Newsletter Spring 2011

Members of the PWWP

•            Francis Bonet (France)  

•            Steve Howard (USA)   

•            Pratyush Gupta (India) 

•            Olli Meretoja (Finland)

•            Roger Moore (USA)

•            Max-André Doppia (França)

•            Gastão F. Duval Neto (Brasil) Chair

Occupational wellbeing is a reflection of job satisfaction, leading to enrichment in our entire life. Finding a healthy way to integrate work into our life in such a way that provides balance and personal satisfaction will lead to enhanced overall wellbeing. “The Professional Wellbeing Work Party” at WFSA aims to promote the wellbeing of anesthesiologists around the world, mainly by encouraging research, recommendations and awareness in this subject.

The nature and intensity of the work performed by anesthesiologists has been transformed dramatically over the past few decades. The advent of new technologies has expanded the surgical horizon, but has also allowed the intervention for much more challenging medical conditions. In association with more difficult case loads are the pressures of increased economic competitiveness, and the need to do more with a downsized workforce. All this transformation has impacted the occupational wellbeing of the anesthesiologist. Hence, it becomes important that anesthesiologists be informed about the aspects of their practices that produce the most stress and to provide direction as to how better working conditions can be established.

The Burnout Syndrome is a well defined medical condition, characterized by emotional exhaustion, depersonalization and diminished personal accomplishment. Emotional exhaustion represents the emotional depletion of an individual, and it is considered the syndrome's initial trait resulting mainly from excessive job demands and conflicts in interpersonal relationships, as well as from the carrying out of professional duties. Depersonalization is characterized by health care provider's emotional insensibility. The appearance of this symptom is essential to the diagnosis of the Burnout Syndrome, since the other features can be found in depressive cases in general. Ultimately, the feeling of diminished personal accomplishment (or incompetence) reveals a negative self-evaluation associated with a lack of satisfaction and unhappiness at work.

The emerging risks of acute and chronic fatigue and high levels of occupational stress, need to be highlighted during staff anesthesiologists’ clinical practice and also during residency training programs. Prof. Olli Meretoja opines that “There is a growing amount of evidence that doctors’ performances are poorer if they work for over-prolonged duties or at night. These working patterns decrease the standard of care and increase health care expenses. Effective ways to reduce the overall consequences of fatigue and night work include minimizing the amount of work carried out at nighttime and setting up rules for maximal hours for each work shift”.  

Another issue of concern is chemical dependency among physicians, especially anesthesiologists who have more accessibility to drugs of abuse. Prof. Francis Bonnet and his colleagues have published a national survey concerning the incidence of addiction among French anesthesiologists. The substances used most frequently were alcohol (in 59%) and tranquillizers -hypnotics (in 41%). Increasing age increased the incidence of abuse. Addicted subjects reported issues in their work environment that may have contributed to the development of their pathology. Similar studies in Brazil have also shown opioids, benzodiazepines and alcohol to be the most common addictions among physicians, including anesthesiologists. There appears to be a relationship between psychogenic pathologies developed during the practice of anesthesiology (fatigue, depression, burnout, etc) and the chemical dependency syndrome.

The Brazilian Society of Anesthesiology (BSA) has shown a growing interest in anesthesiologists’ occupational health since 2000. The BSA has tried to understand, to alert to, and to influence the kind of situations that have significant importance in an anesthesiologist's life. The BSA's Occupational Health Committee has undertaken epidemiological research that aims to evaluate the level of occupational stress and the degree of adaptability to the residents' work conditions and their preceptors in the BSA and Education Governing Center's Teaching and Clinical Training Program.

In spring 2010, the Professional Wellbeing Work Party of the WFSA carried out research involving 120 member societies from across the world. It involved use of a questionnaire aimed at identifying the incidence of occupational health problems amongst members of the particular society and approaches used by these Societies to address anesthesiologists’ occupational health.

The results show that more than 90 % of the National Societies considered Burnout Syndrome as a causative problem but only 14 % had developed any kind of coping strategy for this syndrome. The PWWP has organized a special symposium on this topic during the next World Congress of Anesthesiologists in Buenos Aires in 2012. Important subjects related to health and well-being of anesthesiologists will be covered by representatives of PWWP at this congress.

Further information on PWWP activities and recommended literature is available on WFSA website:

1) http://www.anaesthesiologists.org/committees/working-parties

2) Professional Wellbeing Recommended Reading

        Gastão F. Duval Neto (Brasil)

 Chair of the Professional Wellbeing Working Party of WFSA