Evidence map›Paper›PMID 34766825›Full record

ArticleBone & joint open2021

Physician wellness in orthopaedic surgery : a multinational survey study.

Hassan Mir, Katheryne Downes, Antonia F Chen, Ruby Grewal, Derek M Kelly, Michael J Lee, Philipp Leucht, Sukhdeep K Dulai

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A systematic review of the prevalence of burnout in orthopaedic surgeons.Annals of the Royal College of Surgeons of England · 2025
    Pooled it
  2. Burnout among Orthopedic Residents.Journal of orthopaedic case reports · 2025
    Article
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  9. In-Hospital, 24-Hour Exercise Spaces for Resident and Staff Wellness.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2023
    Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hassan MirFlorida Orthopedic Institute, Tampa, Florida, USA.
Katheryne DownesFlorida Orthopedic Institute, Tampa, Florida, USA.
Antonia F ChenDepartment of Orthopaedics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Ruby GrewalRoth McFarlane Hand and Upper Limb Cente, University of Western Ontario, London, Canada.
Derek M KellyCampbell Clinic Orthopaedics, Memphis, Tennessee, USA.
Michael J LeeDepartment of Orthopaedics, University of Chicago, Chicago, Illinois, USA.
Philipp LeuchtOrtho Surgery & Cell Biology, NYU Langone Health, New York, New York, USA.
Sukhdeep K DulaiUniversity of Alberta, Edmonton, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPhysician burnout and its consequences have been recognized as increasingly prevalent and important issues for both organizations and individuals involved in healthcare delivery. The purpose of this study was to describe and compare the patterns of self-reported wellness in orthopaedic surgeons and trainees from multiple nations with varying health systems.

methodsA cross-sectional survey of 774 orthopaedic surgeons and trainees in five countries (Australia, Canada, New Zealand, UK, and USA) was conducted in 2019. Respondents were asked to complete the Mayo Clinic Well-Being Index and the Stanford Professional Fulfillment Index in addition to 31 personal/demographic questions and 27 employment-related questions via an anonymous online survey.

resultsA total of 684 participants from five countries (Australia (n = 74), Canada (n = 90), New Zealand (n = 69), UK (n = 105), and USA (n = 346)) completed both of the risk assessment questionnaires (Mayo and Stanford). Of these, 42.8% (n = 293) were trainees and 57.2% (n = 391) were attending surgeons. On the Mayo Clinic Well-Being Index, 58.6% of the overall sample reported feeling burned out (n = 401). Significant differences were found between nations with regards to the proportion categorized as being at risk for poor outcomes (27.5% for New Zealand (19/69) vs 54.4% for Canada (49/90) ; p = 0.001). On the Stanford Professional Fulfillment Index, 38.9% of the respondents were classified as being burned out (266/684). Prevalence of burnout ranged from 27% for Australia (20/74 up to 47.8% for Canadian respondents (43/90; p = 0.010). Younger age groups (20 to 29: RR 2.52 (95% confidence interval (CI) 1.39 to 4.58; p = 0.002); 30 to 39: RR 2.40 (95% CI 1.36 to 4.24; p = 0.003); 40 to 49: RR 2.30 (95% CI 1.35 to 3.9; p = 0.002)) and trainee status (RR 1.53 (95% CI 1.15 to 2.03 p = 0.004)) were independently associated with increased relative risk of having a 'at-risk' or 'burnout' score.

conclusionsThe rate of self-reported burnout and risk for poor outcomes among orthopaedic surgeons and trainees varies between countries but remains unacceptably high throughout. Both individual and health system characteristics contribute to physician wellness and should be considered in the development of strategies to improve surgeon wellbeing. Level of Evidence: III Cite this article:

Indexed as

arthroplastyburnedBurnoutchi-squared testsFisher’s exact testmultivariate regression modelsorthopaedic surgeonsorthopaedic surgeryPhysiciansPhysician wellnessstatistical modellingUnivariate analyses

Identifiers

PMID34766825
PMCPMC8636297

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.