Surgeons share how they evaluate whether a wound bed is ready for either an acellular dermal matrix or a skin graft
In response, the American Society of Plastic Surgeons (ASPS) launched Project Well, an initiative to combat stress and job burnout among its members. While some information is already online, a large group of ASPS members are working behind the scenes to provide a much more robust collection of articles, multimedia, podcasts, research papers and other resources. The expanded Project Well library is expected to be ready in Fall 2022—just in time for the association’s annual meeting.
“Physicians and surgeons are among the most resilient in the world,” says Dr. Richard Korentager, chair of plastic, burn and wound surgery at the University of Kansas and co-chair of ASPS’ Wellness Task Force. “But we’re also told we need to work longer, work harder and don’t complain. We have high rates of depression, drug abuse and suicide.” There is data showing that female plastic surgeons are at even higher risk for job burnout.
A literature review of plastic surgery and job burnout found there is vast overlap among burnout, depression and substance abuse. In addition, study noted that burnout is associated with:
A Recent Shift in Surgeons’ Work/Life Priorities
Plastic surgeon stress and burnout aren’t new. What is new is how today’s surgeons react to it, says Dr. Korentager.
“Many of us, when we trained, you expected to be yelled at, to work 100 hours per week, to be on-call all the time,” he says. “It was a sign of weakness if you didn’t do that. And it used to be the norm that you should be miserable and miss all your kids’ soccer games and have an unfulfilling marriage because you’re a surgeon. But that takes a toll and as the generations change, we’ve seen a rapid shift in terms of what people will accept and things began to change.”
In 2018, then ASPS President Dr. Jeff Janus chose wellness as an organizational priority and Project Well was launched. “There was tremendous interest right from the outset,” Dr. Korentager said. “Jeff has said this initiative has generated the most interest among ASPS members than any task force than he’s ever seen. More than 60 members volunteered to work on it.”
Job burnout isn’t always obvious to identify, but Dr. Korentager says stress is a factor. When he oversaw the plastic surgery residency program at the University of Kansas, he saw the signs among residents and attendings. “I noticed the stress levels that people were under was huge,” he says. “For example, in the O.R., if someone didn’t have the equipment they needed or it wasn’t working, there would be this explosive anger. It was dramatic.”
Is the Solution Finding Balance or Finding Joy?
“People love to talk about balance,” Dr. Korentager says. “It’s almost impossible if you’re a surgeon to talk about being completely balanced—it’s about how do we integrate work and home life. Dr. Colin West of the Mayo Clinic describes it as recognizing that both are essential, and it’s like a bank account. If you spend more time on one side—having to go in the middle of the night for a patient—we have to recognize that that’s a withdrawal from our home life.”
Joy is the cure for burnout, Dr. Korentager says. One person may find joy in their children, another in their spouse, yet another in research over clinical practice.
“We’re not going to get more than 24 hours in a day. If you look at Maslow’s needs pyramid, we have to give people food, water and rest,” he says referencing U.S. psychologist Abraham Maslow’s hierarchy of needs outlined in his paper on human motivation.
“If you have to do charts at night, you’re not getting the sleep that you need. The places we work, they frequently speak at cross-purposes. They say that you need to put charts in the system, you need to see patients in clinic, you need to be in surgery…yet they also say you need to have balance.”
How ASPS Sees Its Role in Combatting Plastic Surgeon Burnout
Dr. Korentager studied executive coaching and wellness and completed the Stanford Chief Wellness Officer program in its inaugural year. His passion for the topic is clear, and the issue has genuinely resonated with others at ASPS.
ASPS member volunteers have spent the last few years researching and compiling data on a series of topics and subtopics, and are now working to organize and add information to the Project Well website. The goal is to create a robust online content library to be available by Plastic Surgery: The Meeting in October 2022.
Currently, ASPS offers online a Quick Burnout Self-Assessment, as well as other resources. Once complete, the Project Well website will include information on a host of wellness topics, including awareness and mindfulness, aging parents, organizational culture, workload, family life, promotion, tenure, spouse/significant other and health.
Dr. Korentager says ASPS doesn’t want to simply imitate the great work on wellness that other organizations have already done, including the American Medical Association and the American College of Surgeons.
“The challenge is how do we do something that’s going to be meaningful to our membership but not reinvent the wheel,” he says. “We’re trying to provide resources that people will find important and useful and not trying to be something we can’t be.”