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Semin Pediatr Surg. 2015 Dec;24(6):315-8. doi: 10.1053/j.sempedsurg.2015.08.011.

Improving surgeon wellness: The second victim syndrome and quality of care.

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Division of General and Thoracic Pediatric Surgery, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, George Washington University School of Medicine, 111 Michigan Ave, NW, Washington, District of Columbia 20010. Electronic address:
Division of Pediatric Surgery, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.


Improving quality of care logically involves optimizing the duty-readiness and well-being of the healthcare provider. Medical errors and poor outcomes adversely impact the involved providers, especially surgeons, as well as the patients and their families. Unfortunately our current system does little to support these "second victims" who experience various degrees of emotional and psychological stresses including confusion, loss of confidence, and debilitating anxiety. These factors contribute to the alarmingly high rates of professional "burnout," substance abuse, and suicide of healthcare providers as well as increase the likelihood of subsequent medical errors. Mindful efforts to improve the healthcare culture and develop personal support systems can help surgeons become more resilient, provide higher quality patient care, and have longer productive professional lives. Institutional support systems are also necessary to assist "second victims" to recover from the impact of an adverse patient event.


Burnout; Medical error; Physician; Quality; Second victim; Surgeon

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