Job satisfaction among chairs of surgery from Europe and North America

doi:10.1016/j.surg.2014.04.013

Surgery

Volume 156, Issue 5, November 2014, Pages 1069-1077

https://doi.org/10.1016/j.surg.2014.04.013 Get rights and content

Background

Strong evidence exists associating job satisfaction and risk of burnout with productivity, efficiency, and creativity in many organizations. However no data are available assessing chairs of surgery. This study assessed job satisfaction and risk for burnout of surgical chairs from Europe and North America and identified contributing factors.

Methods

A survey among 650 chairs in surgery from 23 European and 2 North American countries was conducted in 2012. Satisfaction at work was analyzed using the validated Global Job Satisfaction (GJS) instrument and the abbreviated Maslach Burnout Inventory. Additional items targeting personal and environmental factors were included.

Results

The rate of chairs reached successfully was 86%, the overall response rate was 29% (188/650), with 1% female. Median age was 58 years. 11% of chairs were dissatisfied with work. Younger age and being fewer years in practice as a chair was associated with higher job satisfaction (P = .054 and P = .003). Surgical specialty with the greatest median GJS score was hepatopancreatobiliary, whereas vascular surgery scored lowest. Chairs desire to devote 20% more of their time on research. Clerical support as well as the ability to be innovative was suggested by 51% and 45%, respectively, to improve job satisfaction. Compared with Europeans, North American chairs were overall more satisfied and would recommend their job to their children.

Conclusion

North American chairs seem to be more satisfied at work and at less risk for burnout than European chairs. The overall job satisfaction was greater among chairs compared with previously published reports of young, board-certified surgeons or residents (89% vs 87% and 66%, respectively). The superior satisfaction in chairs is strongest related to career achievements, innovation, and lifestyle.

Section snippets

Inclusion criteria

To collect data from a homogenous sample representing the top academic centers in Europe and North America, we asked chairs who are members of the American Surgical Association, the European Surgical Association, and chairs from large European academic centers to participate in our survey by using an online software (Constant Contact, Inc, Waltham, MA). A total of 3 email reminders were sent within a period of 4 weeks (September/October 2012). A total of 650 valid chairs (European Surgical

Participation and response rates

Figure 1 summarizes the methodology and response rates. Briefly, 650 chairs of surgery in Europe and North America (23 countries) were contacted; 220 of them opened the email, 188 replied to the survey, and the rate of chairs that were reached successfully was 86%. The overall response rate was 29%.

Demographics of the participants

Ninety-four respondents were from Europe and 94 from North America, of whom 2 (1%) were female. Ninety-one percent of chairs were full professors, and 37% worked in a hospital with >1,000 beds.

Discussion

After having assessed job satisfaction in surgical residents and young, board-certified surgeons, the current study completes the trilogy by assessing job satisfaction among chairs of surgery.18, 20 We provide an understanding of satisfaction factors that may improve productivity and competence in surgical centers. The superior satisfaction in chairs, compared with junior faculty and trainees (89% vs 87% and 66%, respectively) relates to career achievements, innovation, less burnout, and better

References (29)

M.W. von Websky et al.
Trainee satisfaction in surgery residency programs: modern management tools ensure trainee motivation and success
Surgery
(2012)
C.M. Balch et al.
Surgeon Distress as Calibrated by Hours Worked and Nights on Call
J Am Coll Surg
(2010)
W.W. Souba
New ways of understanding and accomplishing leadership in academic medicine
J Surg Res
(2004)
S. Lloyd et al.
Development of the emergency physician job satisfaction measurement instrument
Am J Emerg Med
(1994)
A.J. Ramirez et al.
Mental health of hospital consultants: the effects of stress and satisfaction at work
Lancet
(1996)
G. Hofstede
Motivation, leadership, and organization - do American theories apply abroad
Organ Dyn
(1980)
T.L. Demmy et al.
Physicians' perceptions of institutional and leadership factors influencing their job satisfaction at one academic medical center
Acad Med
(2002)
J.H. Dulebohn et al.
A meta-analysis of antecedents and consequences of leader-member exchange: integrating the past with an eye toward the future
J Manage
(2012)
S.G. Gabbe et al.
Burnout in medical school deans: an uncommon problem
Acad Med
(2008)
H.M. Kuerer 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
(2007)

T.D. Shanafelt et al.

