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that I was experiencing a very acute episode of the
" three burnout dimensions " that are the core of the
Maslach Burnout Inventory Human Services Survey,
used in this study. These risk factors are increased
emotional exhaustion, increased depersonalization,
and decreased sense of personal accomplishment. I
recall that year as I moved though the various clinical
" rotations " of third-year curriculum, never feeling as
though I had mastered anything, since just when I
would begin to understand the basics of the specialty
to which I was assigned, the rotation ended and I
would again find myself the lowliest and most useless
member of a new team, expected to do things I had
no clue about. In those days, " pimping " the medical
student was a common and often cruel amusement but
was accepted as a sort of rite of passage. These were
perhaps the most depersonalizing experiences I have
ever had. Thankfully medical education has evolved in a
more humane direction.
That is perhaps less true of medical practice, at least
where physicians are concerned. The AMA reported
that " for the first time, most physicians worked
outside of physician-owned practices in 2020, as
doctors continue to gravitate toward employment
by hospitals and other organizations. " The relentless
erosion of autonomy experienced by physicians in
recent decades has been cited as a major contributor
to cynicism, a characteristic of depersonalization. Most
anesthesiologists, like other physicians, have always
accepted long and unpredictable hours, disruptions of
family life, and the many stresses that accompany our
responsibilities for our patients' welfare.
Until recently, these adversities were in some way
compensated by broad autonomy and privileged
authority that is unique to the profession of
medicine. The rigors and sacrifices of a physician's
life were ameliorated by the community's respect
and appreciation. As medical practice has become
more businesslike, conformity and adherence to
the requirements of the new paradigms of EHRs,
2 Hyman, SA: Burnout: the " other " pandemic. Anesthesiology 2021; 673-75
burdensome regulation, practice management
companies, and corporate employment have taken a
large and insidious toll on physician well-being. I was
fortunate to have completed my medical education at
a time when it was within the means of most middleclass
families to finance, without being shackled by
decades of debt repayment worry, but this is exactly
what our youngest colleagues now must face along
with the stresses of being a new doctor.
We all know this. The COVID-19 pandemic has brought
a heightened awareness of our fragility. In medical
institutions and departments of anesthesiology across
the country, physician wellness has become a more
important priority than ever before. We talk about selfcare,
work-life balance, reaching out and supporting
one another, and finding our own individual paths to
personal resilience. These are important conversations
because the well-being of our patients depends so
much on our own.
Yet, this is not enough. In his editorial, Dr. Steve
Hyman, a leading researcher on the well-being of
anesthesiologists, emphasizes that while the subject
has been extensively studied and urgently recognized
to be a rampant problem, burnout and discontent
among us continues to grow. He suggests " future
burnout research should focus not only on the
incidence of burnout, but also on specific modalities
that can mitigate or prevent burnout altogether...To
address individual issues without addressing workplace
issues does not provide a comprehensive solution to
the problem. " 2
Therefore, while we continue to support and befriend
each other, and seek to recognize and understand our
individual spiritual and psychologic health, it is the
world in which we struggle that we must also bend to
our aid. Finding ways to do this through our medical
staff, professional organizations, and society at large is
an imperative for our well-being and the safety of our
patients.
Annual Publication 2021 | 81

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