Orthopaedic Surgeons Have a High Prevalence of Burnout, Depression, and Suicide: Review of Factors Which Contribute or Reduce Further Harm

Abstract

Orthopaedic surgeons have the highest prevalence of death by suicide among all surgical subspecialties, comprising 28.2% of surgeon suicides from 2003 to 2017. There is a continuum of burnout, depression, and other mental health illnesses likely contributing to these numbers in our profession. Stigmatization in terms of medical licensing and professional development are currently barriers to seeking mental health treatment. Education on the risk and treatment of burnout, depression, and suicidal ideations should begin early in a surgeon's career. This review documents the issue of physician burnout and depression and makes recommendations regarding necessary changes to counteract mental illness in orthopaedic surgeons. Mental health issues have recently gained attention in all aspects of society including the medical profession and professional sports. Burnout, depression, and suicide occur in many professions; however, this has largely been overlooked in the orthopaedic literature. [1][2][3] In this review, we study suicide, burnout, and depression with a focus specifically on orthopaedic surgeons. We also analyze the barriers to seek mental health help and discuss particular areas of improvement to enhance our institutional support and ultimately the life of orthopaedic surgeons. Although these are presented individually (ie, burnout, depression, and suicide), it is important for the reader to understand that these can be a continuum on the mental health spectrum. Why Orthopaedic Surgeons?We have all been socialized into an orthopaedic profession rich in history and innovative solutions for treating patients with musculoskeletal issues. As we strive for excellence, many orthopaedic surgeons define their identity in perfection and efficiency at all costs. We must reflect on the burden of this cost though. We have been taught to be tough and push through challenges without

A Comprehensive Umbrella Review for Understanding Burnout in Orthopaedic Surgery

“…8,[16][17][18][19][20] We also found eight narrative reviews on the topic. 3,[21][22][23][24][25][26][27] Although literature revealed high rates of burnout in orthopaedic surgery, the wide range of estimates preclude definitive conclusions on its prevalence. Evidence suggests residents may be particularly susceptible to burnout: just under half were estimated to have high depersonalization, high emotional exhaustion, and clinically significant burnout, and one-quarter to have low personal achievement.…”

“…We deemed 16 reviews to be relevant for inclusion, of which eight were systematic reviews 6,8,[15][16][17][18][19][20] and eight were narrative reviews (Figure 1). 3,[21][22][23][24][25][26][27] Copyright © 2023 JPOSNA® www.jposna.org…”

“…6,16,17,19,20 About half the reviews conducted quality assessments, 8,[17][18][19] with only one using it to inform study inclusion. 8 Narrative Reviews Narrative reviews were conducted between 2016 and 2022; 3,[21][22][23][24][25][26][27] we present the results of these reviews in Appendix 3. We highlight the results of the systematic reviews in the subsequent sections because, unlike narrative reviews, they aim to present all of the available literature on a topic.…”

“…One of these reviews proposed using a topdown approach to addressing burnout, highlighting the importance of buy-in from all stakeholders (Figure 2). 27 We summarize the remainder of strategies in Appendix 3 and wrote a dedicated paper describing these further and proposing new ones based on expert opinion.…”

Burnout und Abhängigkeit bei ärztlichem Personal zeitlos und während der COVID-19-Pandemie am Beispiel der Chirurgie und Anästhesie

“…Über alle Fachgebiete hinweg lagen die Raten bei 6,2 % Depressionen, 19,6 % Burnout und 6,6 % Selbstmordgedanken. Die Ergebnisse für orthopädische Chirurgen lauten wie folgt: 0 % vorläufige Depressionsdiagnose, 3,8 % Selbstmordgedanken und 4 % Burnout [ 1 , 25 ]. Bezüglich der Neurochirurgen hat eine kürzlich durchgeführte Studie gezeigt, dass eine hohe Rate an psychischen Störungen während der Pandemie auftrat.…”