Erratum: Burnout, drop out, suicide: Physician loss in emergency medicine, part 1 (Western Journal of Emergency Medicine (2019) 20:3 (485-494) DOI: 10.5811/westjem.2019.4.40970)

Abstract

Erratum in West J Emerg Med. 2019 November;20(6):840-841. The authors would like to revise the description on the evolution of the definition of burnout in the Introduction. The introduction formerly stated, “Based on his research, Freudenberger used “burnout” as shorthand for a psychological syndrome with three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment.2 Maslach subsequently summarized the dimensions of burnout as “exhaustion,” “cynicism,” and “inefficacy,” providing more identifiable definitions of each dimension that align well with her measurement tool.3” This should be revised to the following: “Based on his experiences, Freudenberger described the phenomenon of “burn-out”, subsequently defined by Maslach as a psychological syndrome with three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment.2,3” Abstract Each year more than 400 physicians take their lives, likely related to increasing depression and burnout. Burnout-a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment-is a disturbingly and increasingly prevalent phenomenon in healthcare, and emergency medicine (EM) in particular. As self-care based solutions have proven unsuccessful, more system-based causes, beyond the control of the individual physicians, have been identified. Such system-based causes include limitations of the electronic health record, long work hours and substantial educational debt, all in a culture of "no mistakes allowed." Blame and isolation in the face of medical errors and poor outcomes may lead to physician emotional injury, the so-called "second victim" syndrome, which is both a contributor to and consequence of burnout. In addition, emergency physicians (EP) are also particularly affected by the intensity of clinical practice, the higher risk of litigation, and the chronic fatigue of circadian rhythm disruption. Burnout has widespread consequences, including poor quality of care, increased medical errors, patient and provider dissatisfaction, and attrition from medical practice, exacerbating the shortage and maldistribution of EPs. Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone. This paper reviews the scope of burnout, contributors, and consequences both for medicine in general and for EM in particular. PMCID: PMC6526882 [PubMed - indexed for MEDLINE].