Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey

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  • 1 School of Medicine, Wake Forest University, Winston-Salem, North Carolina;
  • | 2 Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; 
  • | 3 Departments of Neurosurgery,
  • | 4 Neurology, and
  • | 5 Clinical Pharmacy, University of Tennessee Health Science Center;
  • | 6 Semmes-Murphey Neurologic & Spine Institute;
  • | 8 Le Bonheur Neuroscience Institute, Le Bonheur Children's Hospital, Memphis; and
  • | 7 Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee
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OBJECT

The object of this study was to identify and quantify predictors of burnout and career satisfaction among US neurosurgeons.

METHODS

All US members (3247) of the American Association of Neurological Surgeons (AANS) were invited to participate in a survey between September and December 2012. Responses were evaluated through univariate analysis. Factors independently associated with burnout and career satisfaction were determined using multivariable logistic regression. Subgroup analysis of academic and nonacademic neurosurgeons was performed as well.

RESULTS

The survey response rate was 24% (783 members). The majority of respondents were male, 40–60 years old, in a stable relationship, with children, working in a group or university practice, and trained in a subspecialty. More than 80% of respondents reported being at least somewhat satisfied with their career, and 70% would choose a career in neurosurgery again; however, only 26% of neurosurgeons believed their professional lives would improve in the future, and 52% believed it would worsen. The overall burnout rate was 56.7%. Factors independently associated with both burnout and career satisfaction included achieving a balance between work and life outside the hospital (burnout OR 0.45, satisfaction OR 10.0) and anxiety over future earnings and/or health care reform (burnout OR 1.96, satisfaction OR 0.32). While the burnout rate for nonacademic neurosurgeons (62.9%) was higher than that for academic neurosurgeons (47.7%), academicians who had practiced for over 20 years were less likely to be satisfied with their careers.

CONCLUSIONS

The rates of burnout and career satisfaction were both high in this survey study of US neurosurgeons. The negative effects of burnout on the lives of surgeons, patients, and their families require further study and probably necessitate the development of interventional programs at local, regional, and even national levels.

ABBREVIATIONS

AANS = American Association of Neurological Surgeons; AUC = area under the curve; CSNS = Council of State Neurosurgical Societies; MBI = Maslach Burnout Inventory; PPACA = Patient Protection and Affordable Care Act.

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  • 1

    Balch CM, & Copeland E: Stress and burnout among surgical oncologists: a call for personal wellness and a supportive workplace environment. Ann Surg Oncol 14:30293032, 2007

    • Search Google Scholar
    • Export Citation
  • 2

    Balch CM, , Freischlag JA, & Shanafelt TD: Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg 144:371376, 2009

    • Search Google Scholar
    • Export Citation
  • 3

    Balch CM, , Oreskovich MR, , Dyrbye LN, , Colaiano JM, , Satele DV, & Sloan JA, et al.: Personal consequences of malpractice lawsuits on American surgeons. J Am Coll Surg 213:657667, 2011

    • Search Google Scholar
    • Export Citation
  • 4

    Balch CM, & Shanafelt TD: Burnout among surgeons: whether specialty makes a difference. Arch Surg 146:385386, 2011

  • 5

    Balch CM, , Shanafelt TD, , Dyrbye L, , Sloan JA, , Russell TR, & Bechamps GJ, et al.: Surgeon distress as calibrated by hours worked and nights on call. J Am Coll Surg 211:609619, 2010

    • Search Google Scholar
    • Export Citation
  • 6

    Balch CM, , Shanafelt TD, , Sloan J, , Satele DV, & Kuerer HM: Burnout and career satisfaction among surgical oncologists compared with other surgical specialties. Ann Surg Oncol 18:1625, 2011

    • Search Google Scholar
    • Export Citation
  • 7

    Balch CM, , Shanafelt TD, , Sloan JA, , Satele DV, & Freischlag JA: Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. Ann Surg 254:558568, 2011

    • Search Google Scholar
    • Export Citation
  • 8

    Bertges Yost W, , Eshelman A, , Raoufi M, & Abouljoud MS: A national study of burnout among American transplant surgeons. Transplant Proc 37:13991401, 2005

    • Search Google Scholar
    • Export Citation
  • 9

    Bittner JG IV, , Khan Z, , Babu M, & Hamed O: Stress, burnout, and maladaptive coping: strategies for surgeon well-being. Bull Am Coll Surg 96:1722, 2011

