†Perry RR. Governors’ Committee on Physician Competency and Health.
Bull Am Coll Surg. 2013;98( 5): 44-47.
‡Caropreso P. Dispatches from rural surgeons: ACS rural listserv: An
“underdog” success story. Bull Am Coll Surg. 2014;99( 7): 48-51.
The Board of Governors’ Physician Competency
Learning to ask for help
and Health Workgroup has been studying burnout
for more than a decade, according to its current Chair,
Roger R. Perry, MD, FACS. Results of surveys that
the Workgroup (then an ACS Governors’ committee)
conducted in 2008 and 2010 indicate that 40 percent
of responding ACS Fellows met diagnostic criteria for
burnout. Additionally, 30 percent screened positive
for depression. Other characteristics of burnout men-
tioned in the workgroup’s report included feelings of
cynicism and detachment from the job, irritability,
and over-identification with work to the exclusion of
“It’s a major, major issue,” Dr. Perry said. “Unfor-
tunately, there is not a well-defined strategy of what to
do” if you find yourself suffering from burnout, he said.
Most surgeons interviewed for this article, as well as
the workgroup report, mentioned the tendency of surgeons to be perfectionists as a general rule, making it
difficult for them to ask for help or take time off when
they need it.
“It’s a badge of honor for surgeons to say, ‘I’m so
busy, I’m doing everything,’” said Erika R. Ketteler,
MD, FACS, a vascular surgeon who has been in practice for approximately nine years. Dr. Ketteler is associate program director, general surgery residency program, University of New Mexico and is in practice at
the New Mexico VA (Veterans Affairs) Health Care
Dr. Ketteler said her training in palliative care
enabled her to recognize when she needed to make
improvements to her own quality of life. She realized
that as she had taken on a new supervisory role, had a
couple of very challenging patients at work, and was
dealing with some ill family members at home, she
was feeling very stressed.
“The problem with burnout is that people don’t
realize it until they are finally over that edge,”
Dr. Ketteler said.
To improve her situation, Dr. Ketteler said she
made a concerted effort to find time to do things
she enjoys. She reinvested in activities such as spinning and yoga and dedicated time to being with her
family. She involved her supervisor in what she was
experiencing and realized that she didn’t have to say
yes to everything that came her way. Dr. Ketteler
also found support in social media communities by
looking at palliative care blogs, a topic with which
she became familiar while in training.
“I gained a lot from sharing and listening and
reading about other colleagues who are going
through something similar,” Dr. Ketteler said.
At last year’s Clinical Congress, Dr. Ketteler
spoke on a panel called My Cup Runneth Over:
Surgeon Suffering and Burnout. In feedback from
the panel, many surgeons shared that the topic of
burnout is often seen as an end-of-career event,
Dr. Ketteler said. However, surgeons actually felt
that burnout and near-burnout occurs throughout
surgical residency, fellowship, and surgical practice.
Surgeons on the panel emphasized the importance
of changing the culture of surgery to prevent burnout before it occurs.
Using technology to help surgeons connect has
been a goal of Philip R. Caropreso, MD, FACS, Communications Chair, ACS Advisory Council for Rural
Surgery. Dr. Caropreso is a general surgeon and clinical professor of surgery, University of Iowa Carver
College of Medicine (UICCM), Iowa City.
Now retired from active practice, Dr. Caropreso previously maintained solo surgical practices
in Keokuk, IA, and Carthage, IL, for 37 years. He
wanted to find a way to address the surgeon shortage in rural areas, so he started the College’s rural
surgery e-mail listserv almost three years ago. Dr.
Caropreso described this effort in the “Dispatches
from rural surgeons” that appeared in the July 2014
issue of the Bulletin.‡ This electronic forum offers
surgeons who may sometimes feel professionally
The Board of Governors’ Physician Competency and Health
Workgroup has been studying burnout for more than a
decade.... Results of surveys...indicate that 40 percent of
responding ACS Fellows met diagnostic criteria for burnout.