Just who is burning out ... Chairpersons or program directors?

To the Editor: Dr. De Oliveira et al. recently published an interesting manuscript discussing the apparent high incidence of burnout in academic anesthesiology chairpersons. Risk factors including low job satisfaction and spousal support were discussed at length, and the survey instrument used was attached as an Appendix (pp 189–93). While reading the article, I began to wonder if similar burnout risks applied to program directors, and I was surprised to see that the Appendix specifically asked questions of program directors, not program chairs. I assume that this was either part of a larger survey, or that the wrong Appendix was included with the manuscript; however, I was hoping the authors could comment on their thoughts on program director versus chairperson stress and burnout. Furthermore, did the authors receive comments or data from any of the anesthesiologists who serve as both program director and chair in their departments?