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This narrative review identifies the most commonly reported EHR-related contributors among U.S. surgeons across four domains: documentation burden, time demands (including after-hours work), electronic messaging/in-basket load, and usability. Review findings quantify domain frequencies and summarize available magnitude measures, then propose surgeon- and system-level mitigation and call for future prospective studies.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/electronic-health-record-burnout-in-surgery-and-strategies-to-improve-burnout-a-narrative-review/423081/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/electronic-health-record-burnout-in-surgery-and-strategies-to-improve-burnout-a-narrative-review/423081.png","ImageObject",300,407,{"name":42,"@type":43},"moss~","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What EHR-related domains were used to characterize burnout contributors?","Question",{"text":63,"@type":64},"The review pre-specifies four domains: documentation burden, time demands (including after-hours use), electronic messaging/in-basket load, and usability.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which EHR-related contributors were most frequently reported in U.S. surgical literature?",{"text":68,"@type":64},"Across included studies, documentation burden and time demands were most frequently reported, with additional contributions from electronic messaging and usability.",{"name":70,"@type":61,"acceptedAnswer":71},"What practical strategies does the review recommend to mitigate EHR-related burnout?",{"text":72,"@type":64},"Mitigation includes surgeon-facing efficiency tactics such as templates and dictation plus team inbox protocols, together with system-level usability improvements and policy reforms.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},423081,1790791063,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review began 10/21/2025  \nReview ended 11/21/2025  \nPublished 12/04/2025  \n© Copyright 2025  \nKarwoski et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98469  \nOpen Access Review Article  \nElectronic Health Record Burnout in Surgery and Strategies to Improve Burnout: A Narrative Review  \nAllison Karwoski 1, Nicholas Hricz 1, Kevin Schlidt 2, Yvonne M. Rasko 1  \n1. Department of Surgery, Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, USA 2. Surgery, Sinai Hospital of Baltimore, Baltimore, USA  \nCorresponding author: Allison Karwoski, [allisonk0314@gmail.com](allisonk0314@gmail.com)  \nAbstract  \nPhysician burnout is a prevalent occupational syndrome characterized by emotional exhaustion, depersonalization, and diminished professional efficacy. Use of electronic health records (EHRs; also termed EMRs) has been associated with provider burnout in multiple settings. This review characterizes the most frequently reported EHR‑related contributors to burnout among U.S. surgeons across the following four domains: documentation burden, time demands (including after‑hours work), electronic  \nmessaging/in‑basket load, and usability. We searched PubMed for English-language, U.S. articles published from January 2004 to April 2024 . Two reviewers independently screened and domain‑coded with consensus resolution. We report domain frequencies as n (%) with 95% confidence intervals (CIs) (Wilson) and summarize study‑level magnitudes where available (e.g., hours/day in EHR, after‑hours share, message volume, odds ratios) . Of the 207 screened records, 25 were included across general, vascular, orthopedics, otolaryngology, surgical oncology, and the surgical intensive care unit. Domain frequencies: documentation, 15/25 = 60 .0%(95% CI = 40 .7-76.6); time demands, 17/25 = 68 .0%(95% CI = 48 .4-82.8); electronic messaging, 8/25 = 32 .0%(95% CI = 17.2-51.6); and usability, 4/25 = 16.0%(95% CI = 6 .4-34. 7) . None of the included studies explicitly assessed medicolegal contributors. Examples of magnitudes included EHR hours/day and remote/after‑hours EHR use, message volumes and timing, and fatigue/efficiency markers. In U.S. surgical literature, EHR‑related burnout is most frequently reported in association with documentation burden and time demands, with additional contributions from electronic messaging and usability. Practical mitigation includes surgeon‑facing efficiency tactics (templates, dictation, team inbox protocols) alongside system‑level usability improvements and policy reforms. Further prospective and interventional evaluations are needed.  \nCategories: General Surgery, Healthcare Technology  \nKeywords: burnout, documentation burden, electronic health record, physician well-being, surgery, usability  \nIntroduction And Background  \nElectronic health record (EHR) systems, also termed electronic medical records (EMRs), were introduced to improve clinical efficiency, accessibility, and reliability of patient information [1] . First introduced in the 1970s, EHR use has increased steadily, with broad adoption across U.S. hospitals and office-based practices [2] . EHRs have been linked to increased adherence to evidence-based care and safety improvements, including fewer medication errors, fewer unnecessary tests, improved anticoagulation prophylaxis adherence, increased vaccination rates, and lower mortality [3-7]. Recent narrative reviews of physician and medical student burnout further underscore the need for multilevel strategies to address this syndrome [8] . However, integration into clinical workflow can be associated with burnout among surgical professionals. The magnitude of this association varies by specialty, role, and study design [9-11].  \nPhysician burnout is a preva","cbCaivXdTJZ0gbnR","https://ap.wps.com/l/cbCaivXdTJZ0gbnR","pdf",582385,14,"English","# Introduction And Background\n## Burnout overview and impact on surgeons\n## EHRs and workflow integration\n# Review\n## How to cite this article\n## Methodology\n## Search criteria","[{\"question\":\"What EHR-related domains were used to characterize burnout contributors?\",\"answer\":\"The review pre-specifies four domains: documentation burden, time demands (including after-hours use), electronic messaging/in-basket load, and usability.\"},{\"question\":\"Which EHR-related contributors were most frequently reported in U.S. surgical literature?\",\"answer\":\"Across included studies, documentation burden and time demands were most frequently reported, with additional contributions from electronic messaging and usability.\"},{\"question\":\"What practical strategies does the review recommend to mitigate EHR-related burnout?\",\"answer\":\"Mitigation includes surgeon-facing efficiency tactics such as templates and dictation plus team inbox protocols, together with system-level usability improvements and policy reforms.\"}]","Electronic Health Record Burnout in Surgery and Strategies to Improve Burnout - A Narrative Review | PDF",1790630079,35]