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Bretagne L, Mosimann S, Roten C, Perrig M, Genné D, Essig M, Mancinetti M, Méan M, Darbellay Farhoumand P, Huber LC, Weber E, Knoblauch C, Schoenenberger AW, Frick S, Wenemoser E, Ernst D, Bodmer M, Aujesky D, Baumgartner C. Association of part-time clinical work with well-being and mental health in General Internal Medicine: A survey among Swiss hospitalists. PLoS One 2023; 18:e0290407. [PMID: 37768911 PMCID: PMC10538797 DOI: 10.1371/journal.pone.0290407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/08/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION 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. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Lisa Bretagne
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefanie Mosimann
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Christine Roten
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Perrig
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Genné
- Department of Internal Medicine, Hospital of Biel-Bienne, Bienne, Switzerland
| | - Manfred Essig
- Department of General Internal Medicine, Tiefenau Hospital, Bern, Switzerland
| | - Marco Mancinetti
- Department of Medicine, University and Hospital of Fribourg, Fribourg, Switzerland
| | - Marie Méan
- Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | | | - Lars C Huber
- Department of General Internal Medicine, Stadtspital Zürich Triemli, Zürich, Switzerland
| | - Elisabeth Weber
- Department of General Internal Medicine, Stadtspital Zürich Waid, Zürich, Switzerland
| | - Christoph Knoblauch
- Department of General Internal Medicine, Hospital of Nidwalden, Stans, Switzerland
| | - Andreas W Schoenenberger
- Department of General Internal Medicine, Cantonal Hospital of Münsterlingen, Münsterlingen, Switzerland
| | - Sonia Frick
- Department of General Internal Medicine, Hospital of Limmattal, Schlieren, Switzerland
| | - Eliane Wenemoser
- Department of General Internal Medicine, Hospital Region of Oberaargau, Langenthal, Switzerland
| | - Daniel Ernst
- Department of General Internal Medicine, Hospital of Thun, Thun, Switzerland
| | - Michael Bodmer
- Department of General Internal Medicine, Cantonal Hospital of Zug, Baar, Switzerland
| | - Drahomir Aujesky
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christine Baumgartner
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Delpech R, Le Neindre C, Panjo H, Rigal L. Presence of Primary Care Physicians and Patients' Ability to Register: A Simulated-Patient Survey in the Paris Region. Ann Fam Med 2023; 21:341-343. [PMID: 37487733 PMCID: PMC10365859 DOI: 10.1370/afm.3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 07/26/2023] Open
Abstract
Using the health care system fully in some countries requires patients to register with a primary care physician (PCP). Public health policies measure PCP density to maintain satisfactory local PCP supplies and limit geographic inequalities. In an exhaustive simulated-patient survey in the Paris, France region, we analyzed how well presence of PCPs was associated with patients' ability to register for care. Of 5,188 census blocks, 55.4% had at least 1 PCP; however, only 38.6% had at least 1 PCP accepting registration for office visits, and only 19.4% had at least 1 PCP accepting registration for home visits (P <.001 across the 3 indicators). Cross-block inequalities in accepting registration were steeper than those related to PCP density, indicating that this density metric offers false reassurance and is inadequate to support policy decisions.
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Affiliation(s)
- Raphaëlle Delpech
- Department of General Practice, University of Paris-Saclay, Paris, France
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | - Charlène Le Neindre
- Institute for Research and Information in Health Economics (IRDES), Paris, France
- UMR 8504 Géographie-cités - Équipe PARIS, Paris, France
| | - Henri Panjo
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | - Laurent Rigal
- Department of General Practice, University of Paris-Saclay, Paris, France
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
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Maloney JA, D’Souza RS, Buckner Petty SA, Turkiewicz MJ, Sinha D, Patel A, Strand NH. Job Satisfaction Among Pain Medicine Physicians in the US. J Pain Res 2023; 16:1867-1876. [PMID: 37284326 PMCID: PMC10239623 DOI: 10.2147/jpr.s406701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
Purpose Data are lacking on the factors that contribute to job satisfaction among pain medicine physicians. We sought to determine how sociodemographic and professional characteristics relate to job satisfaction among pain medicine physicians. Methods In this nationwide, multicenter, cross-sectional observational study, an electronic questionnaire related to job satisfaction was emailed in 2021 to pain medicine physicians who were members of the American Society of Anesthesiologists or the American Society of Pain and Neuroscience. The 28-item questionnaire asked physicians about sociodemographic and professional factors. Eight questions related to job satisfaction were based on a 10-point Likert scale, and 1 question was a binary (yes/no) variable. Differences in responses based on sociodemographic and professional factors were assessed with the Kruskal-Wallis rank sum test for Likert scale questions and with the Pearson χ2 test for yes/no questions. Results We determined that several variables, including gender, parental status, geographic location, specialty, years of practice, and volume of patients, are associated with pain medicine physicians' outlook on job satisfaction. Overall, 74.9% of respondents surveyed would choose pain medicine as a specialty again. Conclusion High rates of poor job satisfaction persist among pain medicine physicians. This survey study identified several sociodemographic and professional factors that are associated with job satisfaction among pain medicine physicians. By identifying physicians at high risk for poor job satisfaction, healthcare leadership and occupational health agencies can aim to protect physicians' well-being, enhance working conditions, and raise awareness about burnout.
