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Choosing a Medical Specialty & Balancing Life

The following was posted anonymously as a comment on a blog I wrote about the difficulty one has in choosing a medical specialty. I was so taken with it that I wanted to give it more exposure. [Note: The comment contained a few typos, which I have corrected. Otherwise it is unchanged.] My response has been amplified slightly. Since you are so senior to me, let me ask you for your thoughts. I got into medical school, studied, worked hard, got into residency and learned, spent hours and hours in the hospital, loved critical care and got into fellowship. Along the way met a guy (both were residents at that time), fell in love, and we both dreamt and read and learned and discussed cases. He decided on cardiology and I decided on critical care. Both got into fellowships …. worked hard, spent long hours in fellowship … we were committed. We ARE committed but divided…. We had kids, and now every day I feel divided. I have a feeling that all “old timers ” like you who worked for longer hours and did frequent night calls had a ” spouse” who would take care of your kids, and you did not have to worry as much. Times were different. Times were not so dangerous, and kids’ safety outside of the house was not so concerning. In my situation, my spouse and I are both physicians in fields that require us to spend lots and lots of hours in the hospital. If I were to find a traditional practice and work every 3rd night, who would raise my kids?...
At the Boiling Point: Physician Burnout & Work-Life Balance

At the Boiling Point: Physician Burnout & Work-Life Balance

Previous research has indicated that many physicians throughout the United States experience professional burnout, a syndrome characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Studies suggest that burnout can reduce quality of care and increase risks for medical errors, among other negative consequences. Furthermore, there are other adverse personal consequences for physicians that have been linked to burnout, including contributions to broken relationships, problematic alcohol use, and suicidal ideation (read guest blogger, Dr. Rob’s, Top 10 Burnout Triggers). “We have limited data characterizing physician burnout, but few studies have evaluated rates of burnout among U.S. physicians nationally,” says Colin P. West, MD, PhD. “Previous investigations have speculated on which medical or surgical specialty areas are at higher risk, but these analyses have not been definitive.” He adds that research is also lacking on how rates of burnout for physicians compare with rates for U.S. workers in other fields. Medical Specialty Matters in Burnout In the Archives of Internal Medicine, Dr. West and colleagues published a study on burnout involving a large sample of U.S. physicians from all specialty disciplines using the American Medical Association Physician Masterfile. Surveys were used to assess the prevalence of emotional exhaustion, enthusiasm dissipation, cynicism, depression, suicidal tendencies, negative views on work-life balance, and low professional esteem among physicians. After collecting responses from 7,288 physicians from various healthcare settings, 45.8% reported experiencing at least one symptom of professional burnout. “We observed substantial differences in burnout by specialty,” says Dr. West (Figure). The highest rates of burnout were seen in physicians at the front lines of care, most notably family doctors, general...

Looking at Alcohol Use Disorders Among Surgeons

The prevalence of substance use disorders in the United States has been well documented in published research. Nearly 8% to 12% of Americans aged 12 and older meet criteria for alcohol abuse or dependence, with men being twice as likely to depend upon or abuse alcohol as women. The prevalence of substance use disorders among U.S. physicians has been estimated to range from 10% to 15%, but less is known about alcohol dependence and abuse in particular. “Although actual injury to patients from impaired physicians is incredibly rare, alcohol abuse and dependence are important factors to consider when thinking about patient safety in surgery,” says Michael R. Oreskovich, MD. “These disorders can play a major role in causing clinically significant impairment or distress in social, occupational, and other areas of functioning.” Alcohol Use Disorder: A Problem for Surgeons Nationwide Dr. Oreskovich and colleagues conducted a study, published in the February 2012 Archives of Surgery, in which American surgeons completed online surveys anonymously. “We wanted to gain a better picture of the actual prevalence of alcohol dependence and abuse,” he says. “We also wanted to explore personal and professional characteristics, surgeon distress, and recent self-reported events.” According to the results, about 15% of respondents overall appeared to suffer from alcohol abuse or dependence, a figure that exceeds what has typically been cited for the general public. “Surprisingly, male surgeons were less likely to have these disorders than female surgeons,” Dr. Oreskovich says. “About 14% of male surgeons reported having alcohol issues, compared with a 26% rate that was observed for female surgeons.” In addition, the study found that alcohol issues...
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