Burnout and career satisfaction among American surgeons

Ann Surg

(2009)

L.M. Saari et al.

Employee attitudes and job satisfaction

Human Resour Manage

(2004)

W.B. Yost et al.

A national study of burnout among American transplant surgeons

Transplant Proc

(2005)

A. Businger et al.

Arguments for and against a career in surgery: a qualitative analysis

Ann Surg

(2010)

Cited by (14)

Lifestyle and career satisfaction among US-based oral and maxillofacial surgeons: Results of a nationwide survey
2023, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
This study aims to investigate overall career satisfaction rate amongst US-based oral and maxillofacial surgeons (OMSs) and to evaluate possible predictors of professional stress and quality of life.
Members of the American Association of Oral and Maxillofacial Surgeons were invited to complete an online survey-based assessment. Descriptive statistics were computed; univariate analysis was performed to identify predictors for satisfaction.
The overall response rate was 29%. Most of respondents were male (88.6%), aged >45 years (71.7%), married (91.7%), and working at private and/or group-based practices (55.9%) for >15 years (66.6%). Most surgeons 91.3% reported being satisfied with their career with 84.9% willing to choose a career in OMS again. No significant difference was noted in satisfaction rates between academic and non-academic surgeons. On univariate analysis, no demographic characteristic was predictive of satisfaction.
Reportedly, 91.3% of US-based OMSs have a significant degree of career satisfaction, and a majority would choose the specialty as their profession again.
Diversity efforts in surgery: Are we there yet?
2022, American Journal of Surgery
Citation Excerpt :
However, this study was undertaken towards the latter part of the first wave of the pandemic and with so much uncertainty and multiple challenges we did expect the response rate to be lower than usual. From more recent studies, a response rate of ∼30% seems expected.20,21 With a limited number of questions, we were unable to fully assess the extent of DEI efforts and some departments may have programs not reflected in our survey.
We aimed to assess and quantify recent efforts of surgical departments in achieving diversity, equity and inclusion.
Chairs of surgery at US hospitals were identified from a database maintained by the Association of Women Surgeons and surveyed to assess diversity, equity and inclusion efforts.
A total of 226 surveys were sent out with a 22.6% response rate. Across all survey respondents, only 28.2% of surgeons were female and 24.4% were URiM, with no programs reporting any non-binary surgeons. In the last 3 years, 95.8% programs reported an increase in female surgeons, while only 75.5% programs reported an increase in URiM surgeons. Program size made no difference in diversity across race or gender.
Recent recruitment efforts are bringing change to departments of surgery. Retaining diverse faculty, ensuring equity in promotions, and giving every faculty the opportunity to thrive is essential to fostering diversity, equity and inclusion in surgery.
Leadership of United States Academic Departments of Ophthalmology: Chairperson Characteristics, Accomplishments, and Personal Insights
2018, American Journal of Ophthalmology
Citation Excerpt :
Most chairs reported a drop in their academic productivity since their initial appointment. Despite this, the survey results suggest that chairs still possess a high job satisfaction rate, comparable to that of chairs of other fields of medicine, including anesthesiology and general surgery.5,15 This result is also consistent with several previous studies that reported high satisfaction rates among ophthalmology chairs regarding their career choice and position, often leading to the postponement of retirement to past 70 years of age, implying that only a minority of ophthalmology chairs demonstrate burnout after becoming chair.1–3
To report on the characteristics, accomplishments, and past experiences of current academic ophthalmology department chairs.
Cross-sectional study.
Setting: A confidential online survey. Study Population: Total of 111 chairs of US academic ophthalmology departments. Main Outcome Measures: Chairs' general characteristics, training/former positions held, academic accomplishments, previous organization/committee involvement, motivation/insight, and overall work satisfaction.
