Bretagne Lisa, Mosimann Stefanie, Roten Christine, Perrig Martin, Genné Daniel, Essig Manfred, Mancinetti Marco, Méan Marie, Darbellay Farhoumand Pauline, Huber Lars C, Weber Elisabeth, Knoblauch Christoph, Schoenenberger Andreas W, Frick Sonia, Wenemoser Eliane, Ernst Daniel, Bodmer Michael, Aujesky Drahomir, Baumgartner Christine
Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2023 Sep 28;18(9):e0290407. doi: 10.1371/journal.pone.0290407. eCollection 2023.
Burnout and low job satisfaction are increasing among the General Internal Medicine (GIM) workforce. Whether part-time compared to full-time clinical employment is associated with better wellbeing, job satisfaction and health among hospitalists remains unclear.
We conducted an anonymized cross-sectional survey among board-certified general internists (i.e. hospitalists) from GIM departments in 14 Swiss hospitals. Part-time clinical work was defined as employment of <100% as a clinician. The primary outcome was well-being, as measured by the extended Physician Well-Being Index (ePWBI), an ePWBI ≥3 indicating poor wellbeing. Secondary outcomes included depressive symptoms, mental and physical health, and job satisfaction. We compared outcomes in part-time and full time workers using propensity score-adjusted multivariate regression models.
Of 199 hospitalists invited, 137 (69%) responded to the survey, and 124 were eligible for analysis (57 full-time and 67 part-time clinicians). Full-time clinicians were more likely to have poor wellbeing compared to part-time clinicians (ePWBI ≥3 54% vs. 31%, p = 0.012). Part-time compared to full-time clinical work was associated with a lower risk of poor well-being in adjusted analyses (odds ratio 0.20, 95% confidence interval 0.07-0.59, p = 0.004). Compared to full-time clinicians, there were fewer depressive symptoms (3% vs. 18%, p = 0.006), and mental health was better (mean SF-8 Mental Component Summary score 47.2 vs. 43.2, p = 0.028) in part-time clinicians, without significant differences in physical health and job satisfaction.
Full-time clinical hospitalists in GIM have a high risk of poor well-being. Part-time compared to full-time clinical work is associated with better well-being and mental health, and fewer depressive symptoms.
普通内科（GIM）工作人员的职业倦怠和低工作满意度正在增加。与全职临床工作相比，兼职工作是否与住院医师更好的幸福感、工作满意度和健康状况相关尚不清楚。
我们对瑞士14家医院GIM科室的获得委员会认证的普通内科医生（即住院医师）进行了一项匿名横断面调查。兼职临床工作定义为作为临床医生的工作量<100%。主要结果是幸福感，通过扩展医生幸福感指数（ePWBI）来衡量，ePWBI≥3表明幸福感较差。次要结果包括抑郁症状、心理健康和身体健康以及工作满意度。我们使用倾向评分调整的多变量回归模型比较了兼职和全职工作人员的结果。
在199名受邀的住院医师中，137名（69%）回复了调查，124名符合分析条件（57名全职和67名兼职临床医生）。与兼职临床医生相比，全职临床医生幸福感较差的可能性更大（ePWBI≥3分别为54%和31%，p = 0.012）。在调整分析中，与全职临床工作相比，兼职临床工作与幸福感较差的风险较低相关（优势比0.20，95%置信区间0.07 - 0.59，p = 0.004）。与全职临床医生相比，兼职临床医生的抑郁症状较少（3%对18%，p = 0.006），心理健康状况更好（平均SF - 8心理健康综合评分47.2对43.2，p = 0.028），身体健康和工作满意度无显著差异。
GIM的全职临床住院医师幸福感较差的风险较高。与全职临床工作相比，兼职临床工作与更好的幸福感和心理健康以及更少的抑郁症状相关。
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