title: What is the work environment of orthopaedic surgeons in China?
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127th Changle West Road, Shaanxi, 710032, Xi'an, China, mazhensheng@yahoo.com.
authors.forename: Zhen-Sheng
authors.initials: ZS
authors.lastname: Ma
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Guo-Sheng
authors.initials: GS
authors.lastname: Du
authors.forename: Lynn
authors.initials: L
authors.lastname: Wang
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000374:Aggression; D002681:China; D034462:Dissent and Disputes; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D009985:Orthopedics / Q000458:organization & administration* / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012931:Social Environment; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data; D017132:Workplace / Q000706:statistics & numerical data; D055815:Young Adult
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