A nationwide cross-sectional survey in the United Kingdom evaluated the prevalence of stress-induced burnout among cataract surgeons.
Tell me about the study.
Distributed by the Royal College of Ophthalmologists between December 2019 and February 2020, the three-part survey included data from consultants, trainees, and specialty doctors and associate specialists (SAS).
A total of 406 respondents completed the survey, with a crude response rate of 18%. Participants included 121 trainees (30%) and 285 consultants, SAS, or other ophthalmologists (70%). The largest cohort of respondents included consultants practicing for more than 15 years (n = 92), comprising 23% of the total survey respondents.
How was burnout measured?
Investigators used the Maslach Burnout Inventory (MBI), which measures three dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Logistic regression modeling was used to identify factors linked to high-level burnout in specific domains.
All contributors completed parts 1 (demographic information), 2 (MBI), and 3a (questions about pay and reduced surgical responsibilities). Part 3b (questions about supervising trainees) was only offered to consultants.
What were the results?
While the prevalence of high-level burnout related to cataract surgery was estimated at 3.45%—specifically in the domain of personal accomplishment—40% of respondents exhibited high burnout and 19.7% exhibited moderate burnout.
Within personal accomplishment, multiple factors were associated with increased burnout, including the age of 61 or higher [odds ratio (OR): 2.99 (1.02 – 8.78, p = 0.05)], <3,000 cataract operations completed [OR 2.98 (1.03 – 8.64, p = 0.04)], and lists per week: 2 [OR 2.99 (1.38 – 6.47, p < 0.01)], 2.5 [OR 8.95 (2.58 – 31.02, p < 0.01)], and 3 or more [OR 2.64 (1.07 – 6.54, p = 0.04)].
Sleeping 8 hours or more prior to surgery [OR 0.52 (0.28 – 0.96, p = 0.04)] was found to be a protective measure against burnout. Further, 17% of respondents indicated that they would be willing to give up cataract surgery, if given the opportunity.
What does this mean?
The results suggest that the prevalence of stress-caused burnout from cataract surgery is, while low overall, significant within a minority of surgeons—particularly on their sense of personal achievement and mental well-being.
With a significant portion of respondents reporting a willingness to give up cataract surgery if given the choice, there might be a need to have a greater conversation amongst ophthalmologists to understand the role cataract surgery plays with other professional and personal responsibilities. .
The take home.
The study suggests that developing a workforce of ophthalmologists to include ophthalmologists who perform a high-volume of cataract surgery and ophthalmologists who do not perform cataract surgery could potentially “promote the well-being of future clinicians.”