Plastic and Reconstructive Surgery

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PRSonally Speaking
Tuesday, September 24, 2013
Am I Burned Out?
by Stephanie Rowen, MD
As the mother of a 10-month-old daughter, I’m still trying to figure out how to balance my work and home life.  I feel pressure to be everything in both arenas.  At work I hear about efficiency, doing more with the same or less, patient-driven access, service.  At home I want to be a supportive involved parent and a loving, caring spouse.  I feel pulled in many directions and feel like I need Botox just to keep my brows from furrowing all day long.  Am I burned out?
Physician burnout seems to be a buzzword as we face the imminent squeeze on the healthcare system when many more Americans will have access to health insurance next year.  I was struck by a New York Times article last month, “The Widespread Problem of Physician Burnout” about a recent study published in Archives of Internal Medicine.  The medical journal article, “Burnout and Satisfaction with Work-Life Balance Among US Physicians Relative to the General US Population” by TD Shanafelt, MD, et al, states that almost half of the more than 7000 physicians surveyed reported at least one symptom of burnout.  Compared to other Americans in the workforce, we as physicians have a statistically significant greater risk of burnout.  Another article, “An Interactive Individualized Intervention to Promote Behavioral Change to Increase Personal Well-Being in US Surgeons” from the same lead author in Annals of Surgery, looks specifically at surgeons.  Surgeons were found to be poor judges of their well-being as almost 90% rated their well-being as at or above average while over 70% had scores on the Mayo Clinic Physician Well-Being Index that were in the bottom 30%.
What does this mean for plastic surgeons?  I think we suffer from burnout as much as our other surgeon colleagues, though we probably do not even know it. Knowing is only the beginning. What can we do about it?
We all struggle with work-life balance.  What IS work-life balance?  Is there ever balance?  It seems to be more of a teeter-totter than a balance.  We feel torn between work, families, hobbies, exercise, friends….  As a “caring” profession, we tend to put our patients first and ourselves second.  We want to do the best we can for our patients, even if it means staying up all night, skipping that outing with friends, missing Thanksgiving dinner. 
In 2014 it is estimated that 30 million or more Americans will have access to health insurance who do not have it today.  What will these newly insured people mean for us?  More work, less compensation, less time for ourselves.  “Efficiency” is another buzzword, along with “technology”. I would argue that “physician well-being” should be as important a buzzword as those.  We cannot provide quality medical care to anyone, let alone 30 million more people, if we do not take care of ourselves.
Large HMOs realize this. They have been putting a lot of emphasis on physician health and well-being.  I am on the “Physician Health and Well-Being Council” at my facility.  There is a lot of effort and money being put toward programs to help physicians fight burnout.  Programs are offered to physicians to encourage camaraderie between specialties, to encourage healthy eating, to encourage physical exercise and to encourage mindfulness based stress reduction.  For those physicians who do not have access to these opportunities through work, it is important to find ways to address these issues in their own lives.  We encourage wellness in our patients, but we need to remind ourselves that we are patients as well.  It is becoming more and more important as we become busier and face even more patients in the coming year.  The numbers from the studies above are sobering.  We need to address burnout together and as individuals more so now than ever.
For me, I am definitely going to take the mindfulness based stress reduction seminar, exercise as much as I can and spend quality time with my family as I watch my daughter grow up.  Botox wouldn’t hurt either.
About the Blog

Plastic and Reconstructive Surgery

PRSonally Speaking is the official blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit our blog for exclusive previews of and discussions on hot topics in plastic surgery as well as insider-tips on open access content. PRSonally Speaking is now powered by frequent contributions from the American Society of Plastic Surgeons’ Young Plastic Surgeons Forum (YPS); these practicing plastic surgeons provide the personal side of the plastic surgery story, from daily challenges to unique insights. PRSonally Speaking is home to lively, civil debate on hot topics and great discussions pertaining to our field. So, bookmark us, subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your Journal; have fun, be respectful, get engaged and interact with the PRS community.

The views and recommendations of guest contributors do not necessarily indicate official endorsements or opinions of the Journal, PRS, or the ASPS. All views are those of the authors and the authors alone.


Anureet K. Bajaj, MD is a practicing plastic surgeon in Oklahoma City. She completed residency and fellowship in 2004, had a brief stint in academia at the University of Cincinnati, and then chose to join her father (Paramjit Bajaj MD, also a practicing plastic surgeon) in private practice in OKC, where she focuses on breast reconstruction and general cosmetic surgeries.

Devra B. Becker, MD, FACS, is an Assistant Professor of Plastic Surgery in the Department of Plastic Surgery at University Hospitals/Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed Plastic Surgery residency at Washington University School of Medicine in St. Louis, and completed fellowships with Daniel Marchac and with Bahman Guyuron. She currently has a primarily reconstructive practice.

Henry C. Hsia, MD, FACS is at Robert Wood Johnson Medical School of Rutgers University in New Brunswick, New Jersey and also holds an appointment at Princeton University.  When he’s not working hard trying to be a good father and husband, he runs a practice focused on reconstructive surgery and wound care as well as a research lab focused on wound biology and regenerative medicine.

Stephanie K. Rowen, MD is a senior physician at The Permanente Medical Group in San Jose, California.  She joined TPMG upon finishing residency and a hand surgery fellowship in 2005.  She has a primarily reconstructive practice, about 50% hand surgery.  Outside of work she enjoys participating in triathlons and spending time with her family.

Jon Ver Halen, MD is currently Chief of plastic surgery, Baptist Cancer Center; Research member, Vanderbilt- Ingram Cancer Center; Adjunct clinical faculty, St. Jude Children's Research Hospital. He also acts as Program Director for the plastic surgery microvascular surgery fellowship. His practice focuses on oncologic reconstruction.

Tech Talk Bloggers

Adrian Murphy is a plastic surgery trainee in London, England. He studied medicine in Dublin, Ireland and has trained in Ireland, Boston, MA and the United Kingdom. He is a self-confessed geek and gadget aficionado.

Ash Patel, MD is Assistant Professor of Plastic Surgery and Associate Program Director at Albany Medical College, in Albany NY. His practice is primarily reconstructive.