    • Search Google Scholar
    • Export Citation
  • 10

    Bressi C, , Porcellana M, , Gambini O, , Madia L, , Muffatti R, & Peirone A, et al.: Burnout among psychiatrists in Milan: a multicenter survey. Psychiatr Serv 60:985988, 2009

    • Search Google Scholar
    • Export Citation
  • 11

    Campbell DA Jr, , Sonnad SS, , Eckhauser FE, , Campbell KK, & Greenfield LJ: Burnout among American surgeons. Surgery 130:696705, 2001

  • 12

    Chen KY, , Yang CM, , Lien CH, , Chiou HY, , Lin MR, & Chang HR, et al.: Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci 10:14711478, 2013

    • Search Google Scholar
    • Export Citation
  • 13

    Cruz OA, , Pole CJ, & Thomas SM: Burnout in chairs of academic departments of ophthalmology. Ophthalmology 114:23502355, 2007

  • 14

    Deckard GJ, , Hicks LL, & Hamory BH: The occurrence and distribution of burnout among infectious diseases physicians. J Infect Dis 165:224228, 1992

    • Search Google Scholar
    • Export Citation
  • 15

    Dyrbye LN, & Shanafelt TD: Physician burnout: a potential threat to successful health care reform. JAMA 305:20092010, 2011

  • 16

    Dyrbye LN, , Shanafelt TD, , Balch CM, , Satele D, , Sloan J, & Freischlag J: Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg 146:211217, 2011

    • Search Google Scholar
    • Export Citation
  • 17

    Dyrbye LN, , Varkey P, , Boone SL, , Satele DV, , Sloan JA, & Shanafelt TD: Physician satisfaction and burnout at different career stages. Mayo Clin Proc 88:13581367, 2013

    • Search Google Scholar
    • Export Citation
  • 18

    Dyrbye LN, , West CP, , Satele D, , Sloan JA, & Shanafelt TD: Work/home conflict and burnout among academic internal medicine physicians. Arch Intern Med 171:12071209, 2011

    • Search Google Scholar
    • Export Citation
  • 19

    Firth-Cozens J, & Greenhalgh J: Doctors' perceptions of the links between stress and lowered clinical care. Soc Sci Med 44:10171022, 1997

    • Search Google Scholar
    • Export Citation
  • 20

    Haas JS, , Cook EF, , Puopolo AL, , Burstin HR, , Cleary PD, & Brennan TA: Is the professional satisfaction of general internists associated with patient satisfaction?. J Gen Intern Med 15:122128, 2000

    • Search Google Scholar
    • Export Citation
  • 21

    Jones JW, , Barge BN, , Steffy BD, , Fay LM, , Kunz LK, & Wuebker LJ: Stress and medical malpractice: organizational risk assessment and intervention. J Appl Psychol 73:727735, 1988

    • Search Google Scholar
    • Export Citation
  • 22

    Kent GG, & Johnson AG: Conflicting demands in surgical practice. Ann R Coll Surg Engl 77:5 Suppl 235238, 1995

  • 23

    Klimo P Jr, , DeCuypere M, , Ragel BT, , McCartney S, , Couldwell WT, & Boop FA: Career satisfaction and burnout among U.S. neurosurgeons: a feasibility and pilot study. World Neurosurg 80:e59e68, 2013

    • Search Google Scholar
    • Export Citation
  • 24

    Krasner MS, , Epstein RM, , Beckman H, , Suchman AL, , Chapman B, & Mooney CJ, et al.: Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA 302:12841293, 2009

    • Search Google Scholar
    • Export Citation
  • 25

    Kuerer HM, , Eberlein TJ, , Pollock RE, , Huschka M, , Baile WF, & Morrow M, et al.: Career satisfaction, practice patterns and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology. Ann Surg Oncol 14:30433053, 2007

    • Search Google Scholar
    • Export Citation
  • 26

    Kuhn G, , Goldberg R, & Compton S: Tolerance for uncertainty, burnout, and satisfaction with the career of emergency medicine. Ann Emerg Med 54:106113.e6, 2009

    • Search Google Scholar
    • Export Citation
  • 27

    Lim RC, & Pinto C: Work stress, satisfaction and burnout in New Zealand radiologists: comparison of public hospital and private practice in New Zealand. J Med Imaging Radiat Oncol 53:194199, 2009

    • Search Google Scholar
    • Export Citation
  • 28

    Linn LS, , Brook RH, , Clark VA, , Davies AR, , Fink A, & Kosecoff J: Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med Care 23:11711178, 1985

    • Search Google Scholar
    • Export Citation
  • 29

    Linzer M: Preventing burnout in academic medicine. Arch Intern Med 169:927928, 2009

