The Future of Pediatric Surgery-Women and Part Time?

[Working conditions in surgery and their impact : Results of a national survey]

BACKGROUND

In surgical disciplines poor working conditions and a high level of dissatisfaction among surgeons in the various disciplines have been reported. The psychological consequences of these conditions on the surgeons themselves and the effects on their families have so far been inadequately considered.

OBJECTIVE

The objective of this national survey of the Professional Association of German Surgery (Berufsverband der Deutschen Chirurgie e. V.) was to determine the current status of working conditions in surgical departments of German hospitals and to demonstrate their psychological and familial effects.

MATERIAL AND METHODS

In the period January-February 2024 a questionnaire with 26 questions focusing on psychological stress, work-related partnership and family problems as well as addictive behavior was sent to all members of the Berufsverband der Deutschen Chirurgie e. V. and to all German surgical societies.

RESULTS

A total of 2221 questionnaires could be analyzed. Among the survey participants, bureaucracy (84.4%) and inadequate compensation for overtime (68.1%) were seen as the main stress factors. Alcohol (20.3%), nicotine (8.9%) and medication (8.3%) were cited as ways of managing the workload. Of the surgeons 60% reported a negative impact on their relationship with their partner and 40% on their relationship with their children.

DISCUSSION

The surgeons reported poor working conditions. These have a massive impact on the mental health of surgeons and on their family relationships. Consequently, many surgeons consider leaving the surgical profession. To improve this situation and to make the surgical profession attractive again, a drastic rethinking is needed.

[Physician working hours and effects on health, satisfaction and healthcare]

Changes in the working environment with respect to innovative working time models are also increasingly affecting patient care. The number of physicians working part-time, for example, is continuously rising. At the same time, a general increase in chronic diseases and multimorbid conditions as well as the growing shortage of medical staff, leads to more workload and dissatisfaction among this profession. This short overview summarizes the current study situation and associated consequences regarding working hours of physicians and gives a first explorative overview of possible solutions.

Burnout, work engagement and work hours - how physicians' decision to work less is associated with work-related factors

BACKGROUND

According to new estimates, the health care sector will suffer a shortage of physicians in primary and specialty care. In this context, work engagement and burnout are two constructs that have gained attention recently. The aim of this study was to investigate how these constructs are related to work hour preference.

METHOD

The present study was based on the baseline survey of the long-term study of physicians with different specialties, in which 1,001 physicians took part (response rate: 33.4%). Burnout was measured using the Copenhagen Burnout Inventory adapted for health care professionals; work engagement was assessed using the Utrecht Work Engagement scale. Data analyses included regression and mediation models.

RESULTS

Overall, 297 out of 725 physicians were planning to cut down work hours. Several reasons - such as burnout - are discussed. According to multiple regression analyses desire to work less hours was significantly linked to all three dimensions of burnout (p < 0.001), as well as work engagement (p = 0.001). In addition, work engagement significantly mediated the relationship between the burnout dimensions on work hour reduction (patient-related: b = - 0.135, p < 0.001; work-related: b = - 0.190, p < 0.001; personal: b = - 0.133, p < 0.001 ).

DISCUSSION

Physicians tending to reduce work hours exhibited different levels of work engagement as well as burnout (personal, patient- and work-related). Moreover, work engagement influenced the relationship between burnout and work hour reduction. Therefore, interventions that increase work engagement may positively impact negative effects of burnout on work hour changes.

Challenges of the COVID-19 Pandemic for the Work–Family Balance of Pediatric Surgeons

The COVID-19 pandemic has been a great challenge, especially for families. We aimed to analyze the impact of the pandemic on childcare for and the work–family balance of pediatric surgeons in Germany. An anonymized questionnaire on the working and familial situation before and during the COVID-19 pandemic was sent to the members of the German Society of Pediatric Surgery and trainees in pediatric surgery (April–July 2021). One-hundred-fifty-three participants (59% female) completed the questionnaire. A total of 16% of the males and 62% of the females worked part-time. Most (68%) had underage children. During the COVID-19 pandemic, 36% reported a decrease in patients and interventions, and 55% reported an increase in the organizational work-related burden. Childcare for underage children during lockdown was organized mainly with the help of institutional emergency childcare (45%), staying home (34%), one parent working from a home office (33%), or staying home by themselves (34%). Before the lockdown, 54% reported a good work–family balance. During the lockdown, this worsened by 42%. Most of the families had to organize themselves. Different means such as a home office, flexible working hours, and different models for childcare can help to improve the situation.