Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce

Arch Surg. 2012 Oct;147(10):933-9. doi: 10.1001/archsurg.2012.835.


Objective: To evaluate factors associated with work-home conflicts (W-HCs) of US surgeons and their potential personal and professional consequences.

Design: Cross-sectional study.

Participants: Members of the American College of Surgeons.

Main outcome measures: Burnout, depression, quality of life, alcohol use, career satisfaction, and career decisions (ie, reduce work hours or leave current practice).

Results: Of 7197 participating surgeons, 3754 (52.5%) had experienced a W-HC in the previous 3 weeks. On multivariate analysis, hours worked per week, having children, sex, and work location (Veterans Administration or academic center) were independently associated with an increased risk for W-HC (all P < .01), while some factors (increased age and subspecialty field) reduced the risk. Surgeons with a recent W-HC were more likely to have symptoms of burnout (36.9% vs 17.1%; P < .001), depression (50.9% vs 28.1%; P < .001), alcohol abuse/dependency (17.2% vs 14.4%; P = .003), and were less likely to recommend surgery as a career option to their children (46.0% vs 54.4%; P < .001). Work-home conflicts were also independently associated with surgeons reporting a moderate or higher likelihood of planning to reduce clinical work hours (odds ratio, 1.769) and leave their current practice in the next 24 months for a reason other than retirement (odds ratio, 1.706) after controlling for other personal and professional factors.

Conclusions: Integrating personal and professional lives is a substantial challenge for US surgeons. Conflict in this balance appears to be a major factor in their decision to reduce work hours and/or move to a new practice, with potential substantive manpower implications for the surgical workforce.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcoholism / epidemiology
  • Burnout, Professional / epidemiology*
  • Burnout, Professional / psychology*
  • Career Mobility
  • Comorbidity
  • Cross-Sectional Studies
  • Family / psychology
  • Family Conflict / psychology*
  • Female
  • Humans
  • Incidence
  • Job Satisfaction*
  • Life Change Events
  • Life Style*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Physicians, Women / psychology
  • Physicians, Women / trends
  • Population Surveillance
  • Practice Patterns, Physicians' / trends
  • Quality of Life
  • Risk Assessment
  • Risk Reduction Behavior
  • Specialties, Surgical / statistics & numerical data*
  • Specialties, Surgical / trends
  • Work Schedule Tolerance / psychology
  • Workforce