Intended for healthcare professionals

Rapid response to:


Burnout in healthcare: the case for organisational change

BMJ 2019; 366 doi: (Published 30 July 2019) Cite this as: BMJ 2019;366:l4774

Rapid Response:

Re: Burnout in healthcare: the case for organisational change

Burnout in healthcare by Montgomery et al., is essential reading for the modern clinician. Indeed, it was a topic also discussed in the Royal College of Surgeon of England Bulletin only a few months ago [1]. It is encouraging to see the mental health of our workforce is being increasingly discussed as not only is burnout devastating to the individual, but also, the patients they care for.

The JAMA charter on physician well-being states that “psychological support should be considered as a means to optimise physician performance proactively rather than solely as a response to crises” [2]. However, we need to know what we are tackling and so we certainly agree that more research is needed to identify key stressors. We believe that performance anxiety may be one of these areas. There is definitely a performance aspect to the working lives of most clinicians, particularly surgeons, and like in the performance arts and sports, performance anxiety can be debilitating. Unfortunately, this is something that remains somewhat taboo and barely discussed in our community.

To this end, a shameless plug: we are currently conducting the first national survey of performance anxiety amongst U.K. surgeons. We aim to identify the prevalence of surgical performance anxiety and the impact this is having on surgeons, both trainees and consultants. Those who would like to access our survey and work can do so through our website:

1. Burnout and surgeons. The Bulletin of the Royal College of Surgeons of England. 2019. 101(4), 134-136.
2. Thomas LR, Ripp JA, West CP. Charter on physician well-being. JAMA. 2018 Apr 17;319(15):1541-2.

Competing interests: No competing interests

19 September 2019
Robert L Miller
Plastic Surgery Registrar
Matthew Hotton & James Chan
The Surgical Psychology and Performance Group