Objective To evaluate factors associated with work-home conflicts (W-HC’s) of US surgeons and their potential personal and professional consequences.
Design Cross-sectional study.
Participants Members of the American College of Surgeons.
Main Outcome Measures Burnout, depression, quality of life, alcohol use, career satisfaction, and career decisions (i.e, reduce work hours or leave current practice).
Results Of 7197 participating surgeons, 3754 (52.5%) had experienced a W-HC in the previous 3 weeks. On multivariate analysis, hour worked per week, having children, sex, and work location (Veterans Administration or academic center) were independently associated with an increased risk for W-HC (all P <.01), while some factors (increased age and subspecialty field) reduced the risk. Surgeons with a recent W-HC were more likely to have symptoms of burnout (36.9% vs 17.1%; P
Conclusions Integrating personal and professional lives is a substantial challenge for US surgeons. Conflict in this balance appears to be a major factor in their decision to reduce work hours and/or move to a new practice, with potential substantive manpower implications for the surgical workforce.
US surgeons work an average of 60 hours per week, spend 16 hours in the operating room, and are on call 2 nights per week. 1 Although most are satisfied with their careers, few feel they have enough time for their personal and family lives. 2 In parallel with struggles to maintain a work-life balance, surgeons frequently experience home-work conflicts (W-HCs), with upwards of 62% of women and 48% of men surgeons reporting a substantial W-HC within the previous 3 weeks at the time of the 2008 American College of Surgeons (ACS) study.3 This high prevalence of W-HC is concerning given the link between W-HC and professional burnout and career dissatisfaction for both men and women surgeons 4 and academic internists. 5
Despite the high prevalence of W-HC and the potential serious implications, little remains known about factors contributing to W-HC, the personal consequences, and the extent of the professional ramifications. One strategy surgeons can use to reduce their W-HC is to reduce their clinical workload. Although such an approach may have personal benefits, it has serious potential workforce implications, especially as there is already a projected surgical workforce shortage of 33% in the United States by 2025. 6 Women surgeons, who often experience more W-HCs, 7 comprise a growing proportion of physicians in practice, 8 9 which could magnify this problem in the years ahead. In this present study, we (1) evaluate the relationship between W-HC and the personal and professional characteristics of US surgeons and (2) explore potential personal and professional ramifications of WHC.
1 Shanafelt TD, Balch CM, Bechamps GJ, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009:250 (3):463-471. 2 Ibid. 3 Dyrbe, LN, Shanafelt TD, Balch CM, Satele D, Sloan J, Freischlag J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146(2):211-217 4 Ibid. 5 Dyrbe LN, West CP, Satele D, Sloan JA, Shanafelt TD. Work/home conflict and burnout among acadmic internal medicine physicians. Arch Intern Med.2011;171(13):1207-1209 6 Dill MJ, Salsberg ES. Center for Workforce Studies, Association of American Medical Colleges. The complexities of physician supply and demand: projections through 2025. http://www.innovationlabs.com/pa_future/1/background_docs/AAMC %20Complexities%200f%20physician%200 7 Dyrbe LN, Shanafelt TD, Balch CM, Satele D, Sloan J, Freischlag J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg.2011;146(2):211-217 8 Whitcomb ME. The role of medical schools in graduate medical education. JAMA. 1994;272(9):702-704 9 Association of American Medical Colleges. 2008 Physician Specialty Data. https://www.aamc.org/download/47352/data/ specialtydata.pdf. Used with permission. Copyright (2012) American Medical Association. All rights reserved.