American Surgical Association
2009 Annual Meeting Abstracts

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Burnout and Career Satisfaction Among American Surgeons; A Survey of 7905 ACS Members
Charles M Balch1, Gerald J. Bechamps2, Thomas R. Russell3, Julie A. Freischlag1, *Tait D. Shanafelt4, *Paul Collicott3
1Johns Hopkins Medical Institutions, Baltimore, MD;2Winchester Surgical Clinic, Winchester, VA;3American College of Surgeons, Chicago, IL;4Mayo Clinica, Rochester, MN

OBJECTIVE - to evaluate personal and professional characteristics associated with surgeon burnout
METHODS: American College of Surgeons members were surveyed using validated instruments and logistic regression tools.
RESULTS: Of the 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/week (all median #s). Overall, 40% of responding surgeons were burned out: 32% had high emotional exhaustion, 26% demonstrated high depersonalization, 13% had low sense of personal accomplishment and 30% of study participants screened positive for depression. Professional characteristics associated with a higher overall risk of burnout are shown in Table 1. 74% indicated they would become a surgeon again, but only 51% indicated they would recommend their children pursue a career as a physician/surgeon; only 36% felt their work schedule left enough time for personal/family life. Professional characteristics associated with greater satisfaction with career choice are shown in Table 2.
CONCLUSION: This study of physician burnout, the largest conducted to date, demonstrated that burnout is common among surgeons. A variety of personal and professional characteristics were related to burnout which was the single greatest predictor of surgeons’ satisfaction with their career and specialty choice.
Table 1. Factors Independently Associated with Burnout on Multi-variate Logistic Analysis
Characteristic and Associated FactorsOdds Ratio1P Value
Sub-specialty choice21.2-1.6All <0.013
Youngest child between age 5 and 2131.35-1.41All <0.002
Compensation = incentive pay based entirely on billing1.32<0.001
Spouse works as other healthcare professional1.270.002
# nights on call per week1.06<0.001
# years in practice1.03<0.001
Age (each additional year older)0.95<0.001
1 OR >1 indicate increased risk of burnout; OR<1 indicate lower risk of burnout
2 Trauma(OR=1.57); Urologic(OR=1.46); Otolaryngology (OR=1.38); Vascular(OR=1.36); General (OR 1.21)

Table 2: Factors Independently Associated with Satisfaction with Specialty and Career Choice on Mult
Characteristic and Associated FactorsOdds Ratio1P Value
Absence of Burnout4.57<0.001
Sub-specialty21.4-2.6All <0.015
Higher academic Rank31.4-2.1All <0.002v
Age (each additional year older)1.03<0.001
Hours per week in OR1.01<0.001
# nights on call per week0.970.008
1 OR>1 indicates greater satisfaction career/specialty choice; OR<1 indicate lower satisfaction career/specialty choice
2 Otolaryngology (OR=2.64), Transplant (OR=2.26), Plastic (OR=2.21), Ophthalmology (OR=2.16), Orthopedic (OR=2.09), Pediatric (OR=1.93), Urology (OR=1.90), Trauma (OR=1.80), Neuro (OR=1.65), Oncologic (OR=1.46
3 Full Professor (OR=2.09); Associate professor (OR=1.76); Assistant Professor (O=1.37)


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