The United Airways Clinic: roadmap of a patient-centred multidisciplinary approach to the complex airways patient: the Sydney model.

Severe asthma is a subset of difficult-to-treat asthma which requires a systematic and multidimensional approach including the need to manage multiple comorbidities that mimic asthma. Multidisciplinary care is becoming the standard for the assessment of such patients. Multidisciplinary team (MDT) clinics are virtually nonexistent in the private space. We developed an MDT clinic to handle needs in the private space and found it was an invaluable tool for assessment, reflective practice and professional development.

Occupational Burnout among Otolaryngology-Head and Neck Surgery Trainees in Australia.

OBJECTIVES: Surgical trainee burnout has gained attention recently as a significant factor leading to poorer quality of patient care, decreased productivity, and personal dysfunction. As a result, we aimed to determine the prevalence and associated risk factors for burnout among otolaryngology-head and neck surgery (OHNS) trainees in Australia. STUDY DESIGN: Cross-sectional survey. SETTING: National cohort of accredited OHNS trainees in Australia. SUBJECTS AND METHODS: Participants completed the Maslach Burnout Inventory (MBI). Trainee burnout was defined if any threshold of the 3 MBI domains-emotional exhaustion, depersonalization, or personal accomplishment-reached an established high threshold. Demographic data on potential predictors of burnout, such as stressors, workload, satisfaction, and support systems, were collected from survey responses. Predictors were compared with the burnout status. RESULTS: Of 67 OHNS trainees, 60 responded (66.7% men). Burnout was common among respondents, with 73.3% suffering from burnout in at least 1 of the 3 MBI domains (70.0%, emotional exhaustion; 46.7%, depersonalization; 18.3%, personal accomplishment). Trainee burnout was significantly influenced by training location (chi-square, P = .05), living geographically apart from social supports (odds ratio [OR], 3.49; chi-square, P = .007), number of years trained rurally or away from social supports (Kendall's tau-B, P = .03), difficulty balancing work and nonwork commitments (OR, 10.0; chi-square, P = .03), training negatively affecting their partner or family (OR, 14.30; chi-square, P = .05), and feeling uncomfortable approaching a supervisor (OR, 2.50; chi-square, P < .0001). CONCLUSION: Burnout was found to be very common among OHNS trainees in Australia. The statistically significant predictors identified should be addressed to minimize trainee burnout.