ABSTRACT
BACKGROUND
Work–home conflicts (WHC) threaten work–life balance among physicians, especially those in dual career relationships. In this study, we analyzed factors associated with WHC for physicians and their employed partners.
METHODS
We surveyed 89,831 physicians from all specialty disciplines listed in the Physician Masterfile. Of the 7,288 (27.7 %) physicians who completed the survey, 1,644 provided the e-mail contact information of their partner. We surveyed these partners and 891 (54 %) responded. Burnout, quality of life (QOL), and depression were measured using validated instruments in both surveys. Satisfaction with career, work–life balance, and personal relationships, as well as experience of WHC were also evaluated.
RESULTS
WHC within the previous 3 weeks were commonly experienced by physicians and their employed partners (44.3 % and 55.7 %, respectively). On multivariate analysis, greater work hours for physicians and their employed partners were independently associated with WHC (OR 1.31 and 1.23 for each additional 10 h, respectively, both p < 0.0001). Physicians and partners who had experienced a recent WHC were more likely to have symptoms of burnout (47.1 % vs. 26.6 % for physicians with and without WHC; 42.4 % vs. 23.8 % for partners with and without WHC, both p < 0.0001).
CONCLUSIONS
WHC are commonly experienced by physicians and their employed partners. These conflicts may be a major contributor to personal distress for physicians and their partners.
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REFERENCES
Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work–life balance among U.S. physicians relative to the general U.S. population. Arch Intern Med. 2012;172:1377–85.
Dyrbye LN, Shanafelt TD, Balch C, Satele D, Freischlag F. Relationship between work–home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146:211–7.
Dyrbye LN, Freischlag J, Kaups KA, et al. Work home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012;147:933–9.
Dyrbye LN, West CP, Satele D, Sloan J, Shanafelt TD. Work–home conflict and burnout among academic internal medicine physicians. Arch Intern Med. 2011;171:1207–9.
Warde CM, Moonesinghe K, Allen W, Gelberg L. Marital and parental satisfaction of married physicians with children. J Gen Intern Med. 1999;14:157–65.
Warde C, Allen W, Gelberg L. Physician role conflict and resulting career changes. J Gen Intern Med. 1996;11:729–35.
Fabri PJ, McDaniel MD, Gaskill HV, Garison RN. Great expectations: stress and the medical family. J Surg Res. 1989;47:379–82.
Gabbard GO, Menninger RW, Coyne L. Sources of conflict in the medical marriage. Am J Psychiatry. 1987;144:567–72.
Spendlove DC, Reed BD, Whitman N, Slattery ML, French TK, Horwood K. Marital adjustment among house staff and new attorneys. Acad Med. 1990;65:599–603.
Moore EE. Swimming with the sharks-without the family being eaten alive. Surgery. 1990;108:125–38.
Sotile WM, Sotile MO. Physicians’ wives evaluate their marriages, their husbands, and life in medicine: results of the AMA-Alliance Medical Marriage Survey. Bull Menninger Clin. 2004;68:39–59.
Lewis JM, Barnhart F, David F. Marital satisfaction in the lives of physicians. Bull Menninger Clin. 1993;57:458–65.
The American Association for Public Opinion Research. Standard definitions. Final disposition of case codes and outcome rates for surveys. 2011. Available at: http://www.aapor.org/AM/Template.cfm?Section=Standard_Definitions2&Template=/CM/ContentDisplay.cfm&ContentID=3156, accessed 7/31/13.
Shanafelt T, Boone S, Dyrbye LN, et al. The medical marriage: a national survey of the spouse/partners of U.S. physicians. Mayo Clin Proc. 2013;88:216–25.
Levinson W, Tolle SW, Lewis C. Women in academic medicine. N Engl J Med. 1989;321:1511–7.
Mizgala CL, Mackinnon SE, Walters BC, Ferris LE, McNeill IY, Knighton T. Women surgeons. Results of the Canadian population study. Ann Surg. 1993;218:37–46.
West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306:952–60.
