Burnout Rates Among General Orthopedic Surgeons and Subspecialists: A Pilot Study.

Burnout among physicians is a syndrome of emotional exhaustion, de-personalization, and reduced sense of personal accomplishment that can negatively affect personal relationships, physician well-being, and patient outcomes. Although burnout rates of up to 50% to 60% among orthopedic surgeons have been reported, no studies have evaluated burnout among orthopedic generalists and subspecialists. The primary goal of this study was to examine the prevalence of burnout among orthopedic disciplines. We conducted a multicenter study from March 2019 through December 2019 involving 149 orthopedists. An abbreviated Maslach Burnout Inventory-Human Services Survey was used to measure burnout. Demographic information, personal characteristics, professional characteristics, family life and spousal support, and depression were also assessed. The mean rate of burnout among all respondents was 62%, whereas 16.77% screened positive for depression. Subspecialties with the highest rates of burnout were oncology (100%), sports medicine (68%), and trauma (63%). Similarly, trauma (50.00%), oncology (40.00%), and general orthopedics (20.00%) had the highest positive depression screening rates. In contrast, shoulder and elbow (50%), pediatric (52%), and foot and ankle (54%) specialists had the lowest rates of burnout, whereas shoulder and elbow (0.00%), spine (0.00%), and sports medicine (6.50%) specialists had the lowest rates of positive depression screening. Older age, higher debt load, and oncology subspecialty were associated with increased burnout risk. This study sought to determine burnout rates within each orthopedic discipline, with a secondary aim of disclosing contributing factors. Trauma and oncology had the highest rates of burnout and positive depression screening. Because this study represents a small orthopedic cohort, larger studies are needed to appropriately manage burnout in the future. [Orthopedics. 2022;45(6):333-339.].

Improvements in sexual function following arthroscopic rotator cuff repair.

BACKGROUND: Three-fourths of Americans are sexually active, and studies show a correlation between sexual activity and good health. Rotator cuff tears and subsequent repairs can cause significant disruption in daily living including sexual activity. Orthopedic surgeons rarely discuss sexual activity with patients. Therefore, patients have little information about expectations, restrictions, and return to sexual activity. The primary goal of this study was to evaluate patient improvement in sexual activity following arthroscopic rotator cuff repair and evaluate factors that affect sexual activity. METHODS: An anonymous 20-item multiple-choice survey was sent to patients > 6 months after arthroscopic rotator cuff repair performed by 7 fellowship-trained orthopedic shoulder and elbow surgeons between March 2018 and May 2019. The survey assessed preoperative and postoperative sexual activity and included questions regarding frequency, pain, positioning, and postoperative injury. RESULTS: A total of 88 patients met the inclusion criteria and completed the survey. Preoperatively, 65% of patients admitted that their shoulder interfered with the quality and/or frequency of their sexual activity, most commonly secondary to an inability to bear weight on the affected arm (31%). Postoperatively, the majority of patients (79%) found it easier to engage in sexual activity, with 35% of patients attributing this to less pain. At 6 weeks postoperatively, 72% of patients returned to sexual activity. The overall trend demonstrated a statistically significant (P < .001) increase in sexual activity frequency as one progressed from his or her operative date. It is interesting to note that 31% of patients removed their sling to engage in sexual activity after surgery, with 7% admitting to aggravating their shoulder or causing significant pain. CONCLUSION: Prior to arthroscopic rotator cuff repair, most patients experience limitations in the quality and/or frequency of their sexual activity secondary to their shoulder. Following surgery, the majority of patients will more easily engage in sexual activity by 6 weeks, with increasing frequency as time progresses from surgery. Many patients are noncompliant with sling wear during sexual activity, and 7% will aggravate their shoulder.