: the idea that your personal physician may not be pleased with the current state of his or her life. Even if it has, perhaps you were of the opinion that it was not of minor importance if it did not affect the quality of medical care and attention which you received.

The general public’s image of the lives that medical professionals face is colored by 50 minute sitcoms where problems related to the characters, both personal and professional, are often neatly resolved by the time the final credits roll. The trauma patient who was crashing at the beginning of the episode is seen smiling and leaving the hospital by its conclusion. Furthermore there is a misconception by many that most doctors have amassed vast riches and lavish lifestyles at the expense of the illness of others. Does this translate to the real lives of medical doctors?

A recent study appeared in the American Journal of Bone and Joint Surgery which examined the quality of life among orthopedic surgery residents and attendings. While this article focused on a specific group of individuals, the issues identified as both protective and risk factors are of relevance to everyone. Some of the items which showed a high correlation to dissatisfaction were concern over regular use of alcohol, difficulty disconnecting from work life while at home and high levels of sleep deprivation. Protective factors included making time for exercise and hobbies, spending quality time alone with partner, sense of support or mentor and taking non-work related vacations. Curiously, although high levels of stress were reported, 80% of residents and 88% of the faculty members who responded felt that the sacrifice was worthwhile, and many reported that they would still make the same career choice.

Combined with the 80 hour work week guidelines, this new information leaves us to wonder if patient care is affected. Earlier this year a multi-center study performed in three United States hospitals and one in Canada evaluated whether the outcome of orthopedic surgery performed after-hours was different to that conducted during the day. After-hours surgery refers to procedures conducted outside of the confines of a usual work day, usually at night or in the early hours of the morning. The results of this investigation by Ricci and colleagues showed that most factors were similar, including infection rate, but the after-hours group required more re-operations to remove painful hardware. However, the article was unable to identify what caused this one difference: whether it was related to surgeon fatigue or the varying levels of experience between surgeons who operated during the day or night. Other than that one factor, we can feel reassured that our surgical outcome will be similar regardless of the time of day it is done. To gather more information, more studies into the role of physician quality of life on level of medical care will have to be carried out.

Perhaps these findings will improve the doctor-patient relationship, by ensuring that patients receive a high standard of care regardless of when they see their doctor. Physicians are subject to the same stresses their patients are and, hopefully, will feel more e comfortable addressing risk factors affecting their quality of life.

References

Sargent MC, Sotile W, Sotile MO, Rubash H, & Barrack RL (2009). Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty. The Journal of bone and joint surgery. American volume, 91 (10), 2395-405 PMID: 19797575

Ricci WM, Gallagher B, Brandt A, Schwappach J, Tucker M, & Leighton R (2009). Is after-hours orthopaedic surgery associated with adverse outcomes? A prospective comparative study. The Journal of bone and joint surgery. American volume, 91 (9), 2067-72 PMID: 19723981