title: Employment Satisfaction in Plastic and Reconstructive Surgery and Its Influence on Graduating Residents in an Evolving Health Care Climate.
abstract: BACKGROUND
  The current state of employment satisfaction in plastic surgery has not been defined. Similarly, the factors influencing residents as they search for employment and the role of attending surgeons as mentors in this process have not been elicited. The authors aim to elucidate these measures through a survey of attending surgeons and senior residents.
  
  
  METHODS
  A survey was created assessing employment satisfaction and was distributed to members of the American Society of Plastic Surgeons with available contact information. Responses were analyzed, with values of p < 0.05 deemed significant.
  
  
  RESULTS
  A total of 616 plastic surgeons and senior plastic surgery residents responded. Compared with attending surgeons in private practice, those in academic practice were more satisfied with their case mix (p = 0.0005; OR, not significant) and less satisfied with their incentive structure (p = 0.0001; OR, 0.3155) and payor mix (p = 0.0005; OR, 0.6156). Employment change occurred in 225 surgeons (39.2 percent) since beginning practice. Surgeons that changed employment ranked base salary (p = 0.0031), earning potential (p = 0.0001), and incentive structure (p = 0.0001) as most important. Those that did not change employment ranked lifestyle (p = 0.0048), location (p = 0.0001), and desire to teach (p = 0.0002) as more important. Residents ranked location (p = 0.0030), desired case mix (p = 0.0131), and desire or lack of desire to teach residents (p = 0.0329) as more important than attending surgeons felt they should be, and guaranteed salary (p = 0.0178) and incentive structure (p = 0.0069) as less important.
  
  
  CONCLUSIONS
  In an evolving health care environment, plastic surgeons' employment satisfaction is significantly dependent on a myriad of factors. Residents and their attending mentors differ significantly in perceived importance of these factors.
authors.affiliation: Rochester and New York, N.Y.; San Francisco, Calif.; and Chicago, Ill. From the Division of Plastic Surgery and the Department of Surgery, University of Rochester Medical Center; the Institute of Reconstructive Plastic Surgery, New York University Medical Center; the Division of Plastic and Reconstructive Surgery, University of California, San Francisco Medical Center; and the Section of Plastic and Reconstructive Surgery, The University of Chicago Medical Center.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Koltz
authors.forename: Jordan D
authors.initials: JD
authors.lastname: Frey
authors.forename: Hani
authors.initials: H
authors.lastname: Sbitany
authors.forename: Derek E
authors.initials: DE
authors.lastname: Bell
authors.forename: James C
authors.initials: JC
authors.lastname: Iannuzzi
authors.forename: David H
authors.initials: DH
authors.lastname: Song
authors.forename: Howard N
authors.initials: HN
authors.lastname: Langstein
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D003625:Data Collection; D018166:Health Care Reform; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D012456:Salaries and Fringe Benefits; D013518:Surgery, Plastic / Q000191:economics / Q000193:education; D014481:United States