RESUMEN
STUDY OBJECTIVE: Physician burnout and suicide are at epidemic proportions. There is very little data directly comparing resident versus faculty well-being. The 2017-2018 ACGME resident and faculty surveys mark the first time that well-being questions were included. The purpose of this study was to determine whether responses to ACGME well-being questions would differ significantly between anesthesiology residents and academic anesthesiology faculty. DESIGN: 2017-2018 ACGME well-being survey responses. SETTING: All eight Pennsylvania anesthesiology residency programs. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: The authors compared the 5-point Likert scale responses (1â¯=â¯Never through 5â¯=â¯Very Often) between residents (371/384 responses, 97%) and faculty (277/297 responses, 93%) for each of the twelve well-being questions. Responses were also dichotomized as being ≥4 versus <4 for categorical comparisons. MAIN RESULTS: Faculty responded higher than residents both by mean scores and percent of scoresâ¯≥â¯4 for 6/12 questions (questions 1 (pâ¯<â¯0.001), 2 (pâ¯<â¯0.001), 4 (pâ¯<â¯0.001), 5 (pâ¯<â¯0.001), 8 (pâ¯<â¯0.001), and 11 (pâ¯=â¯0.001)). Residents responded categorically higher for question 9 (pâ¯=â¯0.022) although this was not considered statistically significant. Residents responded lowest for "Reflected on how your work helps make the world a better place" (question 1), whereas the lowest faculty responses were for questions 1, 9, and 10. Both had high responses for "Had an enjoyable interaction with a patient" (question 11). CONCLUSIONS: Pennsylvania academic anesthesiology faculty survey responses demonstrated a higher level of well-being compared to their residents. The variation in scoring suggests that anesthesiology residents and faculty have differing perceptions of various well-being domains. Information from well-being surveys can help provide programs with focus areas that they can intervene on to improve physician well-being.
Asunto(s)
Anestesiología/educación , Agotamiento Profesional/psicología , Docentes Médicos/psicología , Internado y Residencia/estadística & datos numéricos , Médicos/psicología , Agotamiento Profesional/prevención & control , Estudios Transversales , Docentes Médicos/estadística & datos numéricos , Humanos , Pennsylvania , Médicos/estadística & datos numéricos , Encuestas y CuestionariosAsunto(s)
Analgésicos Opioides/efectos adversos , Epidemias/legislación & jurisprudencia , Epidemias/prevención & control , Política de Salud/legislación & jurisprudencia , Trastornos Relacionados con Opioides/prevención & control , Salud Pública/legislación & jurisprudencia , Evaluación y Mitigación de Riesgos/legislación & jurisprudencia , United States Food and Drug Administration/legislación & jurisprudencia , Regulación Gubernamental , Humanos , Trastornos Relacionados con Opioides/diagnóstico , Trastornos Relacionados con Opioides/epidemiología , Formulación de Políticas , Medición de Riesgo , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
Insertion of drug-eluting stents is one of the strategies for treating patients with coronary artery disease. These patients can be a perioperative challenge in management as they need to be maintained on antiplatelet therapy to prevent stent thrombosis, which puts them at an increased risk for surgical bleeding. Recently revised guidelines on elective surgery following insertion of a drug-eluting stent recommend dual antiplatelet therapy for a period of twelve months. The management of a patient who presented for surgery more than two years after the insertion of a drug-eluting stent, and who developed in-stent thrombosis intraoperatively, is presented.