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Lack of control of work hours leads to burnout and physician dissatisfaction
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A new national survey of physicians has found that a lack of control of their work hours and schedule often leads to burnout, while many other difficult issues that physicians face do not seem to diminish their career satisfaction.

Results published at a time when many studies report widespread career discontent among physicians.

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Viewed against the backdrop of recent studies suggesting that dissatisfaction and burnout are on the rise among physicians, the results of this study by researchers at the University of Michigan Health System are particularly timely.

“The strongest predictors of whether physicians will experience burnout and career dissatisfaction are how much control they have over their schedules and over the total number of hours worked in a week,” says Kristie Keeton, M.D., MPH, a fellow in maternal-fetal medicine at the U-M Medical School Department of Obstetrics and Gynecology.

“The good news is that I think career satisfaction among physicians can be improved if we work toward ways that physicians can have more control over their schedules and their work hours,” continues Keeton, lead author of the study, which appears in the current issue of the journal Obstetrics & Gynecology.

Researchers began the study with a questionnaire sent to randomly selected physicians around the country, including internists, pediatricians, general surgeons, family practitioners and obstetrician-gynecologists. Results were based on the 935 completed surveys.

In general, the analysis of the results revealed that female and male physicians are highly satisfied with their careers. Both women and men reported moderate levels of satisfaction with work-life balance, moderate levels of emotional resilience and high levels of personal accomplishment.

Somewhat surprisingly to the researchers, the physicians’ work-life balance does not predict their satisfaction with their careers – that is, physicians can struggle with work-life balance and still remain highly satisfied with their careers. On the other hand, personal accomplishment and emotional resilience both were connected strongly with the level of the physicians’ career satisfaction.

Control over one’s schedule and the number of hours of work each week was tied to how the physicians felt about their personal accomplishment, emotional resilience and other factors that affect burnout and career satisfaction.

The results of the study occur at a time, Keeton notes, when the current generation of medical students, residents and junior faculty is believed to value time-off and a balanced life more than the “Boomer” generation tended to. Because of that, she says, this generation tends to be more interested in selecting specialties that allow for a controllable lifestyle.

The senior author of the paper was Rodney A. Hayward, M.D., professor in the Department of Internal Medicine at the U-M Medical School and the Department of Health Management and Policy at the U-M School of Public Health, and director of the VA Center for Practice Management and Outcomes Research. Other authors were Dee E. Fenner, M.D., professor in the Department of Obstetrics and Gynecology, and director of gynecology; and Timothy R.B. Johnson, M.D., chair of the Department of Obstetrics and Gynecology, and Bates Professor of the Diseases of Women and Children.

Funding for the research came from the Robert Wood Johnson Foundation, the Department of Veterans Affairs Health Services Research and Development Service, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. This work represents the research and views of the authors and does not necessarily represent the views or positions of the funding organizations.

Reference: Obstetrics & Gynecology, April 2007, 109: 949-955.

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