Service to Others May Be the Answer to Physician Burnout

Abstract

There is a crescendo of attention focused on compassion training in health care. Importantly, this is not just about meeting the needs of patients, but also about learning how compassion can bring personal joy. Some of these concepts can be conceptualized as seva: a service that is performed without any expectation of result or award for performing it. Such services can be performed to benefit other human beings or society. "Seva is an ancient Sanskrit term, which originally referred to the service performed by members of the community." 1 A more recent interpretation of the word is "dedication to others."I suggest more emphasis and inclusion of global surgery in medical school and residency curriculums to facilitate "dedication to others" (seva), which will give meaning, purpose of profession, and balance in life. Bidirectional learning experiences fostered by global surgery electives will generate compassion and also improve care delivered in both high-income and lowincome countries if set up thoughtfully with carefully selected candidates. 2 Approximately 30% of North American medical students pursue electives in global health, and only 13% of general surgery programs in the United States offer electives in global surgery.My hypothesis is that in addition to the perceived benefits of global surgery, such as exposure to a new disease pathology, learning to do more with less resources, and personal enrichment, there will be additional benefits of preventing physician burnout. While improvement in the well-being of populations in low-income and middle-income countries should be the primary goal, I strongly suggest that promotion of seva will lead to a reduction in "physician burnout," which could be considered a secondary benchmark. However, care should be exercised in not increasing burden on the already overstretched and arguably burned-out health care workers. While individual physicians might create harmony in their lives by pursuing seva and institutions might create opportunities to do so, organized medicine should take ownership of systematic conditions that are the root causes of physician burnout.Physician burnout, now labeled a public health crisis, is one of the tragic developments in the field of surgery. It is thought to be multifactorial owing to many complex factors and influences, leading to emotional fatigue, depersonalization, and loss of enthusiasm among physicians. A 2018 article, 3 published by the

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