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Editorial Commentary

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In light of the increasing demand but obvious impending shortage in urology, the author presents a timely report on burnout. Unfortunately specific studies for urologists are rare but certainly the prevalence is unacceptably high among surgeons. The implications of this progressing burnout and dissatisfaction are concerning. Middle and early career surgeons and women seem to be at greatest risk. Tschuor et al noted several factors that increase job satisfaction, including administrative support, innovation, autonomy, decentralized control and ability to attend conferences, along with networking and peer support.1 Many of these factors are being threatened directly or indirectly with decreasing reimbursement, increasing workload and insurance driven metrics. However, the United States is not unique in these problems. In France 24% of the urologists surveyed had severe burnout on the Maslach Burnout Inventory. I worry about the long-term consequences to our field if we do not act. There is certainly the risk of early retirement. In addition, medical students sense physician unhappiness, which ultimately may affect their choice of specialty. Thus, burnout could limit the qualified candidate pool. Both problems cause a decrease in our workforce supply. Finally, for those currently practicing the possibility of developing unhealthy coping mechanisms exists. Franke et al demonstrated a 20% use of cognitive enhancing and 15% use of mood enhancing drugs (prescription and illicit) among surgeons. We need to start caring for ourselves. I agree completely with the author—we need to pay attention to the problem and develop realistic solutions.
机译：鉴于泌尿外科的需求不断增加，但明显的短缺迫在眉睫，作者提出了一份关于倦怠的及时报告。不幸的是，专门针对泌尿科医生的研究很少，但在外科医生中的患病率确实高得令人无法接受。这种持续的倦怠和不满的影响令人担忧。职业生涯中早期的外科医生和女性似乎风险最大。Tschuor等人指出了提高工作满意度的几个因素，包括行政支持、创新、自主性、分散控制和参加会议的能力，以及网络和同伴支持。1其中许多因素正受到直接或间接的威胁，包括报销减少、工作量增加和保险驱动的指标。然而，美国在这些问题上并不是独一无二的。在法国，接受调查的泌尿科医生中有24%在马斯拉赫倦怠量表上有严重的倦怠。我担心如果我们不采取行动，会给我们的领域带来长期后果。当然存在提前退休的风险。此外，医学生感觉到医生的不快，这最终可能会影响他们对专业的选择。因此，倦怠可能会限制合格候选人的数量。这两个问题都会导致劳动力供应减少。最后，对于那些目前正在实践的人来说，存在发展不健康应对机制的可能性。Franke等人证明，外科医生中有20%使用认知增强药物，15%使用情绪增强药物（处方药和非法药物）。我们需要开始照顾自己。我完全同意作者的观点，我们需要关注这个问题，并制定切实可行的解决方案。

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