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Heavier workload, less personal control: Impact of delivery on obstetrician/gynecologists' career satisfaction

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Abstract

Objective

Obstetrician/gynecologists' career satisfaction with certain work-related activities was examined among clinicians who perform deliveries and clinicians who do not.

Study design

A questionnaire was sent to 1500 member-fellows of the American College of Obstetricians and Gynecologists; 842 members (56%) responded. The questionnaire was designed to distinguish between obstetrician/gynecologists who perform deliveries and clinicians who do not in the areas of satisfaction with specific aspects of career and work-related activities. Data were examined initially by multivariate analysis of variance and subsequently by univariate analysis of variance if the multivariate test was found to be significant.

Results

Workload and personal control were the primary factors for which there was a significant difference in satisfaction between clinicians who perform deliveries and clinicians who do not (P<.001). Obstetrician/gynecologists who do not perform deliveries reported working significantly fewer hours per week (P<.001) and had more satisfaction with their work activities than the delivery group overall. Despite lowered satisfaction with certain career aspects among the delivery Group, the highest positive disposition ratings that was given by respondents were for surgery, vaginal delivery, and planned cesarean delivery, with gender differences observed in the level of disposition for these particular activities. The most negative rating was reported for on-call/in-hospital time.

Conclusion

Although positive disposition is associated with the activity of vaginal and cesarean delivery overall, 2 primary contributing factors of dissatisfaction that were identified among obstetrician/gynecologists who perform deliveries were increased workload and decreased personal control.

Section snippets

Material and methods

One thousand five hundred questionnaires were mailed in the first week of June 2001 to a sample of American College of Obstetricians/Gynecologist (ACOG) fellows, who were selected randomly by computer from those fellows who had not been surveyed in the previous year. The sample was chosen in this manner so as not to overburden ACOG fellows with questionnaire surveys and to obtain a group that is most closely representative of the general ACOG membership. A second mailing was sent out in the

Data analysis

Data were analyzed with a personal computer-based version of SPSS (version10.0; SPSS Inc, Chicago, Ill). Differences in ratings on the dependent measures (disposition and satisfaction ratings for the 7 professional activities and satisfaction with professional features) were examined with multivariate analysis of variance. For those analyses for which there was a significant multivariate effect, univariate F tests were conducted to determine which, if any, activity ratings or satisfaction

Results

A total of 842 clinicians returned questionnaires out of 1500 questionnaires mailed, which yielded a response rate of 56%. Eleven respondents were omitted because they were retired from active practice, and 3 respondents were omitted because of substantial missing data, none of whom had provided ratings on the satisfaction or disposition items, which resulted in a final sample of 828 clinicians. Respondent demographics are presented in Table I. The delivery group comprised 81% of the sample,

Hours worked

As can be seen in Table II, the delivery groups differed significantly in the total number of hours worked (P<.001); indeed, those who perform deliveries work nearly 20 hours more per week on average. It should be noted that there is substantial variability in all of these measures, which indicates a wide diversity of experiences and time commitments within this sample. Clinicians who do not perform deliveries are significantly older (P<.001) than those who do. Male and female clinicians did

Satisfaction with features of professional life

Ratings on the individual satisfaction with features of professional life items were made on a scale from −5 (negative) to +5 (positive), with 0 defined as neutral. For the full sample, the highest satisfaction ratings were for physical safety (x = 2.58±2.22), variety (x = 2.30±2.14), and interpersonal contact (x = 2.30±2.23). Neutral (close to zero) means were found for workload/demand (x = 0.39±2.91), income level (x = 0.40±2.92), and personal control (x = 0.80±3.01).

The multivariate effect of delivery

Professional activities and disposition

Obstetrician/gynecologists' dispositions varied considerably among the 7 professional activities. Clinicians reported the highest positive scores for vaginal deliveries, planned cesarean deliveries, and surgery (P<.01, compared with other activities), which suggests that positive disposition, and thus a greater sense of satisfaction, is garnered from these activities. Specifically, performing deliveries and surgery is associated with feelings of fulfillment, competence, friendliness, and energy.

Satisfaction intensity and professional activities

Table III shows that the most satisfaction is derived from the performance of surgery and deliveries and that the least satisfaction is associated with on-call/in-hospital hours.

Social support

There was a positive disposition correlation with certain social support items and the career satisfaction score. Respondents who reported spending time alone with their spouse/partner each week (r = 0.18; P<.001) and feeling supportive of one's spouse/partner (r = 0.13; P<.001) were more likely to have higher career satisfaction.

Gender effects

Controlling for age, there was no difference between male and female responses on ratings of satisfaction with the individual professional features. However, there were significant effects of gender on the disposition factor scores for vaginal deliveries. Male respondents (x = 0.84±0.91) had higher scores than female respondents (x = 0.64±0.78) on internalization (P<.001); female respondents (x = 4.58±0.99) had higher scores than male respondents (x = 4.46±1.01) on positive disposition (P<.044). In

Comment

The goals of this research were to identify some of the primary factors that influence satisfaction with a career in obstetrics/gynecology and to understand better the disposition that is associated with each major work-related activity that is performed by these clinicians. By doing this, we can suggest ways in which to improve career satisfaction among obstetrician/gynecologists, specifically through increased participation in activities that foster greater satisfaction and the identification

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    Supported by a grant from HRSA-MCHB.

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