Investigating the Perceived Impact of Surgeons' Burnout on Surgical Physician Associates' Wellness in United States Ambulatory Surgery Centers

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended essay questions regarding surgeons' burnout and SPAs' wellness. To ensure validity and reliability, we individually reviewed the survey instrument to ensure it be formative of the two study constructs, two retired newspaper editors completed the cognitive interviews, and four subject matter experts critically reviewed it. Demographic data were analyzed using Minitab V21, and qualitative data were analyzed using MAXQDA V2022. The final sample (n = 29) represented 29 unique ASCs across all five U.S. geographic regions. Three main findings emerged from the thematic analyses. First, the SPAs experienced poor and decreased work life balance, decreased exercise, stress, burnout, increased job demand, exhaustion, and decreased job satisfaction when their supervising surgeons' burnout affected their wellness negatively. Second, the SPAs experienced work-related frustration when their interaction with supervising surgeons decreased as a result of the surgeons' burnout. Finally, the SPAs reported feeling supported when their supervising surgeons were supportive and affected their wellness positively.