The Increased Risk of Burnout for Anesthesiologists in the Post Pandemic Era

The SNACC EDI Committee includes wellness issues in its purview. In this issue of the SNACC Newsletter we will focus on burnout in our specialty. The potential for stress in anesthesiology is already high but compounded with the added stressors of the COVID pandemic and the resulting social isolation and staffing shortages, the potential for burnout is understandably increased. Being at high risk for burnout is characterized by emotional exhaustion and depersonalization. Burnout syndrome is characterized by “emotional exhaustion, depersonalization, and low sense of personal accomplishment.”1 It is linked to decreased physician quality of life and health, increased lack of professionalism and substance abuse, as well as poorer patient satisfaction and outcomes. This is a global issue with studies demonstrating high rates of burnout in the U.S, Europe, Africa, and Asia. You probably know someone who is dealing with these issues or you yourself might be struggling with it.

A survey among American Society of Anesthesiologists (ASA) members practicing in the United States on burnout was conducted in March 2020, with the results published in Anesthesiology.1 There was a 13.6% response rate with 59.2% of respondents found to be at high risk for burnout. The rate of burnout syndrome was found to be 13.8%. Factors associated with increased burnout risk included working more than 40 hours/week, staffing shortages, perception of no support at work, and identifying as LBGTQ. Interestingly the authors found that respondents from racial minorities did not have increased risk of burnout as compared to whites. They also found that anesthesiologists with English as a second language tended to have lower rates of burnout. The authors are unclear about these findings but note that they echo results from prior work.

The reasons why anesthesiologists originally from outside the United States or with a different native language tend to have lower rates of burnout than American anesthesiologists are not well established. In some non-English-speaking countries or in non-academic environments, anesthesiologists may have less pressure to carry out educational, research and /or teaching activities outside the operating room. Such pressures may understandably increase stress levels and the risk of burnout in our profession. Further investigation is warranted to better understand some of the factors that might help to reduce the risk of burnout in these non-native groups as compared to their American colleagues.

The authors conclude that feeling supported by mentors, colleagues, and loved ones is one of the most important factors for anesthesiologists’ well-being. They note that there are systemic, institutional, and individual actions that can help to make physicians feel more supported. Systemic changes include destigmatizing mental health care, educational debt forgiveness, and limiting discoverability of peer support programs. Institutional programs include peer support programs, electronic health optimization, and effective mentorship. Individual efforts that may help include mindfulness and stress reduction programs, as well as optimizing health and nutrition.1

The authors conducted a follow-up survey in November 2022 which demonstrated a significant increase in the risk of burnout and incidence of burnout syndrome among anesthesiologists after the COVID-19 pandemic as compared to their original cohort.The risk of burnout increased to 67.7% and the rate of burnout syndrome increased to 18.9%. As we continue to navigate the increasingly stressful challenges of our specialty post pandemic let us make a renewed commitment to supporting and being kind to one another and perhaps even more importantly, to ourselves.

References

  1. Afonso AM, Caldwell JB, Staff SJ, Zurakowski D, Vinson AE. Burnout rate and risk factors among anesthesiologists in the United States.Anesthesiology. 2021; 134:683-96.
  2. Afonso AM, Caldwell JB, Staff SJ, Sinskey JL, Vinson AE. U.S. attending anesthesiologist burnout in the postpandemic era.Anesthesiology. 2024; 140:38–51.

Mia Kang, MD, MHS, FASA

Associate Professor, Division Chief, Neuroanesthesiology,
UNC Department of Anesthesiology
N2201 UNC Hospitals

Mauricio Giraldo, MD

Assistant Professor and Anesthesia staff
Western University and LHSC
London, Ontario, Canada