  • 30

    Maslach C, , Jackson SE, & Leiter MP: Maslach Burnout Inventory Manual ed 3 Palo Alto, CA, Consulting Psychologists Press, 1996

  • 31

    Merlani P, , Verdon M, , Businger A, , Domenighetti G, , Pargger H, & Ricou B: Burnout in ICU caregivers: a multicenter study of factors associated to centers. Am J Respir Crit Care Med 184:11401146, 2011

    • Search Google Scholar
    • Export Citation
  • 32

    Profit J, , Sharek PJ, , Amspoker AB, , Kowalkowski MA, , Nisbet CC, & Thomas EJ, et al.: Burnout in the NICU setting and its relation to safety culture. BMJ Qual Saf 23:806813, 2014

    • Search Google Scholar
    • Export Citation
  • 33

    Sargent MC, , Sotile W, , Sotile MO, , Rubash H, & Barrack RL: Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty. J Bone Joint Surg Am 91:23952405, 2009

    • Search Google Scholar
    • Export Citation
  • 34

    Shanafelt T, & Dyrbye L: Oncologist burnout: causes, consequences, and responses. J Clin Oncol 30:12351241, 2012

  • 35

    Shanafelt T, , Sloan J, , Satele D, & Balch C: Why do surgeons consider leaving practice?. J Am Coll Surg 212:421422, 2011

  • 36

    Shanafelt TD, , Balch CM, , Bechamps G, , Russell T, , Dyrbye L, & Satele D, et al.: Burnout and medical errors among American surgeons. Ann Surg 251:9951000, 2010

    • Search Google Scholar
    • Export Citation
  • 37

    Shanafelt TD, , Balch CM, , Bechamps GJ, , Russell T, , Dyrbye L, & Satele D, et al.: Burnout and career satisfaction among American surgeons. Ann Surg 250:463471, 2009

    • Search Google Scholar
    • Export Citation
  • 38

    Shanafelt TD, , Boone S, , Tan L, , Dyrbye LN, , Sotile W, & Satele D, et al.: Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 172:13771385, 2012

    • Search Google Scholar
    • Export Citation
  • 39

    Shanafelt TD, , Bradley KA, , Wipf JE, & Back AL: Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 136:358367, 2002

    • Search Google Scholar
    • Export Citation
  • 40

    Shanafelt TD, , Gradishar WJ, , Kosty M, , Satele D, , Chew H, & Horn L, et al.: Burnout and career satisfaction among US oncologists. J Clin Oncol 32:678686, 2014

    • Search Google Scholar
    • Export Citation
  • 41

    Shanafelt TD, , Kaups KL, , Nelson H, , Satele DV, , Sloan JA, & Oreskovich MR, et al.: An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons. Ann Surg 259:8288, 2014

    • Search Google Scholar
    • Export Citation
  • 42

    Shanafelt TD, , Oreskovich MR, , Dyrbye LN, , Satele DV, , Hanks JB, & Sloan JA, et al.: Avoiding burnout: the personal health habits and wellness practices of US surgeons. Ann Surg 255:625633, 2012

    • Search Google Scholar
    • Export Citation
  • 43

    Shanafelt TD, , Raymond M, , Kosty M, , Satele D, , Horn L, & Pippen J, et al.: Satisfaction with work-life balance and the career and retirement plans of US oncologists. J Clin Oncol 32:11271135, 2014

    • Search Google Scholar
    • Export Citation
  • 44

    Sharma A, , Sharp DM, , Walker LG, & Monson JR: Stress and burnout in colorectal and vascular surgical consultants working in the UK National Health Service. Psychooncology 17:570576, 2008

    • Search Google Scholar
    • Export Citation
  • 45

    Streu R, , Hansen J, , Abrahamse P, & Alderman AK: Professional burnout among US plastic surgeons: results of a national survey. Ann Plast Surg 72:346350, 2014

    • Search Google Scholar
    • Export Citation
  • 46

    West CP, , Dyrbye LN, , Rabatin JT, , Call TG, , Davidson JH, & Multari A, et al.: Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med 174:527533, 2014

    • Search Google Scholar
    • Export Citation
  • 47

    West CP, , Huschka MM, , Novotny PJ, , Sloan JA, , Kolars JC, & Habermann TM, et al.: Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA 296:10711078, 2006

    • Search Google Scholar
    • Export Citation
  • 48

    Williams ES, , Manwell LB, , Konrad TR, & Linzer M: The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev 32:203212, 2007

    • Search Google Scholar
    • Export Citation

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