Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings

Charles M. Balch, Tait D. Shanafelt, Jeff A Sloan, Daniel V. Satele, Julie A. Freischlag

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

OBJECTIVE(S): We compared distress parameters and career satisfaction from survey results of surgeons from 14 specialties practicing in an academic versus private practice environment. METHODS: The 2008 American College of Surgeons survey evaluated demographic variables, practice characteristics, career satisfaction, and distress parameters using validated instruments. RESULTS: The practice setting (academic vs. private practice) was independently associated with burnout in a multivariate (MV) analysis (odds ratio [OR] 1.172, P = 0.02). Academic surgeons were less likely to experience burnout compared to those in private practice (37.7% vs. 43.1%), less likely to screen positive for depression (27.6% vs. 33%) or to have suicide ideation (4.7% vs. 7.4%; all P < 0.0001). They were also more likely to have career satisfaction (77.4% of academic surgeons would become a surgeon again vs. 64.9% for those in private practice; P < 0.0001)) and to recommend a medical career to their children (61.3% vs. 43.7%, P < 0.0001). For academic surgeons, the most significant positive associations with burnout were: (1) trauma surgery (OR 1.513, P = 0.0059), (2) nights on call (OR 1.062, P = 0.0123), and (3) hours worked (OR 1.019, P < 0.0001), whereas the negative associations were: (1) having older children (>22 years; OR 0.529, P < 0.0001), (2) pediatric surgery (OR 0.583, P = 0.0053), (3) cardiothoracic surgery (OR 0.626, P = 0.0117), and (4) being male (OR 0.787, P = 0.0491). In a private practice setting, the most significant positive associations with burnout were: (1) urologic surgery (OR 1.497, P = 0.0086), (2) having 31% to 50% time for nonclinical activities (OR 1.404, P = 0.0409), (3) incentive based pay (OR 1.344, P < 0.0001), (4) nights on call (OR 1.045, P = 0.0029), and (5) hours worked (OR 1.015, P < 0.0001), whereas the negative associations were: (1) older children (OR 0.677, P = 0.0001), (2) physician spouse (OR 0.753, P = 0.0093), and (3) older age (OR 0.989, P = 0.0158). The independent factors relating to career satisfaction for surgeons in private practice and academic practice were also different. CONCLUSIONS: Factors associated with burnout were distinct for academic and private practice surgeons. Distress parameters were lower and career satisfaction higher for academic surgeons.

Original languageEnglish (US)
Pages (from-to)558-568
Number of pages11
JournalAnnals of Surgery
Volume254
Issue number4
DOIs
StatePublished - Oct 2011

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Surgical Specialties
Private Practice
Odds Ratio
Spouses
Suicide

ASJC Scopus subject areas

  • Surgery

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Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. / Balch, Charles M.; Shanafelt, Tait D.; Sloan, Jeff A; Satele, Daniel V.; Freischlag, Julie A.

In: Annals of Surgery, Vol. 254, No. 4, 10.2011, p. 558-568.

