Coaching, Separate from Mentoring, May Provide Skill Acquisition, Improved Well-Being, and Career Advancement in Orthopaedic Surgery

Samora, Julie Balch; Brown, Gregory A.; Clohisy, Denis R.; Weber, Kristy

doi:10.2106/jbjs.21.01198

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Factors most associated with this attrition were academic affiliation, being a woman, and clinical subspecialization. Academic orthopaedic practices might consider expanding the role of routine exit interviews to identify and help support individuals facing severe illness, injury, career dissatisfaction, or other personal hardships [24,42,43]. Likewise, such interviews might also identify individuals transitioning to alternative career paths and elucidate reasons for discontinuation of clinical practice [34,52].…”

Section: Discussionmentioning

confidence: 99%

“…Based on these findings, academic orthopaedic practices might consider expanding the role of routine exit interviews to identify instances in which young surgeons face severe illness, disability, or job dissatisfaction or transition to nonclinical career paths [34,52]. If early-career attrition is secondary to major personal hardships, these individuals may benefit from connection to well-vetted coaching or counseling services [24,42,43]. Furthermore, professional societies may be well positioned to conduct more detailed surveys to assess the distribution of reasons for early The Area Deprivation Index is a national percentile ranking of United States counties based on a compilation of more than 20 socioeconomic indices such as educational attainment, median family income, unemployment rate, and proportion without access to a telephone, motor vehicle, or adequate plumbing.…”

Section: Discussionmentioning

confidence: 99%

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What Factors Are Associated With Early Career Attrition Among Orthopaedic Surgeons in the United States?

Jella

Patel

Cwalina

et al. 2023

Clin Orthop Relat Res

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Background The attrition of medical personnel in the United States healthcare system has been an ongoing concern among physicians and policymakers alike. Prior studies have shown that reasons for leaving clinical practice vary widely and may range from professional dissatisfaction or disability to the pursuit of alternative career opportunities. Whereas attrition among older personnel has often been understood as a natural phenomenon, attrition among early-career surgeons may pose a host of additional challenges from an individual and societal perspective. Questions/purposes (1) What percentage of orthopaedic surgeons experience early-career attrition, defined as leaving active clinical practice within the first 10 years after completion of training? (2) What are the surgeon and practice characteristics associated with early-career attrition? Methods In this retrospective analysis drawn from a large database, we used the 2014 Physician Compare National Downloadable File (PC-NDF), a registry of all healthcare professionals in the United States participating in Medicare. A total of 18,107 orthopaedic surgeons were identified, 4853 of whom were within the first 10 years of training completion. The PC-NDF registry was chosen because it has a high degree of granularity, national representativeness, independent validation through the Medicare claims adjudication and enrollment process, and the ability to longitudinally monitor the entry and exit of surgeons from active clinical practice. The primary outcome of early-career attrition was defined by three conditions, all of which had to be simultaneously satisfied (“condition one” AND “condition two” AND “condition three”). The first condition was presence in the Q1 2014 PC-NDF dataset and absence from the same dataset the following year (Q1 2015 PC-NDF). The second condition was consistent absence from the PC-NDF dataset for the following 6 years (Q1 2016, Q1 2017, Q1 2018, Q1 2019, Q1 2020, and Q1 2021), and the third condition was absence from the Centers for Medicare and Medicaid Services Opt-Out registry, which tracks clinicians who have formally discontinued enrollment in the Medicare program. Of the 18,107 orthopaedic surgeons identified in the dataset, 5% (938) were women, 33% (6045) were subspecialty-trained, 77% (13,949) practiced in groups of 10 or more, 24% (4405) practiced in the Midwest, 87% (15,816) practiced in urban areas, and 22% (3887) practiced at academic centers. Surgeons not enrolled in the Medicare program are not represented in this study cohort. A multivariable logistic regression model with adjusted odds ratios and 95% confidence intervals was constructed to investigate characteristics associated with early-career attrition. Results Among the 4853 early-career orthopaedic surgeons identified in the dataset, 2% (78) were determined to experience attrition between the first quarter 2014 and the same point in 2015. After controlling for potential confounding variables such as years since training completion, practice size, and geographic region, we found that women were more likely than men to experience early-career attrition (adjusted OR 2.8 [95% CI 1.5 to 5.0]; p = 0.006]), as were academic orthopaedic surgeons compared with private practitioners (adjusted OR 1.7 [95% CI 1.02 to 3.0]; p = 0.04), while general orthopaedic surgeons were less likely to experience attrition than subspecialists (adjusted OR 0.5 [95% CI 0.3 to 0.8]; p = 0.01). Conclusion A small but important proportion of orthopaedic surgeons leave the specialty during the first 10 years of practice. Factors most-strongly associated with this attrition were academic affiliation, being a woman, and clinical subspecialization. Clinical Relevance Based on these findings, academic orthopaedic practices might consider expanding the role of routine exit interviews to identify instances in which early-career surgeons face illness, disability, burnout, or any other forms of severe personal hardships. If attrition occurs because of such factors, these individuals could benefit from connection to well-vetted coaching or counseling services. Professional societies might be well positioned to conduct detailed surveys to assess the precise reasons for early attrition and characterize any inequities in workforce retention across a diverse range of demographic subgroups. Future studies should also determine whether orthopaedics is an outlier, or whether 2% attrition is similar to the proportion in the overall medical profession.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What Factors Are Associated With Early Career Attrition Among Orthopaedic Surgeons in the United States?

