Sunday Surgical Scrub: 26 June 2016

burnout pile of papers

“I have a theory that burnout is about resentment. And you beat it by knowing what it is you’re giving up.” Marissa Mayer, Chief Executive Officer, Yahoo!


TASK AT HAND: This week I’m thinking about burnout. I’ve received a lot of emails about this recently and, when you consider the most recent data, US worker burnout rates are as high as 45%. So, let’s define burnout, uncover what makes you susceptible to burnout, and – most importantly – how you can avoid it.

What is burnout? This is a difficult concept to grasp and ranges from excessive work load to erosion of motivation and worth from one’s occupation. Personally, I believe that burnout goes beyond work load and is actually based on a balance between drive and work load; specifically, when work load is greater than your drive or motivation to complete it, you get into burnout territory. Burnout is a chronic condition and should not be equated with acute stress. Acute stress can be an excellent driving force but, if excessive and prolonged, can lead to burnout. As balance is lost, more work piles up, and motivation dips further. The cycle of burnout quickly gets out of control and resentment becomes a dominant sentiment. This resentment hinders both personal satisfaction and meaningful relationships.

What makes you susceptible to burnout? I have found there are two key characteristics that increase your likelihood of burnout. First, if you are the person that says “yes” to every request – be careful! Now, please realize, I am this type of person: I want to say yes to every request but, this is not a sustainable strategy! Start saying no and you will see how liberating it is. Every time you say yes to a task you are saying no to everything else: to time with family, to time with friends, to time with activities that renew you. David Allen wrote, “Much of the stress that people feel doesn’t come from having too much to do. It comes from not finishing what they’ve started.” If you say yes to every request, you will start having difficulty finishing it all. Second, isolation is a major risk factor for burn out. Isolated individuals are more likely to get caught in the cycle of dipping motivation and increased workloads because they lack positive external forces to help identify this.

So, what can you do to minimize burnout? Once again, I must emphasize that stress is not burnout; stress is acute and usually for a short period while burnout is a prolonged chronic condition. For stress, I really like Lee Iacocca’s advice: “In times of great stress or adversity, it’s always best to keep busy, to plow your anger and your energy into something positive.” However, if the stress is endless and burnout has started – mostly because your motivation and drive are fading – you need to change your strategy. This is where I really like the Mayer quote: always know what you are giving up! This way, you will learn to say no and remain focused on your priorities and principals. Finally, meaningful activities and relationships are paramount. Do not isolate yourself from loved ones, friends, or new experiences. Renew your motivation hourly and realign your focus constantly!


MEDICINE & MACULA: Interesting study in the journal Eye on patient perspectives in the delivery of treatment for neovascular age-related macular degeneration. Survey of 87 patients found the most important factor to patients was: (1) having good vision, (2) one-stop service, and (3) less frequent follow up. The least important factors were label status of the drug, cost to the health service, and grade of the injector. Drives home what I see in clinic every day: patients want to preserve the best possible vision in the most convenient manner.

Check out the study here.


GRATIS: I attended the WAVE Ocular Imaging Conference this week (June 22-25) in beautiful Vail, Colorado. It was a wonderful meeting delving deep into complex and challenging vitreoretinal topics. I presented, Surgical Techniques and Outcomes for Retinal Detachment Secondary to Viral Retinitis (below is a preoperative and postoperative photo of one of the patients), and grateful to my colleagues for the fantastic discussion.

RS Figure ARN


My best to you,

David Almeida

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