Physician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Its three domains are emotional exhaustion, depersonalization, and a sense of reduced accomplishment among physicians, with the Maslach Burnout Inventory (MBI) being the gold standard questionnaire used to scale physician burnout. This concern not only impacts physicians but the entire healthcare system in general. There is growing awareness regarding the mental health of physicians and the consequences faced by the healthcare system as a result of burnout. According to a recent study, more than 50% of physicians reported suffering from at least one burnout symptom. In this review article, we aim to identify the causes leading to burnout, its impact on physicians, and hospital management as well as interventions to reduce this work-related syndrome. Some contributing factors leading to burnout are poor working conditions with long work shifts, stressful on-call duties, lack of appreciation, and poor social interactions. Burnout can lead to adverse consequences, such as depression, substance use, and suicidal ideation in physicians and residents. This can result in poor patient care increasing total length of stay, re-admissions, and major medical errors. Due to increased scrutiny of patient and healthcare costs, along with increased lawsuits as a result of major medical errors, it is crucial for both the hospital management and physicians to recognize and address burnout among physicians. Comprehensive professional training such as Cognitive behavioral therapy (CBT), stress-reducing activities such as mindfulness and group activities, and strict implementation of work-hour limitations recommended by Accreditation Council for Graduate Medical Education (ACGME) for residents are a few methods that may help to manage burnout and increase productivity in hospitals.

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Objective: We investigated the relationship between cannabis use disorder (CUD) and persistent vomiting (PV)-related hospitalization. Methods: Nationwide Inpatient Sample (NIS) was analyzed from 2010-2014 for patients (age 15-54) with a primary diagnosis of PV (N=55,549) and comparison was made between patients with ICD-9 classification of CUD versus non-CUD cohorts. We used logistic regression to study the odds ratio (OR) between CUD and PV. Results: The number of PV-related hospitalization with CUD had a significantly increasing trend (P<.001) with a 286% increase over five years. Higher proportion of these patients with CUD were younger (15-24 years), female and African American/Hispanic. In regression analysis, cannabis was associated with seven-fold higher odds (95% CI 6.931-7.260) of PVrelated hospitalization. Conclusions: This study found that CUD is independently associated with a 609% increased likelihood of PV-related hospitalization and this association persists even after adjusting for known risk factors and other substances.

ObjectivesThe objective of this study was to analyze the differences in the prevalence and association of medical and psychiatric comorbidities in bipolar disorder (BD) patients versus the general inpatient population.MethodsA cross-sectional analysis was conducted using the national inpatient sample (NIS). Using the international classification of diseases, ninth revision (ICD-9) diagnostic codes, we extracted the BD inpatients and then obtained information about comorbidities. The odds ratio (OR) of comorbidities in BD inpatients were evaluated using a logistic regression model.ResultsHypertension (31.1%), asthma (11.7%) and diabetes, obesity, and hypothyroidism (11% each) were the prevalent medical comorbidities found in BD inpatients. Hypothyroidism, asthma, and migraine were seen in BD inpatients (OR 1.59, OR 1.37 and OR 1.23; respectively) compared to general inpatients. Drug abuse (33.5%), anxiety disorders (31.8%), and alcohol abuse (18.3%) were the most prevalent psychiatric comorbidities in BD inpatients. They had a seven-fold higher likelihood of comorbid borderline personality disorders compared to general inpatients. Among other psychiatric comorbidities, the odds of the association were higher for drug abuse (OR 4.33), ADHD (OR 3.06), and PTSD (2.44).ConclusionA higher burden of medical and psychiatric comorbidities is seen in BD inpatients compare to the general inpatient population. A collaborative care model is required for early diagnosis and management of these comorbidities to improve the health-related quality of life.