Research output: Contribution to journalArticle

Balch, Charles M. ; Shanafelt, Tait D. ; Sloan, Jeff A ; Satele, Daniel V. ; Freischlag, Julie A. / Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. In: Annals of Surgery. 2011 ; Vol. 254, No. 4. pp. 558-568.
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N2 - OBJECTIVE(S): We compared distress parameters and career satisfaction from survey results of surgeons from 14 specialties practicing in an academic versus private practice environment. METHODS: The 2008 American College of Surgeons survey evaluated demographic variables, practice characteristics, career satisfaction, and distress parameters using validated instruments. RESULTS: The practice setting (academic vs. private practice) was independently associated with burnout in a multivariate (MV) analysis (odds ratio [OR] 1.172, P = 0.02). Academic surgeons were less likely to experience burnout compared to those in private practice (37.7% vs. 43.1%), less likely to screen positive for depression (27.6% vs. 33%) or to have suicide ideation (4.7% vs. 7.4%; all P < 0.0001). They were also more likely to have career satisfaction (77.4% of academic surgeons would become a surgeon again vs. 64.9% for those in private practice; P < 0.0001)) and to recommend a medical career to their children (61.3% vs. 43.7%, P < 0.0001). For academic surgeons, the most significant positive associations with burnout were: (1) trauma surgery (OR 1.513, P = 0.0059), (2) nights on call (OR 1.062, P = 0.0123), and (3) hours worked (OR 1.019, P < 0.0001), whereas the negative associations were: (1) having older children (>22 years; OR 0.529, P < 0.0001), (2) pediatric surgery (OR 0.583, P = 0.0053), (3) cardiothoracic surgery (OR 0.626, P = 0.0117), and (4) being male (OR 0.787, P = 0.0491). In a private practice setting, the most significant positive associations with burnout were: (1) urologic surgery (OR 1.497, P = 0.0086), (2) having 31% to 50% time for nonclinical activities (OR 1.404, P = 0.0409), (3) incentive based pay (OR 1.344, P < 0.0001), (4) nights on call (OR 1.045, P = 0.0029), and (5) hours worked (OR 1.015, P < 0.0001), whereas the negative associations were: (1) older children (OR 0.677, P = 0.0001), (2) physician spouse (OR 0.753, P = 0.0093), and (3) older age (OR 0.989, P = 0.0158). The independent factors relating to career satisfaction for surgeons in private practice and academic practice were also different. CONCLUSIONS: Factors associated with burnout were distinct for academic and private practice surgeons. Distress parameters were lower and career satisfaction higher for academic surgeons.

AB - OBJECTIVE(S): We compared distress parameters and career satisfaction from survey results of surgeons from 14 specialties practicing in an academic versus private practice environment. METHODS: The 2008 American College of Surgeons survey evaluated demographic variables, practice characteristics, career satisfaction, and distress parameters using validated instruments. RESULTS: The practice setting (academic vs. private practice) was independently associated with burnout in a multivariate (MV) analysis (odds ratio [OR] 1.172, P = 0.02). Academic surgeons were less likely to experience burnout compared to those in private practice (37.7% vs. 43.1%), less likely to screen positive for depression (27.6% vs. 33%) or to have suicide ideation (4.7% vs. 7.4%; all P < 0.0001). They were also more likely to have career satisfaction (77.4% of academic surgeons would become a surgeon again vs. 64.9% for those in private practice; P < 0.0001)) and to recommend a medical career to their children (61.3% vs. 43.7%, P < 0.0001). For academic surgeons, the most significant positive associations with burnout were: (1) trauma surgery (OR 1.513, P = 0.0059), (2) nights on call (OR 1.062, P = 0.0123), and (3) hours worked (OR 1.019, P < 0.0001), whereas the negative associations were: (1) having older children (>22 years; OR 0.529, P < 0.0001), (2) pediatric surgery (OR 0.583, P = 0.0053), (3) cardiothoracic surgery (OR 0.626, P = 0.0117), and (4) being male (OR 0.787, P = 0.0491). In a private practice setting, the most significant positive associations with burnout were: (1) urologic surgery (OR 1.497, P = 0.0086), (2) having 31% to 50% time for nonclinical activities (OR 1.404, P = 0.0409), (3) incentive based pay (OR 1.344, P < 0.0001), (4) nights on call (OR 1.045, P = 0.0029), and (5) hours worked (OR 1.015, P < 0.0001), whereas the negative associations were: (1) older children (OR 0.677, P = 0.0001), (2) physician spouse (OR 0.753, P = 0.0093), and (3) older age (OR 0.989, P = 0.0158). The independent factors relating to career satisfaction for surgeons in private practice and academic practice were also different. CONCLUSIONS: Factors associated with burnout were distinct for academic and private practice surgeons. Distress parameters were lower and career satisfaction higher for academic surgeons.

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