Work week duration, work-family balance and difficulties encountered by female and male physicians: results from the French SESMAT study.

OBJECTIVE: France encounters difficulties attracting physicians to work in hospitals. Organisation at work and at home may be at the heart of the problem for female as well as for male physicians. PARTICIPANTS: A comprehensive questionnaire was filled out online by a representative sample of 1924 French hospital physicians. METHODS: We conducted gender bivariate and multivariate analysis of the risk factors for burnout and intent to leave the profession(ITL). RESULTS: ITL was declared by 17.4% of physicians. According to 41.3% of female physicians (FP), their profession was an obstacle to having children (versus 19.3% for male physicians (MP)). Major factors linked with burnout were Effort/Reward imbalance (FP adjOR = 5.09, MP adjOR = 5.93), Work-family conflicts (FP adjOR = 2.97, MP adjOR = 3.04), and Low quality of teamwork (FP adjOR = 1.82, MP adjOR = 2.68). Major factors linked with ITL were Low quality of teamwork (FP adjOR = 4.49, MP adjOR = 3.03), Patient-related burnout (FP adjOR = 2.10, MP adjOR = 2.35) and General burnout (FP adjOR = 1.85, MP adjOR = 1.45). CONCLUSIONS: Excessive job demands are linked with burnout and with work-family conflicts, conducting to difficulties in organising one's life in order to have and raise children. Potential solutions include facilitating teamwork in order to reduce departure, which increase workload on those who stay increasing their work family conflict.

Emergency physicians accumulate more stress factors than other physicians-results from the French SESMAT study.

INTRODUCTION: France is facing a shortage of available physicians due to a greying population and the lack of a proportional increase in the formation of doctors. Emergency physicians are the medical system's first line of defence. METHODS: The authors prepared a comprehensive questionnaire using established scales measuring various aspects of working conditions, satisfaction and health of salaried physicians and pharmacists. It was made available online, and the two major associations of emergency physicians promoted its use. 3196 physicians filled out the questionnaire. Among them were 538 emergency physicians. To avoid bias, 1924 physicians were randomly selected from the total database to match the demographic characteristics of France's physician population: 42.5% women, 57.5% men, 8.2% < 35 years old, 33.8% 35-44 years old, 34.5% 45-54 years old and 23.6% ≥ 55 years old. The distribution of physicians in the 23 administrative regions and by speciality was also precisely taken into account. This representative sample was used to compare subgroups of physicians by speciality. RESULTS: The outcomes indicate that the intent to leave the profession (ITL) was quite prevalent across French physicians and even more so among emergency physicians (17.4% and 21.4% respectively), and burnout was highly prevalent (42.4% and 51.5%, respectively). Among the representative sample and among emergency physicians, work-family conflict (OR=4.47 and OR=6.14, respectively) and quality of teamwork (OR=2.21 and OR=5.44, respectively) were associated with burnout in a multivariate analysis, and these risk factors were more prevalent among emergency physicians than other types. A serious lack of quality of teamwork appears to be associated with a higher risk of ITL (OR=3.92 among the physicians in the representative sample and OR=4.35 among emergency physicians), and burnout doubled the risk of ITL in multivariate analysis. CONCLUSIONS: In order to prevent the premature departure of French doctors, it is important to improve work-family balance, working processes through collaboration, multidisciplinary teamwork and to develop team training approaches and ward design to facilitate teamwork.

[Lactic acidosis and metformin implicated: why better information about risk factors?]. / Acidose lactique et metformine impliquée: pourquoi mieux informer sur les facteurs de risque?

In type II diabetes treated with metformin (Glucophage) lactic acidosis is a rare adverse reaction, fatal in approximately 50 per cent of cases. Metformin is implicated by plasma and intra-erythrocyte levels. An analysis is carried out on available information about this risk for healthcare professionals and for patients. A comparison is made of approved labelling information on Glucophage and its patient leaflets in France and in the USA and an analysis made of the differences. In France, Information given to physicians, pharmacists and patients on the risk of lactic acidosis where Glucophage is implicated must be improved, and on the interest of the metformin plasma level in this case. These are primary points because the issue for the few patients concerned may be fatal. Advice on self-medication may be introduced. The evolution of information provided on these risks depends on the pharmaceutical laboratory, government authorities and healthcare professionals.