Skip to main content

A Survey of U.S. Physicians and Their Partners Regarding the Impact of Work–Home Conflict

Journal of General Internal Medicine volume 29, pages 155–161 (2014)Cite this article

ABSTRACT

BACKGROUND

Work–home conflicts (WHC) threaten work–life balance among physicians, especially those in dual career relationships. In this study, we analyzed factors associated with WHC for physicians and their employed partners.

METHODS

We surveyed 89,831 physicians from all specialty disciplines listed in the Physician Masterfile. Of the 7,288 (27.7 %) physicians who completed the survey, 1,644 provided the e-mail contact information of their partner. We surveyed these partners and 891 (54 %) responded. Burnout, quality of life (QOL), and depression were measured using validated instruments in both surveys. Satisfaction with career, work–life balance, and personal relationships, as well as experience of WHC were also evaluated.

RESULTS

WHC within the previous 3 weeks were commonly experienced by physicians and their employed partners (44.3 % and 55.7 %, respectively). On multivariate analysis, greater work hours for physicians and their employed partners were independently associated with WHC (OR 1.31 and 1.23 for each additional 10 h, respectively, both p < 0.0001). Physicians and partners who had experienced a recent WHC were more likely to have symptoms of burnout (47.1 % vs. 26.6 % for physicians with and without WHC; 42.4 % vs. 23.8 % for partners with and without WHC, both p < 0.0001).

CONCLUSIONS

WHC are commonly experienced by physicians and their employed partners. These conflicts may be a major contributor to personal distress for physicians and their partners.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

REFERENCES

  1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work–life balance among U.S. physicians relative to the general U.S. population. Arch Intern Med. 2012;172:1377–85.

    PubMed  Article  Google Scholar 

  2. Dyrbye LN, Shanafelt TD, Balch C, Satele D, Freischlag F. Relationship between work–home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146:211–7.

    PubMed  Article  Google Scholar 

  3. Dyrbye LN, Freischlag J, Kaups KA, et al. Work home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012;147:933–9.

    PubMed  Article  Google Scholar 

  4. Dyrbye LN, West CP, Satele D, Sloan J, Shanafelt TD. Work–home conflict and burnout among academic internal medicine physicians. Arch Intern Med. 2011;171:1207–9.

    PubMed  Article  Google Scholar 

  5. Warde CM, Moonesinghe K, Allen W, Gelberg L. Marital and parental satisfaction of married physicians with children. J Gen Intern Med. 1999;14:157–65.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  6. Warde C, Allen W, Gelberg L. Physician role conflict and resulting career changes. J Gen Intern Med. 1996;11:729–35.

    CAS  PubMed  Article  Google Scholar 

  7. Fabri PJ, McDaniel MD, Gaskill HV, Garison RN. Great expectations: stress and the medical family. J Surg Res. 1989;47:379–82.

    CAS  PubMed  Article  Google Scholar 

  8. Gabbard GO, Menninger RW, Coyne L. Sources of conflict in the medical marriage. Am J Psychiatry. 1987;144:567–72.

    CAS  PubMed  Google Scholar 

  9. Spendlove DC, Reed BD, Whitman N, Slattery ML, French TK, Horwood K. Marital adjustment among house staff and new attorneys. Acad Med. 1990;65:599–603.

    CAS  PubMed  Article  Google Scholar 

  10. Moore EE. Swimming with the sharks-without the family being eaten alive. Surgery. 1990;108:125–38.

    CAS  PubMed  Google Scholar 

  11. Sotile WM, Sotile MO. Physicians’ wives evaluate their marriages, their husbands, and life in medicine: results of the AMA-Alliance Medical Marriage Survey. Bull Menninger Clin. 2004;68:39–59.

    PubMed  Article  Google Scholar 

  12. Lewis JM, Barnhart F, David F. Marital satisfaction in the lives of physicians. Bull Menninger Clin. 1993;57:458–65.

    CAS  PubMed  Google Scholar 

  13. The American Association for Public Opinion Research. Standard definitions. Final disposition of case codes and outcome rates for surveys. 2011. Available at: http://www.aapor.org/AM/Template.cfm?Section=Standard_Definitions2&Template=/CM/ContentDisplay.cfm&ContentID=3156, accessed 7/31/13.

  14. Shanafelt T, Boone S, Dyrbye LN, et al. The medical marriage: a national survey of the spouse/partners of U.S. physicians. Mayo Clin Proc. 2013;88:216–25.

    PubMed  Article  Google Scholar 

  15. Levinson W, Tolle SW, Lewis C. Women in academic medicine. N Engl J Med. 1989;321:1511–7.

    CAS  PubMed  Article  Google Scholar 

  16. Mizgala CL, Mackinnon SE, Walters BC, Ferris LE, McNeill IY, Knighton T. Women surgeons. Results of the Canadian population study. Ann Surg. 1993;218:37–46.

    CAS  PubMed  Article  Google Scholar 

  17. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306:952–60.

    CAS  PubMed  Article  Google Scholar 

  18. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto: Consulting Psychologists Press; 1996.

    Google Scholar 

  19. West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24:1318–21.

    PubMed Central  PubMed  Article  Google Scholar 

  20. West CP, Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27:1445–52.

    PubMed Central  PubMed  Article  Google Scholar 

  21. Grunberg SMGS, Steingass S, Zaretsky S, Meyerowitz B. Comparison of conditional quality of life terminology and visual analogue scale measurements. Qual Life Res. 1996;5:65–72.

    CAS  PubMed  Article  Google Scholar 

  22. Gudex CDP, Kind P, Williams A. Health state valuations from the general public using the visual analogue scale. Qual Life Res. 1996;5:521–31.

