A couple of years ago, a "toxic work environment" helped to push one plastic surgeon into a devastating spiral. "I developed irritability, anxiety, volatile mood," says C. Scott Hultman, M.D., MBA, professor of Plastic and Reconstructive Surgery and professor of Surgery at the University of North Carolina School of Medicine.
It's not unusual for physicians to develop this kind of burnout on the job. But plastic surgeons, like Dr. Hultman, are especially vulnerable for reasons that aren't entirely clear.
"We’re at risk as a specialty," he warned during a keynote presentation on burnout held at Plastic Surgery The Meeting 2016 in Los Angeles. The joint session was held by the American Society of Plastic Surgeons and the American Council of Academic Plastic Surgeons.
Indeed, a 2016 JAMA Surgery systematic review of 41 studies into surgeon burnout found that plastic surgeons had one of the lowest levels of job satisfaction among 16 specialties.
Only a third of plastic surgeons reported being satisfied on the job; the next lowest percentage (64%) was among vascular surgeons. Pediatric and endocrine surgeons had the highest levels of satisfaction, at 86% to 96% and 96%, respectively.
There's other evidence that job woes can be devastating for plastic surgeons. Dr. Hultman spoke about his mentor John Bostwick III, M.D., director of Emory's Division of Plastic Surgery and chief of plastic surgery at Emory Clinic and Emory University Hospital. According to Dr. Hultman, Dr. Bostwick killed himself in 2001.
"I completely lost my bearing," Dr. Hultman says. "We still don’t know what happened to John. He was under a lot of stress and probably experiencing his own form of burnout. It left me without any anchor for my professional career. That didn’t cause me to burn out, but I just became depressed."
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Work-Life Balance
What should plastic surgeons do in order to protect themselves? Dr. Hultman says he was able to turn around his burnout "by focusing on my health, starting an exercise regimen, changing my diet, focusing on my faith, taking medication. These were all crucial elements to my core recovery."
In addition, "It's about scheduling discrete, concrete nights at home with family, and date nights with your spouse," he says. "I also started declining or cancelling many of my day-to-day meetings. It's one of the greatest things I could do."
What else can plastic surgeons do? "Integrate your home and work families, infuse fun at home and at work," advises Michael Bentz, M.D., FAAP, FACS, interim chairman of the Department of Surgery and chairman of the Division of Plastic Surgery at University of Wisconsin School of Medicine and Public Health.
Also, Dr. Bentz suggests, "Actively manage your time in a thoughtful way. There are times in your career when you need to be home earlier in the day, and times when you need to be home later in the day. You need to modulate your schedule to accommodate the things that happen at work and home in the most symbiotic fashion year by year."
Dr. Bentz also recommends that plastic surgeons bring their families along for work travel and "build mutually supportive clinical and administrative teams."
In addition, Dr. Bentz pointed to a 2012 Annals of Surgery study into the health and wellness habits of American surgeons. The study reports that "surgeons placing greater emphasis on finding meaning in work, focusing on what is important in life, maintaining a positive outlook, and embracing a philosophy that stresses work/life balance were less likely to be burned out."
Dr. Hultman and Dr. Bentz report no relevant disclosures.