This Article Corrects: “Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part 1”

Abstract

The authors would like to revise the description on the evolution of the definition of burnout in the Introduction. The introduction formerly stated, "Based on his research, Freudenberger used "burnout" as shorthand for a psychological syndrome with three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. 2 Maslach subsequently summarized the dimensions of burnout as "exhaustion," "cynicism," and "inefficacy," providing more identifiable definitions of each dimension that align well with her measurement tool. 3 " This should be revised to the following: "Based on his experiences, Freudenberger described the phenomenon of "burn-out", subsequently defined by Maslach as a psychological syndrome with three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. 2,3 " Abstract Each year more than 400 physicians take their lives, likely related to increasing depression and burnout. Burnout-a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment-is a disturbingly and increasingly prevalent phenomenon in healthcare, and emergency medicine (EM) in particular. As self-care based solutions have proven unsuccessful, more system-based causes, beyond the control of the individual physicians, have been identified. Such system-based causes include limitations of the electronic health record, long work hours and substantial educational debt, all in a culture of "no mistakes allowed." Blame and isolation in the face of medical errors and poor outcomes may lead to physician emotional injury, the so-called "second victim" syndrome, which is both a contributor to and consequence of burnout. In addition, emergency physicians (EP) are also particularly affected by the intensity of clinical practice, the higher risk of litigation, and the chronic fatigue of circadian rhythm disruption. Burnout has widespread consequences, including poor quality of care, increased medical errors, patient and provider dissatisfaction, and attrition from medical practice, exacerbating the shortage and maldistribution of EPs. Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone. This paper reviews the scope of burnout, contributors, and consequences both for medicine in general and for EM in particular.

Mediating role of psychological distress in the associations between medical errors, adverse events, suicidal ideation and plan among operating room nurses in China: a cross-sectional study

“…37 38 These emotional problems may be caused by a sense of blame and isolation following MEs, which are defined as ‘second victim’ syndrome. 39 Prior research has supported the evidence indicating that MEs and AEs have persistently negative impacts including depression and anxiety on healthcare professionals. 1 14 Although the fact that MEs and AEs may occur in different departments within the medical institutions, operating room nurses have a higher level of patient intimacy and contact, which strengthen the association between psychological distress and errors.…”

“…When healthcare professionals cause an error or AE to their patients, they suffer complex psychological harm, emotional distress and symptoms of depression 37 38. These emotional problems may be caused by a sense of blame and isolation following MEs, which are defined as ‘second victim’ syndrome 39. Prior research has supported the evidence indicating that MEs and AEs have persistently negative impacts including depression and anxiety on healthcare professionals 1 14.…”

Compassion Fatigue in Emergency Medicine: Current Perspectives

“…While medicine in general has high demands and a “no mistakes allowed culture”, EPs are expected to make accurate, high stakes decisions in rapid succession with little a priori information. 31 EDs manage almost half of the hospital-associated medical care in the US, with EPs enduring the daily grind of a large, unpredictable, and unscheduled workload. 32 EM culture places pressure on EPs to maximize the patient experience while also providing efficient, cost-effective care.…”

Optimizing Wellness in Academic Emergency Medicine

“…and their patients. Burned-out physicians enjoy their jobs less [16] and likely intend to leave [17][18][19], and demonstrate both decreased productivity [20,21]and a higher prevalence of substance abuse disorders [22,23]. These physicians also practice less cost-effective medicine.…”