Fifty-five chair responses were received (96% male, mean age 57 years, mean term 7 years). The majority were American medical graduates (93%), full professors of ophthalmology (93%), and permanent chairs (96%). All completed their residency in the US and 96% completed a fellowship (25% vitreoretinal surgery, 22% cornea and external disease, and 20% glaucoma). On average, chairs authored 98 peer-reviewed articles, 2 books, and 11 book chapters. They were also significantly involved in peer-reviewed journal literature, serving as editors (20%), associate editors (18%), or editorial board members (60%). The majority of chairs indicated they decided to seek their position late in their career, having already become a full (33%) or associate professor (26%), primarily owing to a desire to build and promote an academic ophthalmology department (61%). Chairs regarded their experience as head of service as most important for their current performance as department heads. Their principal advice to aspiring ophthalmology chairs was to focus on developing skills as a clinician, researcher, and educator (“triple threat”).
Overall, academic department chairs are accomplished leaders in ophthalmology and prolific authors with an established academic record. Chairs regarded their previous leadership roles within the department as invaluable to their effectiveness as chair.
Are ENT surgeons in the UK at risk of stress, psychological morbidities and burnout? A national questionnaire survey
2018, Surgeon
Citation Excerpt :
Such fulfillment may apply both to the clinical and academic side of the specialty based on Johns et al.'s 2005 analysis on 107 academic chairs of otolaryngology within the US which noted that only 3% were at high risk of burnout.13 Despite the high figures seen amongst American surgeons, a comparison study in 2014 found that the North American chairs of surgery had greater job satisfaction and were at lower risk of burnout than their European counterparts.14 In the far east, a recent electronic survey amongst 621 Korean surgeons found that the mean Korean occupational stress scale (KOSS) scores were higher than the national average and that of other specialized professions.
Work-related stress, psychological disorders and burnout are common occupational disorders affecting UK doctors. To date, there are no studies looking at these psychosocial morbidities amongst ENT surgeons worldwide.
The General Health Questionnaire-12 (GHQ-12) and abbreviated Maslach Burnout Inventory (aMBI) were incorporated into a questionnaire on occupational diseases amongst ENT surgeons and distributed to the entire membership of ENT-UK. The survey study also acquired demographic data on grade of respondent, years of experience in ENT and subspecialty interest.
We received 108 (8.1% response rate) appropriately filled GHQ-12 and 121 (9.0% response rate) aMBI questionnaires. 61 respondents (56.5%) on the GHQ-12 were at high risk of developing stress and psychological morbidity and 35 (28.9%) had high enough aMBI scores to suggested burnout. When comparing scores of both GHQ-12 and aMBI with grade of respondent, years of experience in ENT and subspecialty, statistical difference was only found on the risk of stress and psychiatric disorders amongst paediatric ENT surgeons (7 high risk vs 0 low risk, p = 0.02), however the number of these respondents was small (7 in total). Both questionnaires had been validated for use within our population.
We found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our responding cohort of UK Oto-rhino-laryngologists. No meaningful differences were found between stress, psychological morbidity and burnout with grade of ENT surgeon, years of experience in ENT and subspecialty within ENT.
Editorial Commentary
2017, Urology Practice
Towards a virtual “global academia of surgeons”
2022, Annals of Surgery

View all citing articles on Scopus

: C.T. and D.A.R. contributed equally as first authors.

View full text

EducationJob satisfaction among chairs of surgery from Europe and North America

Background

Methods

Results

Conclusion

Section snippets

Inclusion criteria

Participation and response rates

Demographics of the participants

Discussion

Surgery

J Am Coll Surg

J Surg Res

Am J Emerg Med

Lancet

Organ Dyn

Physicians' perceptions of institutional and leadership factors influencing their job satisfaction at one academic medical center

Acad Med

A meta-analysis of antecedents and consequences of leader-member exchange: integrating the past with an eye toward the future

J Manage

Burnout in medical school deans: an uncommon problem

Acad Med

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

Burnout and career satisfaction among American surgeons

Ann Surg

Employee attitudes and job satisfaction

Human Resour Manage

A national study of burnout among American transplant surgeons

Transplant Proc

Arguments for and against a career in surgery: a qualitative analysis

Ann Surg

Education
Job satisfaction among chairs of surgery from Europe and North America