A.L. Marshall is associate professor of medicine, Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0001-7388-0422.
L.N. Dyrbye is professor of medicine and medical education, Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Acad Med. 2020 Sep;95(9):1435-1443. doi: 10.1097/ACM.0000000000003521.
To explore the interaction between practice setting (academic practice [AP], private practice [PP]) and gender in relation to physician burnout and satisfaction with work-life integration (WLI).
In 2017, the authors administered a cross-sectional survey of U.S. physicians and characterized rates of burnout and satisfaction with WLI using previously validated and/or standardized tools. They conducted multivariable logistic regression to determine the interaction between the included variables.
Of the 3,603 participants in the final analysis, female physicians reported a higher prevalence of burnout than male physicians in both AP (50.7% vs 38.2%, P < .0001) and PP (48.1% vs 40.7%, P = .001). However, the multivariable analysis found no statistically significant gender-based differences in burnout (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.76-1.17, P = .60). Women and men in AP were less likely to report burnout than men in PP (OR 0.70, 95% CI 0.52-0.94, P = .01 and OR 0.69, 95% CI 0.53-0.90, P < .01, respectively); women in PP did not report different burnout rates from men in PP (OR 0.89, 95% CI 0.68-1.16, P = .38). Women in both AP and PP were less likely to be satisfied with WLI than men in PP (OR 0.62, 95% CI 0.47-0.83, P < .01 and OR 0.75, 95% CI 0.58-0.97, P = .03, respectively); men in AP did not report different satisfaction with WLI than men in PP (OR 1.05, 95% CI 0.82-1.33, P = .71).
Gender differences in rates of burnout are related to practice setting and other differences in physicians' personal and professional lives. These results highlight the complex relationships among gender, practice setting, and other personal and professional factors in their influence on burnout and satisfaction with WLI.
探讨实践环境（学术实践[AP]、私人实践[PP]）与性别之间的相互作用，以及它们与医生倦怠和工作-生活融合满意度（WLI）的关系。
2017 年，作者对美国医生进行了横断面调查，并使用先前经过验证和/或标准化的工具来描述倦怠和 WLI 满意度的发生率。他们进行了多变量逻辑回归分析，以确定纳入变量之间的相互作用。
在最终分析的 3603 名参与者中，女性医生在 AP（50.7%比 38.2%，P<.0001）和 PP（48.1%比 40.7%，P=.001）中的倦怠发生率均高于男性医生。然而，多变量分析并未发现性别与倦怠之间存在统计学上显著的差异（比值比[OR]0.94，95%置信区间[CI]0.76-1.17，P=.60）。AP 中的女性和男性医生比 PP 中的男性医生更不可能报告倦怠（OR 0.70，95%CI0.52-0.94，P=.01 和 OR 0.69，95%CI0.53-0.90，P<.01，分别）；PP 中的女性医生报告的倦怠率与 PP 中的男性医生没有差异（OR 0.89，95%CI0.68-1.16，P=.38）。AP 和 PP 中的女性医生比 PP 中的男性医生更不可能对 WLI 感到满意（OR0.62，95%CI0.47-0.83，P<.01 和 OR0.75，95%CI0.58-0.97，P=.03，分别）；AP 中的男性医生与 PP 中的男性医生对 WLI 的满意度没有差异（OR1.05，95%CI0.82-1.33，P=.71）。
倦怠发生率的性别差异与实践环境以及医生个人和职业生活中的其他差异有关。这些结果突出了性别、实践环境以及其他个人和职业因素之间的复杂关系，这些因素对倦怠和 WLI 的满意度都有影响。
