isolated due to their practice location a space to
discuss cases in an objective, non-confrontational
way, he said.
Dr. Caropreso added that he was fortunate during
his career to develop positive relationships and maintain contact with other surgeons at UICCM—about
100 miles from Keokuk—where he still teaches two
trauma courses. His connection with the university
helped to ensure his techniques stayed current and
his knowledge was sufficient, despite his isolation,
Dr. Caropreso said.
In his own experience, Dr. Caropreso said, he has
felt support from the community of Keokuk, and that
sense of belonging has kept him from feeling burned
out. His involvement around town, including serving
as president of Friends of the Animal Shelter and on
his church council, has earned him respect from the
people who live in the area. Even in the case of a complication or a death, Dr. Caropreso said, most people
understand that humans make mistakes.
Staying enthusiastic about surgery
For some surgeons, variety at work helps ward off
burnout. Dr. Ketteler said the mix of operating, working with residents, and teaching courses makes for
a better environment than doing the same thing
every day. Carol-anne Moulton, MB, BS, FRACS,
MEd, PhD, agreed that variety has been helpful in
maintaining her enthusiasm for her work. For Dr.
Moulton, that has meant following her interest in
surgical qualitative research.
“I think I’ve kept moving. I’m somebody who’s
always looking out for something new,” Dr. Moulton
said. Dr. Moulton is staff surgeon and associate profes-
sor of surgery, University of Toronto, ON, and scien-
tist, University of Toronto Donald R. Wilson Centre
for Research in Education. She joined Dr. Ketteler and
Gregory R. D. Evans, MD, FACS, at last year’s Clini-
cal Congress to speak on the panel on burnout. Dr.
Moulton has researched and studied burnout exten-
sively, which she thinks has helped her to avoid suc-
cumbing to the syndrome so far.
“We can’t be brave and all-knowing all the time,”
Dr. Moulton said. “Because I study [burnout], I’m very
aware of that pressure within me to fit into that stereotype.” Dr. Moulton said she has developed a group
practice so that the workload is distributed among
several surgeons, and everyone can have some time
off without carrying a pager. She added that finding
challenges in her work has helped her maintain an
Changes in health care
One factor that contributes to burnout, according to
Dr. Perry, is the unpredictability of how our health
care system will evolve. Dr. Perry said that the implementation of electronic health records and administrative requirements, as well as the changing rules of
insurance companies, add to the pressures surgeons
are already under, which is very unsettling.
Dr. Caropreso agreed that the environment outside clinical practice was a big source of stress during
his career, and external influences still affect surgeons
today, because nonphysicians are telling doctors what
“I’ve recognized that so much of it is outside of
our control, and I try not to get upset about things
that are out of my control,” Dr. Perry said.
Dr. Caropreso Dr. Perry Dr. Ketteler