Surgeons' pressures may worsen shortage: study

NEW YORK Wed Jun 20, 2012 4:13pm EDT

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NEW YORK (Reuters Health) - Balancing work and personal responsibilities is a challenge for the majority of U.S. surgeons, and that struggle could lead them to cut back on their office hours or leave their practices altogether, according to a new survey.

Of 7,197 surgeons, more than 52 percent said they recently had a work-home conflict. About a quarter said they were likely to reduce their work hours within the next year and about a third said they planned to leave their practice within the next two years.

While surgeons believe cutting back or moving may help them, the researchers say it could signal trouble for the U.S., which is already facing a shortage of surgeons.

"There could be potential ramifications to patients in terms of access to care," said Dr. Liselotte Dyrbye, the study's lead author from the Mayo Clinic in Rochester, Minnesota. She said patients may have trouble getting in to see a doctor. Also, the health system may see increased costs thanks to physician turnover and the price to recruit and train new surgeons.

The findings, published in the Archives of Surgery, are the latest from a series of surveys of the American College of Surgeons (ACS), which previously found that alcoholism in not uncommon among surgeons and one in 16 have considered suicide (see Reuters Health articles of February 22, 2012 and January 18, 2011; reut.rs/Mro8VD and reut.rs/MrodsA).

"Integrating personal and professional lives is a big challenge for U.S. surgeons. Their ability to resolve work and home conflicts really relates to both important personal and professional factors," said Dyrbye.

In 2010, Dyrbye and her colleagues sent emails to ACS members that asked about their careers, burnout, depression, quality of life, alcohol abuse and how happy they were with the career and choices.

They found that surgeons who reported having a work-home conflict in the three weeks before taking the survey were more likely to work long hours, be women, have children and work in either an academic or Veterans Affairs medical center.

"They were also less likely to think surgery would be a good career option for their child," said Dyrbye.

Dyrbye said that's important, because about one in five medical students is the son or daughter of a doctor. That means their parents could influence them to turn away from medical school.

PERSONAL CONSEQUENCES

Beyond plans to cut office hours or leave their practice, surgeons who reported a recent work-home conflict were more likely to have certain troubles at home, too.

Overall, they were more likely to report feeling burned out and depressed, and said they had relationship difficulties and problems with alcohol.

Also, when they were asked about their quality of life, surgeons with a recent work-home conflict had worse scores than those without a conflict.

"It's not surprising to see some of these unhealthier behaviors in surgeons with these workplace characteristics," said Amanda Buhl from the Washington Physicians Health Program.

"We're never going to eliminate work-home conflicts, but what's important is how work-home conflicts are resolved," said Dyrbye.

She told Reuters Health that the data do not provide those answers, but she can speculate that there are a number of things surgeons and organizations can do to minimize the conflicts. Those include better scheduling and providing childcare onsite.

The researchers write that past research showed surgeons in the U.S. work an average of 60 hours per week, 16 hours in the operating room and are on call about two nights.

For her, Dyrbye said, it helps to get her child's school calendar as soon as it come out to block off days when she needs to be home or out of the office. But she admits that there will always be unexpected conflicts.

SOURCE: bit.ly/KzjxBG Archives of Surgery, online June 18, 2012.

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