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto: Consulting Psychologists Press; 1996.
West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24:1318–21.
West CP, Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27:1445–52.
Grunberg SMGS, Steingass S, Zaretsky S, Meyerowitz B. Comparison of conditional quality of life terminology and visual analogue scale measurements. Qual Life Res. 1996;5:65–72.
Gudex CDP, Kind P, Williams A. Health state valuations from the general public using the visual analogue scale. Qual Life Res. 1996;5:521–31.
Hyland ME, Sodergren SC. Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res. 1996;5:469–80.
Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther. 1983;34:234–9.
Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227–36.
Bretscher M, Rummans T, Sloan J, Kaur J, Bartlett A, Borkenhagen L, Loprinzi C. Quality of life in hospice patients: a pilot study. Psychosomatics. 1999;40(4):309–13.
Shanafelt TD, Novotny P, Johnson ME, et al. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group. Oncology. 2005;68:23–32.
Rummans T, Clark MM, Sloan JA, et al. Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. J Clin Oncol. 2006;24:635–42.
Locke DE, Decker PA, Sloan JA, et al. Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. J Pain Symptom Manage. 2007;34:628–38.
West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302:1294–300.
Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994;272:1749–56.
Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12:439–45.
Norman GR, Sloan JA, Wyrwich KW. The truly remarkable universality of half a standard deviation: confirmation through another look. Expert Rev Pharmacoecon Outcomes Res. 2004;4:515–9.
Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714–21.
Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.
Campbell DA Jr, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery. 2001;130:696–702. discussion −5.
West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071–8.
Kelly EL, Moen P, Tranby E. Changing workplaces to reduce work-family conflict: schedule control in a white-collar organization. Am Sociol Rev. 2011;76:265–90.
Malin MH, Still MC, Milligan MK, Williams JC. Work/family conflict, union style: Labor arbitrations involving family care. Program on Worklife law. The Washington College of Law. 2004. Available at: http://worklifelaw.org/pubs/conflictunionstyle.pdf, accessed 7/24/2013.
Jagsi R, Griffith KA, Stewart A, Sambuco D, DeCastro R, Ubel PA. Gender differences in the salaries of physician researchers. JAMA. 2012;307:2410–7.
Ward K, Wolf-Wendel L. Academic Motherhood: How Faculty Manage Work and Family. New Brunswick: Rutgers Univeristy Press; 2012.
Fletcher RH, Fletcher SW. Here come the couples. Ann Intern Med. 1993;119:628–30.
Gautam M. Women in medicine: stresses and solutions. West J Med. 2001;174:37–41.
Keeton K, Fenner DE, Johnson TRB, Hayward RA. Predictors of physician career satisfaction, work–life balance, and burnout. Obstet Gynecol. 2007;109:949–55.
Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002;288:1447–50.
Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg. 2009;144:371–6.
Allegra C, Hall R, Yothers G. Prevalence of burnout in the U.S. oncology community: results of a 2003 survey. J Oncol Pract. 2005;1:140–7.
Kuerer HM, Eberlein TJ, Pollock RE, et al. Career satisfaction, practice patterns and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology. Ann Surg Oncol. 2007;14:3043–53.
Kellerman S, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med. 2001;20:61–71.
Asch D, Jedrziewski M, Christakis N. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–36.
Acknowledgements
Funding for this study was provided by the American Medical Association and the Mayo Clinic Department of Medicine Program on Physician Well-being.
Conflict of Interest
Dr. Wayne Sotile receives royalties from AMA Press for books “The Medical Marriage” and “The Resilient Physician”, and honoraria for speaking engagements to medical conferences, regarding burnout, resilience and work/life issues. All other authors declare no conflicts of interest.
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Dyrbye, L.N., Sotile, W., Boone, S. et al. A Survey of U.S. Physicians and Their Partners Regarding the Impact of Work–Home Conflict. J GEN INTERN MED 29, 155–161 (2014). https://doi.org/10.1007/s11606-013-2581-3
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DOI: https://doi.org/10.1007/s11606-013-2581-3