    CAS  PubMed  Article  Google Scholar 

  23. Hyland ME, Sodergren SC. Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res. 1996;5:469–80.

    CAS  PubMed  Article  Google Scholar 

  24. Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther. 1983;34:234–9.

    CAS  PubMed  Article  Google Scholar 

  25. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227–36.

    Google Scholar 

  26. Bretscher M, Rummans T, Sloan J, Kaur J, Bartlett A, Borkenhagen L, Loprinzi C. Quality of life in hospice patients: a pilot study. Psychosomatics. 1999;40(4):309–13.

  27. Shanafelt TD, Novotny P, Johnson ME, et al. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group. Oncology. 2005;68:23–32.

    PubMed  Article  Google Scholar 

  28. Rummans T, Clark MM, Sloan JA, et al. Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. J Clin Oncol. 2006;24:635–42.

    PubMed  Article  Google Scholar 

  29. Locke DE, Decker PA, Sloan JA, et al. Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. J Pain Symptom Manage. 2007;34:628–38.

    PubMed Central  PubMed  Article  Google Scholar 

  30. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302:1294–300.

    CAS  PubMed  Article  Google Scholar 

  31. Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994;272:1749–56.

    CAS  PubMed  Article  Google Scholar 

  32. Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12:439–45.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  33. Norman GR, Sloan JA, Wyrwich KW. The truly remarkable universality of half a standard deviation: confirmation through another look. Expert Rev Pharmacoecon Outcomes Res. 2004;4:515–9.

    Article  Google Scholar 

  34. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714–21.

    PubMed  Article  Google Scholar 

  35. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.

    PubMed  Article  Google Scholar 

  36. Campbell DA Jr, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery. 2001;130:696–702. discussion −5.

    PubMed  Article  Google Scholar 

  37. West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071–8.

    CAS  PubMed  Article  Google Scholar 

  38. Kelly EL, Moen P, Tranby E. Changing workplaces to reduce work-family conflict: schedule control in a white-collar organization. Am Sociol Rev. 2011;76:265–90.

    PubMed Central  PubMed  Article  Google Scholar 

  39. Malin MH, Still MC, Milligan MK, Williams JC. Work/family conflict, union style: Labor arbitrations involving family care. Program on Worklife law. The Washington College of Law. 2004. Available at: http://worklifelaw.org/pubs/conflictunionstyle.pdf, accessed 7/24/2013.

  40. Jagsi R, Griffith KA, Stewart A, Sambuco D, DeCastro R, Ubel PA. Gender differences in the salaries of physician researchers. JAMA. 2012;307:2410–7.

    CAS  PubMed  Article  Google Scholar 

  41. Ward K, Wolf-Wendel L. Academic Motherhood: How Faculty Manage Work and Family. New Brunswick: Rutgers Univeristy Press; 2012.

    Google Scholar 

  42. Fletcher RH, Fletcher SW. Here come the couples. Ann Intern Med. 1993;119:628–30.

    CAS  PubMed  Article  Google Scholar 

  43. Gautam M. Women in medicine: stresses and solutions. West J Med. 2001;174:37–41.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  44. Keeton K, Fenner DE, Johnson TRB, Hayward RA. Predictors of physician career satisfaction, work–life balance, and burnout. Obstet Gynecol. 2007;109:949–55.

    PubMed  Article  Google Scholar 

  45. Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002;288:1447–50.

    PubMed  Article  Google Scholar 

  46. Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg. 2009;144:371–6.

    PubMed  Article  Google Scholar 

  47. Allegra C, Hall R, Yothers G. Prevalence of burnout in the U.S. oncology community: results of a 2003 survey. J Oncol Pract. 2005;1:140–7.

    PubMed Central  PubMed  Article  Google Scholar 

  48. Kuerer HM, Eberlein TJ, Pollock RE, 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;14:3043–53.

    PubMed  Article  Google Scholar 

  49. Kellerman S, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med. 2001;20:61–71.

    CAS  PubMed  Article  Google Scholar 

  50. Asch D, Jedrziewski M, Christakis N. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–36.

    CAS  PubMed  Article  Google Scholar 

Download references

Acknowledgements

Funding for this study was provided by the American Medical Association and the Mayo Clinic Department of Medicine Program on Physician Well-being.

Conflict of Interest

Dr. Wayne Sotile receives royalties from AMA Press for books “The Medical Marriage” and “The Resilient Physician”, and honoraria for speaking engagements to medical conferences, regarding burnout, resilience and work/life issues. All other authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Liselotte N. Dyrbye MD, MHPE, Colin P. West MD, PhD, Daniel Satele MS, Jeff Sloan PhD & Tait Shanafelt MD

  2. Tulane University School of Medicine, New Orleans, LA, USA

    Wayne Sotile MD

  3. University of Illinois Hospital and Health System, Chicago Campus, Community Based Practice, Chicago, IL, USA

    Sonja Boone MD, FACP

  4. Immunization Action Coalition, 1573 Selby Avenue, St. Paul, MN, 55104, USA

    Litjen Tan MS, PhD

  5. University of Washington, Seattle, WA, USA

    Mick Oreskovich MD

Authors
  1. Liselotte N. Dyrbye MD, MHPE
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wayne Sotile MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sonja Boone MD, FACP
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Colin P. West MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Litjen Tan MS, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daniel Satele MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jeff Sloan PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mick Oreskovich MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tait Shanafelt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liselotte N. Dyrbye MD, MHPE.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 18 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dyrbye, L.N., Sotile, W., Boone, S. et al. A Survey of U.S. Physicians and Their Partners Regarding the Impact of Work–Home Conflict. J GEN INTERN MED 29, 155–161 (2014). https://doi.org/10.1007/s11606-013-2581-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-013-2581-3

KEY WORDS

  • physician
  • spouses
  • work–home conflict
  • burnout
  • quality of life
  • career satisfaction