Burnout, Well-being, and Distress Among Orthopaedic Surgeons in Puerto Rico

Physician burnout is a global concern, yet its prevalence among Puerto Rico’s surgeons remains underexplored. This study assesses burnout among orthopaedic surgeons working within the island’s strained healthcare system, marked by economic disparities, privatization, and physician exodus. A cross-sectional survey was conducted among 67 orthopaedic surgeons (over 60% of the island's workforce) and 27 romantic partners. The survey included the Maslach Burnout Inventory-Human Services Survey, General Health Questionnaire 12, and the Revised Dyadic Adjustment Scale. Burnout was identified in 28.4% of surgeons, with 58.2% reporting high emotional exhaustion and 37.3% high depersonalization. No respondents exhibited low personal accomplishment. The most frequently cited stressor was Puerto Rico's healthcare system, particularly health insurance restrictions (66.7%). Additionally, 25.4% of surgeons showed signs of mental health concerns, and 22.0% experienced relationship distress. While emotional exhaustion and depersonalization present as alarmingly high, resilience in personal accomplishment was notable. Interventions are needed to address systemic stressors while leveraging cultural factors that protect against burnout.