The Physician Attrition Crisis: A Cross-Sectional Survey of the Risk Factors for Reduced Job Satisfaction Among US Surgeons.

INTRODUCTION: A physician shortage is on the horizon, and surgeons are particularly vulnerable due to attrition. Reduced job satisfaction leads to increased job turnover and earlier retirement. The purpose of this study is to delineate the risk factors that contribute to reduced job satisfaction. METHODS: A cross-sectional survey of US surgeons was conducted from September 2016 to May 2017. Screening for job satisfaction was performed using the abridged Job in General scale. Respondents were grouped into more and less satisfied using the median split. Twenty-five potential risk factors were examined that included demographic, occupational, psychological, wellness, and work-environment variables. RESULTS: Overall, 993 respondents were grouped into more satisfied (n = 502) and less satisfied (n = 491) cohorts. Of the demographic variables, female gender and younger age were associated with decreased job satisfaction (p = 0.003 and p = 0.008). Most occupational variables (specialty, experience, academics, practice size, payment model) were not significant. However, increased average hours worked correlated with less satisfaction (p = 0.008). Posttraumatic stress disorder, burnout, wellness, all eight work-environment variables, and unhappiness with career choice were linked to reduced job satisfaction (p = 0.001). CONCLUSION: A surgeon shortage has serious implications for health care. Job satisfaction is associated with physician retention. Our results suggest women and younger surgeons may be at increased risk for job dissatisfaction. Targeted work-environment interventions to reduce work-hours, improve hospital culture, and provide adequate financial reimbursement may promote job satisfaction and wellness.

PTSD and surgical residents: Everybody hurts sometimes.

BACKGROUND: We aim to evaluate the prevalence of PTSD, its association with physician burnout, and risk factors for PTSD among surgical residents. METHODS: A cross-sectional national survey of surgical residents was conducted screening for PTSD. Causative traumatic stressors were queried, and thirty-one potential risk factors for PTSD were evaluated. RESULTS: A positive PTSD screen (PTSD+) was found in 22% of 582 surgical residents, and an additional 35% were "at risk" for PTSD. Traumatic experiences occurred most commonly as a PGY1, and the most common stressor was bullying. An increase in average hours of work per week (p < 0.001), a high-risk screen for PBO (p < 0.001), and feeling unhealthy (p = 0.001) were associated with an increasing prevalence of screening PTSD+. CONCLUSIONS: The prevalence of screening PTSD+ among surgical residents (22%) was more than three times the general population. Increased work-hours, a high-risk PBO screen, and reduced resident wellness were associated with screening PTSD+.