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What is the Work Environment of Orthopaedic Surgeons in China?

  • Survey
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Physicians in China face heavy demands from patients and the government for services but deal with the threat of unpredictable legal and physical conflicts with patients, some ending with the death of doctors. More than 40 doctors and nurses have been killed by patients since 2001.

Questions/purposes

We sought to evaluate (1) the demographics of orthopaedic practice, (2) duty periods, (3) practice support, and (4) job satisfaction among orthopaedic surgeons in China.

Methods

Questionnaires were posted online at www.OrthoChina.org for download by orthopaedic surgeons in 2006 to 2007, and sent to those attending meetings in 2013. In 2013, a total of 1350 surgeons were invited and 456 participated in the survey at meetings. In 2007, during the period of the survey, 9759 individuals were qualified orthopaedic surgeons, and 334 participated in the survey at www.OrthoChina.org.

Results

Ninety-one percent of orthopaedic surgeons work in public and 9% in private hospitals. Ninety-four percent work more than 8 hours per day 6 to 7 days a week. Twenty-five percent work more than 12 hours per day 6 to 7 days a week without extra compensation. The majority of orthopaedic surgeons must work on national statutory holidays. Almost none received contractually mandated income for weekends and national holidays. Approximately 80% of participants reported an attack of some kind, including physical or psychologic harm. With respect to job satisfaction, 73% stated they would not choose to be a physician again and 86% reported that they do not want their children to become a physician.

Conclusions

China’s rapid economic growth and resulting demands for modern health care have resulted in heavy pressure on orthopaedic surgeons, financially and personally. Chinese orthopaedic surgeons are overworked, suffer lack of respect, and face the possibility of serious personal harm. As a consequence, they are demoralized and unsatisfied. Significant reforms are needed.

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Acknowledgments

We thank the Director of the Department of Statistics in Medicine of the Fourth Military Medical University, Jie-Lai Xia, and his colleague, Jin-Fang Xu, for their help in designing a statistical program (Epidata) for input and analyzing the collected data. We thank Stephen Eisenstein, Honorary Professor of Keele University, Consultant Spine Surgeon of The Robert Jones and Agnes Hunt Orthopaedic Hospital, for previewing the draft and discussion with us for the manuscript. We thank Steven R. Garfin MD, Distinguished Professor and Chair of the University of California-San Diego Department of Orthopaedic Surgery and Spine Surgery, for his kindness, talents, and consideration in helping us by editing and rewriting the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127th Changle West Road, Shaanxi, 710032, Xi’an, China

    Zhen-Sheng Ma MD, PhD & Lin Wang MD, PhD

  2. Rende Hospital, Wuxi, Jiangsu, China

    Guo-Sheng Du MD

  3. Department of Health Statistics, Fourth Military Medical University, Shaanxi, China

    Lynn Wang PhD

  4. Department of Pediatric Orthopaedics, Traditional Chinese Medicine Hospital, Luzhou Medical College, Sichuan, China

    Xiao-Jun Chen MD, PhD

Authors
  1. Zhen-Sheng Ma MD, PhD
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  2. Lin Wang MD, PhD
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  3. Guo-Sheng Du MD
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  4. Lynn Wang PhD
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  5. Xiao-Jun Chen MD, PhD
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Corresponding author

Correspondence to Zhen-Sheng Ma MD, PhD.

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Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

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Ma, ZS., Wang, L., Du, GS. et al. What is the Work Environment of Orthopaedic Surgeons in China?. Clin Orthop Relat Res 472, 3576–3580 (2014). https://doi.org/10.1007/s11999-014-3859-4

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  • DOI: https://doi.org/10.1007/s11999-014-3859-4

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