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Affiliation(s)
- Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Ryan S D’Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Debarshi Sinha
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Ajay Patel
- Department of Rehabilitation & Regenerative Medicine (Patel), New York-Presbyterian Hospital-University Hospital of Columbia and Cornell, New York, NY, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA
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Burnout, work engagement and work hours - how physicians' decision to work less is associated with work-related factors. BMC Health Serv Res 2023; 23:157. [PMID: 36793035 PMCID: PMC9930013 DOI: 10.1186/s12913-023-09161-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
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.
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Bodendieck E, Jung FU, Luppa M, Riedel-Heller SG. Burnout and work-privacy conflict - are there differences between full-time and part-time physicians? BMC Health Serv Res 2022; 22:1082. [PMID: 36002851 PMCID: PMC9404597 DOI: 10.1186/s12913-022-08471-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
Background Changes in everyday work with regard to working time models have reached the medical profession. The number of physicians working part-time is steadily increasing. At the same time, however, the population's need for care is also rising. This can reinforce the impending shortage of doctors in the future. The aim was to investigate differences in work-privacy conflict and burnout among physicians working full-time or part-time. Method The present study includes data from a baseline survey of the long-term study of physicians with different medical backgrounds. The analysis focused on a sub-sample of 598 physicians (not self-employed). The two main outcomes under investigation—burnout and work-privacy conflict—were measured using the Copenhagen Burnout Inventory adapted for health care professionals, as well as the associated subscale of the Copenhagen Psychosocial Questionnaire (COPSOQ). Data analyses included descriptive statistics followed by regression models. Results Descriptive analyses show, that 31.8% of physicians are working part-time, whereas 68.2% are working full-time. The part-time subsample is significantly older, and female physicians are more likely to work part-time. With regard to workload and work-privacy conflict, significant differences between part-time and full-time physicians were only observed in terms of work-privacy-conflict. However, regression analysis underline the importance of possible confounding variables (such as medical setting) within the relationship between job size and job-related well-being. Discussion Differences in working hour arrangements (full-time or part-time work) are only accompanied by less work-privacy conflict. No differences with regard to burnout (patient-related, work-related or personal) could be obtained. Rather, the data suggests that other job-related variables may play a role and should be further investigated.
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Affiliation(s)
- E Bodendieck
- General Practice, Dresdner Straße 34a, 04808, Wurzen, Germany
| | - F U Jung
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - M Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
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Liu J, Yu W, Ding T, Li M, Zhang L. Cross-sectional survey on job satisfaction and its associated factors among doctors in tertiary public hospitals in Shanghai, China. BMJ Open 2019; 9:e023823. [PMID: 30826758 PMCID: PMC6429855 DOI: 10.1136/bmjopen-2018-023823] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Doctors in public hospitals in China face considerable pressure and excessive workloads, which are likely to predispose them to job dissatisfaction. We explored the job satisfaction of doctors and examined the influence of diverse sociodemographic characteristics. DESIGN This was a cross-sectional study. SETTING Eleven tertiary public hospitals in Shanghai, China. PARTICIPANTS The questionnaire was designed based on the fifth National Health Service General Research, which was based on the Minnesota Satisfaction Questionnaire. Questionnaires were administered to 897 doctors randomly (using random number tables) and 730 were returned completed (response rate=81.4%). Doctors who volunteered and provided informed, written consent participated. PRIMARY OUTCOME MEASURES The dependent variable was doctors' job satisfaction. RESULTS Statistical analyses were conducted using SPSS and SAS. Overall, 64.8% of participants were dissatisfied with their jobs. Factors that were statistically significant to doctors' job satisfaction in the univariate analysis were entered into the logistic regression analysis, including doctors' professional title, department, work hours, work requirements (reflected as the number of patients they diagnosed and treated monthly), life and work stress, and the types of patients that doctors treated or expected to treat. The results of the logistic regression analysis suggested that doctors' job satisfaction was related to their professional title, types of patients that doctors treated or expected to treat, as well as their work stress. CONCLUSIONS There is an urgent need for public hospitals in China to establish a more reasonable promotion and management system for doctors, encourage patients to accept the two-way referral, pay more attention to less-experienced staff and help doctors release their work stress.
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Affiliation(s)
- Jiazhen Liu
- Shanghai Information Center for Health, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Wenya Yu
- College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Tao Ding
- College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Meina Li
- College of Military Health Service Management, Second Military Medical University, Shanghai, China
| | - Lulu Zhang
- College of Military Health Service Management, Second Military Medical University, Shanghai, China
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