Kathrin M. Troppmann, MD, FACS, associate professor in the department of surgery at the University of California–Davis Health System, in Sacramento, presented the results here at the American College of Surgeons 94th Annual Clinical Congress.
The survey was undertaken “to study surgeons’ satisfaction with lifestyle and career,” and “to study risk factors for dissatisfaction and inability to achieve a work–life balance.” A major impetus for the survey was a current mismatch: there is a decreasing supply of surgeons resulting largely from medical students’ concerns about surgeons’ lifestyles, and an increasing demand for surgeons based on population growth and aging. Career satisfaction and attitudes toward their lifestyle influence the recruitment of new surgeons from medical students and the retention of those already practicing.
Despite some areas of dissatisfaction, Dr. Troppmann told Medscape General Surgery that the survey "shows that surgeons are very satisfied with their lives and that...75% would choose surgery again.”
The 56-item survey was mailed to all surgeons who were certified by the American Board of Surgery in 1988, 1992, 1996, 2000, and 2004. Multivariate analysis was used to explore covariation between career dissatisfaction and work–life balance and a spectrum of demographic and professional factors. Satisfaction with reimbursement (yes or no) was also included in the analysis.
The average age of the 895 respondents was 45.6 years, and 79.7% were male and 20.3% were female. The respondents were grouped into those who were ABS-certified in 1988, 1992, or 1996, and those who were ABS-certified in 2000 or 2004. Location of the surgical practice was compared (university/Veteran’s Administration [VA] setting vs nonuniversity/non-VA setting). Similarly, urban and rural locations were compared.
“I would have thought perhaps that rural surgeons might be somewhat more dissatisfied, but in fact they were not — it was not significant,” noted Dr. Troppmann.
Results showed that the average respondent worked a median of 64 hours a week, but regarded 50 hours per week as ideal. Overall, 59% of those responding “felt that they worked too many hours.” A median of 20 hours per week were spent with family and friends, and 4 hours per week were spent on hobbies/recreation. Of the respondents, 68.5% were satisfied with the amount of time spent with family and friends, but only 40.5% were satisfied with the amount of time spent in hobbies/recreation.
Only 25.8% of respondents were satisfied with their reimbursement with respect to the total number of hours worked, only 15.7% were satisfied in light of their unpredictable schedule, and a meager 13.7% were satisfied with reimbursement considering their responsibility for patients’ health and lives.
Despite obvious areas of dissatisfaction, 85.0% of respondents were satisfied overall with their career as a surgeon. Satisfaction with specific aspects of a surgical career (for instance, technical aspects, helping others, and surgical colleagues) was expressed by 96.5%, 93.2%, and 72.6% of respondents, respectively. However, 2 significant risk factors for dissatisfaction were reimbursement and practice setting (university vs nonuniversity) (P < .001 for each).
The leading areas requiring improvement in surgeons’ quality of life were reimbursement (93.4%), diminish litigation (92.3%), and exclude/minimize emergency calls (76.1%). Dissatisfaction with reimbursement was also a risk factor for career dissatisfaction, work–life imbalance, and “nonrecommendation of surgical career to own children.”
Medscape General Surgery spoke with the session moderator, Amy B. Reed, MD, FACS, associate professor in the division of vascular surgery at the University of Cincinnati, in Ohio. “It’s a very hot topic, and timely, because when medical students are looking to determine their careers, career satisfaction is very important, particularly if you’re a role model or mentor and you’re not very satisfied. If you find that a larger percentage are not satisfied, how can you project a positive view of your field to those behind you?” asked Dr. Reed. “I’m worried that [the people who aren’t satisfied are] the people who are showing their faces to our upcoming students.... They might not choose our path because these role models are unhappy.”
Dr. Troppmann concluded her presentation by urging advocacy by surgeons and their professional organizations in the areas that need most change to improve the quality of life — all 3 areas are primarily policy issues. Changes in these areas will increase career satisfaction for current surgeons and make the profession more attractive to others contemplating a surgical career.
Neither Dr. Troppmann nor Dr. Reed disclosed any relevant financial relationships.
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