Newly Published
Correspondence  |   March 2020
Anesthesiologist Burnout, Distress, and Depression: Comment
Author Notes
  • National University of Singapore, Singapore (J.O.). jo401@cam.ac.uk
  • (Accepted for publication February 21, 2020.)
    (Accepted for publication February 21, 2020.)×
Article Information
Correspondence
Correspondence   |   March 2020
Anesthesiologist Burnout, Distress, and Depression: Comment
Anesthesiology Newly Published on March 17, 2020. doi:https://doi.org/10.1097/ALN.0000000000003261
Anesthesiology Newly Published on March 17, 2020. doi:https://doi.org/10.1097/ALN.0000000000003261
We read with interest the recent article on burnout among anesthesiology residents by Sun et al.1  Burnout within anesthesiology is of growing concern and quite rightly so; unaddressed burnout can lead to suboptimal patient care and clinical practice, mental health issues, and long-term physical disease in clinicians.2  Although an important issue to tackle, the accurate estimation of burnout in large-scale surveys is difficult and poses a significant challenge to academics. Some of these reasons are discussed below and should be considered when interpreting the prevalence of burnout reported in the literature.
Burnout is poorly characterized. Burnout is classified as an “occupational phenomenon” by the World Health Organization (Geneva, Switzerland) and not a medical condition. As such, a diagnostic criterion does not exist. The 11th revision of the International Classification of Disease (ICD-11) characterizes burnout by the presence of (1) feelings of energy depletion or exhaustion, (2) increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job, and (3) reduced professional efficacy. This description reflects a shift in the field to recognize broader areas of “cynicism” and “professional efficacy” as part of the dimensions of “depersonalization” and a perceived sense of “lack of personal achievement” respectively.2  Nonetheless, these dimensions vary over time and exist on a scale of varying severity, not as dichotomous variables. That said, how does one measure such dimensions reliably and then decide universally what and when is it problematic? Such fundamental questions are part of ongoing debates because moderate or severe symptoms can be present in clinicians who are not burnt out. These uncertainties reflect our limited understanding of the syndrome.