Troppmann Kathrin M, Palis Bryan E, Goodnight James E, Ho Hung S, Troppmann Christoph
Department of Surgery, University of California, Davis, 2221 Stockton Blvd, Sacramento, CA 95817, USA.
J Am Coll Surg. 2009 Aug;209(2):160-9. doi: 10.1016/j.jamcollsurg.2009.03.021.
Optimizing recruitment of the next surgical generation is paramount. Unfortunately, many nonsurgeons perceive surgeons' lifestyle as undesirable. It is unknown, however, whether the surgeons-important opinion makers about their profession-are indeed dissatisfied.
We analyzed responses to a survey mailed to all surgeons who were certified by the American Board of Surgery in 1988, 1992, 1996, 2000, and 2004. We performed multivariate analyses to study career dissatisfaction and inability to achieve work-life balance, while adjusting for practice characteristics, demographics, and satisfaction with reimbursement.
A total of 895 (25.5%) surgeons responded: mean age was 46 years; 80% were men; 88% were married; 86% had children; 45% were general surgeons; 72% were in urban practice; and 83% were in nonuniversity practice. Surgeons worked 64 hours per week; ideally, they would prefer to work 50 hours per week (median). Fifteen percent were dissatisfied with their careers. On multivariate analysis, significant (p < 0.05) risk factors were nonuniversity practice (odds ratio [OR] 3.3) and dissatisfaction with reimbursement (OR 5.9). Forty percent would not recommend a surgical career to their own children. On multivariate analysis, significant risk factors were nonuniversity practice (OR 2.5) and dissatisfaction with reimbursement (OR 3.4). In all, 33.5% did not achieve work-life balance. On multivariate analysis, dissatisfaction with reimbursement (OR 3.0) was a significant risk factor. Respondents' lives could be improved by "limiting emergency call" (77%), "diminishing litigation" (92%), and "improving reimbursement" (94%).
Most surgeons are satisfied with their careers. Areas in need of improvement, particularly for nonuniversity surgeons, include reimbursement, work hours, and litigation. Strong local and national advocacy may not only improve career satisfaction, but could also render the profession more attractive for those contemplating a surgical career.
优化下一代外科医生的招募至关重要。不幸的是，许多非外科医生认为外科医生的生活方式不理想。然而，作为其职业重要意见领袖的外科医生是否真的不满意尚不清楚。
我们分析了对邮寄给1988年、1992年、1996年、2000年和2004年获得美国外科委员会认证的所有外科医生的一项调查的回复。我们进行了多变量分析，以研究职业不满和无法实现工作与生活的平衡，同时对执业特征、人口统计学和对报销的满意度进行了调整。
共有895名（25.5%）外科医生回复：平均年龄为46岁；80%为男性；88%已婚；86%育有子女；45%为普通外科医生；72%在城市执业；83%在非大学附属医院执业。外科医生每周工作64小时；理想情况下，他们希望每周工作50小时（中位数）。15%的人对自己的职业不满意。在多变量分析中，显著（p<0.05）的风险因素是非大学附属医院执业（优势比[OR]3.3）和对报销不满意（OR 5.9）。40%的人不会向自己的孩子推荐外科职业。在多变量分析中，显著的风险因素是非大学附属医院执业（OR 2.5）和对报销不满意（OR 3.4）。总体而言，33.5%的人没有实现工作与生活的平衡。在多变量分析中，对报销不满意（OR 3.0）是一个显著的风险因素。通过“限制紧急呼叫”（77%）、“减少诉讼”（92%）和“改善报销”（94%）可以改善受访者的生活。
大多数外科医生对自己的职业感到满意。需要改进的方面，特别是对于非大学附属医院的外科医生，包括报销、工作时间和诉讼。强有力的地方和全国性宣传不仅可以提高职业满意度，还可以使该职业对那些考虑从事外科职业的人更具吸引力。
