Monday, July 2, 2012

Surgery & Work-Home Conflict

An article published ahead of print in Archives of Surgery [full text here], reported the results of a survey of over 7100 members of the American College of Surgeons. Over 52% said they had experienced at least one work-home conflict in the 3 weeks preceding the survey. Work-home conflicts were more common in those surgeons who were young, female and had young children.

Surgeons with a recent work-home conflict were more likely to have symptoms of burnout, depression, alcohol abuse/dependency, and were less likely to recommend surgery as a career option to their children.

A surgeon I follow on Twitter, Dr. Mary L. Brandt, posted a link to a video produced by Redefining Surgery, “a project sponsored by the Association for Academic Surgery, the Society for University Surgeons, and the American College of Surgeons to provide information for young bright students contemplating a career in Surgery.” This 12 minute series of interviews with surgeons young and old, male and female was intended to show how one can be a surgeon and still have a life.

Here is the video. Just watch a few minutes and you will get the idea. 

I watched it all the way to the end just to see if anyone really seemed to believe what they were saying. My reaction was that most of the participants lacked conviction. It all seemed rather forced, as if they were trying to persuade themselves that all was well with the balance between family and work.

So what’s the point?

I am surprised that only about half of surgeons polled admitted to having recent work-home conflicts. When my children were younger and I was a surgical chairman with a fairly manageable schedule, I still faced at least two or three work-home conflicts per week. Despite what the video rather unconvincingly tries to portray, surgery does present huge challenges to maintaining balance in life.

Is there a solution? I’m not sure. I know many people with responsible jobs in finance and business. They have stress, burnout and work-home conflicts too. Also note the recent buzz about Anne-Marie Slaughter’s Atlantic piece on why women “can’t have it all.”

Maybe there is no answer. I would be interested in hearing what you have to say.


UtilityKnife said...

My wife is a nurse so perhaps she is more accepting of my time conflicts with home. She's also a great person and that is likely a better reason for her acceptance. I appreciated Anne-Marie Slaughter's comments and often think the 'triple threat' in medicine is a myth without a devoted army of helpers. Short of that army a loving wife is more than sufficient.

Solitary Diner said...

I love the surgeon in the video who said "I make it home just about every night to put my kids to bed." I don't think most people would consider that to be an acceptable amount of family time!

Skeptical Scalpel said...

Utility, I too am blessed with a wife who is a saint. She has enabled me to come as close as one can to "having it all."

Solitary, yes, that was a good one. I liked the surgeon whose daughter had a lunch appointment with her every Tuesday. What fun those lunches must be!

Anonymous said...

I'm a female and just finished my 3rd yr of medical school. I absolutely love surgery, but I'm very concerned about the work/life balance I will face as a female surgeon. Many of the female surgeons I've spoken with have a hard time balancing the two. In order to cope, some work part time; others designate 20-30% of their time to research or administrative responsibilities to get more flexibility; some simply accept that they won't get to see their kids as much as they'd like; a few decided not to have kids at all. To be quite honest, none of these options is particularly appealing. In my opinion, the best advice I've gotten thus far is to pick a less time intensive surgical specialty (ie not general surgery, neurosurgery, vascular, etc).

Skeptical Scalpel said...

Anonymous, thanks for commenting. I'm not sure what the less time intensive surgical specialties are except for breast surgery, which has virtually no emergencies.

avi said...

how come all of those physician-physician kids look so.. sick?

Anonymous said...

I'm glad there is more awareness about physician burnout and lifestyle. You can debate the 80-hour rule and physician "commitment" and so forth until you're blue in the face (and I can't say I know what the right answer is), but the point remains that being accepting of physicians who want more of a life outside of the hospital is good for everyone involved, including the patients.

Skeptical Scalpel said...

Avi, thanks for the comment. I didn't really notice that. I was focused on th sad looking docs.

Anonymous, good comments. I hope it's good for the patients. I'm not sure though.

Roa'a Khan said...

It's a common issue specially for woman doctor who her choice to be a surgeon,even she's trying to manage work-home conflict but still exist if you have demanding family member (single or married) & not understanding your job nature (parent or husband) although you do your best this is the problem. So, some woman to continue this path will choose surgical specialties that less stressfull than general surgery like opthalmology, ENT, etc, or spcialized as endocrine or breast surgeries.

Skeptical Scalpel said...

Roa'a, thanks for commenting. Well said.

G2 said...

As a female general surgeon in a small town with two kids under 5, balance is VERY difficult. I have a supportive stay-at-home spouse, but conflicts still arise ALL THE TIME. I don't think there is an answer to that--any job that has potential of extending past "work hours" (including emails, phone calls, etc) is going to give you conflict potentials at home. You do the best you can. Sometimes, that requires a change in job and location (this is currently occuring in my life)to see if it can be better somewhere else... So, surgery can "be what you make it" as they state in the video to some extent, but most jobs in medicine (and most higher responsibility jobs in any category) are going to cause home/job conflicts. If you want taht kind of job/status/pay, that's what you get.

Skeptical Scalpel said...

G2, thanks for the interesting and obviously heartfelt comments. I've "been there, done that" myself. I wish you luck in achieving the elusive balance.

RuggerMD said...

Group practice is the way.
Somehow I have been blessed with a group of 4 of us that I joined 3 yrs ago and we to all gen surgery call for the hospital.
We each do seven 24 hrs shifts usually every other night for a week and then backup the next day, and then are off for a week, then repeat.
But its also flexible.
So 7 days call, 7 days backup, 14 days off. Don't be jealous.

Skeptical Scalpel said...

Rugger, that's not exactly a dream call schedule. You are on call every other night. I'm not that jealous.

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