Healthy patients, sick surgeons?
MUNICH, Germany: On the one hand, progress in surgery is making more and more possible. Where previously extensive scars developed, today often only small incisions are necessary, even for malignant diseases such as tumours of the oesophagus, intestine, stomach and liver. Even back operations and artificial hips often no longer represent an unacceptable risk, even for very elderly patients, thanks to proper preparation. On the other hand, studies report increasing burnout rates among hospital doctors. Where does this total exhaustion come from? Experts will discuss these and other questions at the 136th Congress of the German Society of Surgery (Kongress der Deutschen Gesellschaft für Chirurgie, or DGCH), which will be held in Munich from 26 to 29 March 2019 under the motto "Full steam ahead - with heart, hand and mind".
"Empathy, manual skills, knowledge and experience shape surgical action", explains DGCH President Professor Dr. med. Matthias Anthuber the congress motto. "In addition, there is the courageous look ahead, which opens up better healing opportunities for the patient time and time again. All this, the Augsburg surgeon notes, is excellent prerequisite for a fulfilling and meaningful professional activity, for which great commitment is gladly shown.
"All the more reason to think when more and more doctors burn out," says Anthuber. Studies from 2014 show that almost two thirds of German hospital physicians experience negative stress in excess ("distress"), a quarter have the desire to quit clinical work. A British study from 2018 speaks of burnout among doctors as an "epidemic".
Experts identify the causes for the increasing health risk above all in an excess of bureaucracy, multitasking, frequent interruptions as well as economic and political constraints that are not related to the medical field. "Together with lack of time and understaffing, this leads to frustration and fainting," criticises Matthias Anthuber. "It is high time to take countermeasures. Against the background of demographic developments, we must not lose doctors who have received the best training in Germany to curative medicine in hospitals or practices.
The latest successes in the surgical treatment of elderly patients would not be possible without qualified medical personnel. "Today, we can use new hip or knee prostheses for people over 80 with a clear conscience because we know how to effectively reduce the risks associated with an operation for heart attack and pneumonia," says Anthuber.
Thanks to outstanding expertise, surgeons can now also remove intestinal cancer, for example, which occurs more frequently at an advanced age, minimally invasively. Studies have shown that this surgical technique leads to fewer wound infections and pain, and a quicker return to everyday life. Disadvantages such as increased rates of tumour relapse or increased tumour-related mortality do not occur. "However, the success of the operation depends on the technical skills and experience of the surgeon, particularly in the diagnosis of tumours," emphasises Anthuber.
In addition to minimally invasive surgery, interventions in elderly patients and stress management in the surgical disciplines, surgical progress through robotics and digitisation, for example, as well as organ replacement, are further key topics of the 136th Surgeons' Congress.