Are French orthopedic and trauma surgeons affected by burnout? Results of a nationwide survey

Introduction: Burnout is a pathology that can affect care-giving professionals. It associates emotional exhaustion (EE), depersonalization (DP) and impaired personal accomplishment (PA). Surgery entails great responsibility and frequently heavy workloads, incurring risk of burnout. Data, however, are not available for French orthopedic and trauma surgeons. We therefore conducted a prospective survey to 1) assess burnout prevalence in French orthopedic surgeons, and 2) investigate risk factors and protective factors. Hypothesis: Burnout prevalence is at least as high in French orthopedic surgeons as in other medical and surgical specialties. Materials and methods: A nationwide survey was conducted in France between February and April 2017, using a digitized questionnaire sent out by e-mail. Burnout was assessed on the MBI (Maslach Burnout Inventory), and depressive symptoms on the GHQ-12 (General Health Questionnaire-12). Demographic and occupational data were also collected. Results: Out of 1,900 surgeons contacted, 441 (23%) responded. Mean age was 50.2 +/- 10.1 years; 413 (93.7%) were male. Sixty one (14%) reported elevated EE, 100 (23%) elevated DP, and 82 (19%) impaired AP. One hundred and seventy two (39%) showed burnout symptomatology (e.g., pathologic score on one MBI scale), while 47 (10%) had pathologic scores on 2 or 3 scales, indicating severe burnout. One hundred and ninety three (43%) would not advise their children to take up orthopedic surgery. Thirty eight (8%) expressed suicidal ideation. Statistical analysis identified public-sector practice (OR = 4.6; 95% CI: 2.1-10.7; p = 0.0002) and pathologic GHQ-12 score (OR= 6.3; 95% CI: 2.2-17.8; p = 0.0006) as risk factors for burnout. Outside activity (OR= 0.39; 95% CI: 0.1-0.9; p = 0.0406) and male gender (OR= 0.2; 95% CI: 0.05-0.7; p = 0.0160) emerged as protective factors. Discussion: Despite a response rate of only 23% (n= 441/1,900), the present study sheds light on burnout rates in French orthopedic surgeons, with 39% burnout symptoms and 10% severe burnout. Burnout impacts personal and occupational life, with increased suicidal ideation and impaired quality of life. The present results confirm the importance of screening and treatment in care-providers. Type of study: Level IV, prospective descriptive transverse study without control group. (C) 2019 Published by Elsevier Masson SAS.