title: Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce.
abstract: OBJECTIVE
  To evaluate factors associated with work-home conflicts (W-HCs) of US surgeons and their potential personal and professional consequences.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Members of the American College of Surgeons.
  
  
  METHODS
  Burnout, depression, quality of life, alcohol use, career satisfaction, and career decisions (ie, reduce work hours or leave current practice).
  
  
  RESULTS
  Of 7197 participating surgeons, 3754 (52.5%) had experienced a W-HC in the previous 3 weeks. On multivariate analysis, hours worked per week, having children, sex, and work location (Veterans Administration or academic center) were independently associated with an increased risk for W-HC (all P < .01), while some factors (increased age and subspecialty field) reduced the risk. Surgeons with a recent W-HC were more likely to have symptoms of burnout (36.9% vs 17.1%; P < .001), depression (50.9% vs 28.1%; P < .001), alcohol abuse/dependency (17.2% vs 14.4%; P = .003), and were less likely to recommend surgery as a career option to their children (46.0% vs 54.4%; P < .001). Work-home conflicts were also independently associated with surgeons reporting a moderate or higher likelihood of planning to reduce clinical work hours (odds ratio, 1.769) and leave their current practice in the next 24 months for a reason other than retirement (odds ratio, 1.706) after controlling for other personal and professional factors.
  
  
  CONCLUSIONS
  Integrating personal and professional lives is a substantial challenge for US surgeons. Conflict in this balance appears to be a major factor in their decision to reduce work hours and/or move to a new practice, with potential substantive manpower implications for the surgical workforce.
authors.affiliation: Mayo Clinic Department of Medicine, Rochester, MN, USA. dyrbye.liselotte@mayo.edu
authors.forename: Liselotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Julie
authors.initials: J
authors.lastname: Freischlag
authors.forename: Krista L
authors.initials: KL
authors.lastname: Kaups
authors.forename: Michael R
authors.initials: MR
authors.lastname: Oreskovich
authors.forename: Daniel V
authors.initials: DV
authors.lastname: Satele
authors.forename: John B
authors.initials: JB
authors.lastname: Hanks
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Charles M
authors.initials: CM
authors.lastname: Balch
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology*; D002322:Career Mobility; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D007588:Job Satisfaction; D008016:Life Change Events; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010822:Physicians, Women / Q000523:psychology / Q000639:trends; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000639:trends; D011788:Quality of Life; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D013043:Specialties, Surgical / Q000706:statistics & numerical data* / Q000639:trends; D014940:Work Schedule Tolerance / Q000523:psychology; D000078329:Workforce