Jella

Patel

Cwalina

et al. 2023

Clin Orthop Relat Res

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“…Lastly, we see potential for coaching in health care to help destigmatize failure. Drawing from the business world, health care has recently begun to embrace 106–108 the value of professional coaches. Coaches utilize guided inquiry to help an individual reach certain insights about one’s potential and abilities 108 .…”

Section: The Potential Of Failurementioning

confidence: 99%

Embracing failure: Nurturing learning and well-being in anesthesiology and perioperative medicine

Higgins,

Vinson,

Petrini

et al. 2024

International Anesthesiology Clinics

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Failure, ubiquitous in life and medical practice, offers myriad opportunities for learning and growth alongside challenges to overall well-being. In this article, we explore the nature of failure, it’s sources and impacts in perioperative medicine, and the specific challenges it brings to trainee well-being. With a deeper understanding of the societal, psychological and cognitive determinants and effects of failure, we propose solutions in order to harness the opportunities inherent in failures to create brave and supportive learning environments conducive to both education and well-being.

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“…The career of an orthopaedic surgeon begins with a rigorous training period and continues directly into the challenges of running a practice. In 2022, Samora et al drew a unique distinction between mentoring and coaching in practicing orthopaedic surgeons 43 . This review highlights how coaching can “reduce burnout, focus on varying individual needs, promote well-being, positively affect purpose, hone surgical and leadership skills, and assist with internal motivation requisites for leadership and career successes 43 .” The constellation of these positive factors established during residency builds a strong foundation and directly contributes to the ongoing development of resilience in the practicing orthopaedic surgeon.…”

Section: Finding the Pathway To Resiliencementioning

confidence: 99%

Resilience in Residency and Beyond

et al. 2023

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Distinct from the burnout and wellness continuum, resilience is a developed and refined characteristic that propels an individual toward personal and professional success.We propose a clinical resilience triangle consisting of 3 components that define resilience: grit, competence, and hope.Resilience is a dynamic trait that should be built during residency and constantly fortified in independent practice so that orthopaedic surgeons may acquire and hone the skills and mental fortitude required to take on the overwhelming challenges that we all inevitably face.

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Coaching, Separate from Mentoring, May Provide Skill Acquisition, Improved Well-Being, and Career Advancement in Orthopaedic Surgery

Cited by 6 publications

References 19 publications

What Factors Are Associated With Early Career Attrition Among Orthopaedic Surgeons in the United States?

What Factors Are Associated With Early Career Attrition Among Orthopaedic Surgeons in the United States?

Embracing failure: Nurturing learning and well-being in anesthesiology and perioperative medicine

Resilience in Residency and Beyond

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