Your Best Life: Resiliency Builder: Delivering Orthopaedic Care Abroad

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Although burnout affects physicians in all medical disciplines, orthopaedic surgeons can be particularly at risk, with prevalence rates up to 60% higher than their general surgeon counterparts [1]. Previous columns have catalogued the direct effects of burnout including depression, substance abuse, decreased work performance, and the potential for damaging relationships with loved ones [1, 9, 13, 15]. The high rates of burnout have been related to excessive administrative tasks [14], loss of autonomy to choose treatment strategies, feelings of insignificance, and the sense that patients are treated as litigation risks, as opposed to opportunities to deliver compassionate healing to a person in need [15]. We have highlighted some means of counteracting this trend, including the practice of mindfulness, taming the scourge of perfection, and focusing on maintaining intimate relationships. A less commonly cited antidote to emotional exhaustion, however, is delivering care abroad.
When considering the benefits of delivering orthopaedic care to low- and middle-income countries [7], we tend to focus on the benefits delivered to those international sites [2]. In addition to those benefits, we have found through our own personal experiences that spending time abroad can improve the mental health of the delivering surgeons themselves. Each author has volunteered in developing countries including India (JDK), Nicaragua (JDK, DJD), and Haiti (JF).
Volunteering abroad to practice surgery can serve as a healthy and sustainable method for US surgeons to stave off burnout by reigniting the passion to help others and by reconnecting surgeons with their patients. Participating in international surgical trips to developing areas offers autonomy, opportunities to make larger impacts on communities, an escape from excessive administrative tasks, and a return to patient-focused practice. In this context, practicing abroad may be an underutilized approach for surgeons who want to avoid burnout.
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