Sunday, June 19, 2005

Ob/Gyns Suffer Burnout

This doesn't sound good at all:

A survey of ob.gyns. from Delaware, New Jersey, and Pennsylvania revealed that almost two-thirds suffer the symptoms of burnout, Vincent A. Pellegrini, M.D., reported at the annual meeting of the American College of Obstetricians and Gynecologists.

All ACOG members in District III were surveyed in 2004, and 863 responded, for a response rate of 30%, reported Dr. Pellegrini, who is in private practice in West Reading, Pa. Of those physicians, 64% reported the symptoms of burnout, as judged by the Maslach Burnout Inventory. Burnout is defined as a syndrome of physical, emotional, and attitudinal exhaustion.

Dr. Pellegrini lists a number of factors that appeared to protect against burnout, and he divides them into controllable and less controllable categories:

Among the controllable factors are regular exercise, adequate sleep, working part time, practicing gynecology only, allowing 45 minutes for each new patient, and being connected to the community.

Allowing 45 minutes per new patient! Either the good doctor hasn't been in clinical practice for some time, or he has way too many residents helping out.


At 3:27 PM, Anonymous Anonymous said...

Do you think medmal or an out of control schedule is a bigger factor? Or something completely different?

At 4:14 PM, Blogger Dr. Charles said...

i read this article too. the advent of the 'obstetricianist' (i.e. the equivalent of the 'hospitalist') might help alleviate some of that burn out. there are a few pilots in california where docs work four 10.5 hour shifts on L&D per week. seems like a better way for those who love ob but want a life. as an fp, i would love to do the prenatal care (and not get paid crap ofcourse) and then send them to you at the hospital for delivery. patients probably would miss the continuity at delivery, but that's going by the wayside anyway.

At 2:20 PM, Blogger ema said...


I think it's medmal; in particular having to practice silly defensive medicine ("if you don't document it, preferably in triplicate, it wasn't done"), and being forced to treat your patients like "clients".

The out of control schedule is baseline for us. I doubt there are many med students who enter the specialty unaware of it.

Dr. Charles,

Here's an article about laborists. I'm still not sure how I feel about it.

At 11:22 PM, Anonymous Anonymous said...

From the outside (L&D RN and 5 time mother) I thought probably medmal.
As far as the laborist idea, I think mothers will hate it and insurance companies will find a way to save money by it. Guess who will win? Better continuity of care (including 45 min or longer prenatals ;)) is one reason many women are opting for midwifery care.

At 8:17 PM, Anonymous Anonymous said...

I think the real problem is poor reimbursement. If physicians were paid appropriately for their time then there would be less dismay over premiums. Decreased reimbursement leads to overworking, over-filling every minute with patients to make up the loss in volume. This then leads to out of control schedules & eventual further upsetment.
Dr Vince


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