Factors influencing surgeon well-being: qualitatively exploring the joy of surgery

Abstract

Background There has been considerable research into burnout but much less into how surgeons thrive and find joy. This study, conducted by the SAGES Reimagining the Practice of Surgery Task Force, explored factors influencing surgeon well-being, the eventual goal being translating findings into tangible changes to help restore the joy in surgery. Methods This was a qualitative, descriptive study. Purposive sampling ensured representation across ages, genders, ethnicities, practice types, and geographies. Semi-structured interviews were recorded and transcribed. We coded inductively, finalized the codebook by consensus, and then constructed a thematic network. Global themes formed our conclusions; organizing themes gave additional detail. Analysis was facilitated by NVivo. Results We interviewed 17 surgeons from the US and Canada. Total interview time was 15 hours. Our global and organizing themes were: Stressors (Work–life Integration, Administration-related Concerns, Time and Productivity Pressures, Operating Room Factors, and Lack of Respect). Satisfaction (Service, Challenge, Autonomy, Leadership, and Respect and Recognition). Support (Team, Personal Life, Leaders, and Institutions). Values (Professional and Personal). Suggestions (Individual, Practice, and System level). Values, stressors, and satisfaction influenced perspectives on support. Experiences of support shaped suggestions. All participants reported stressors and satisfiers. Surgeons at all stages enjoyed operating and being of service. Supports and suggestions included compensation and infrastructure, but human resources were most critical. To experience joy, surgeons needed high-functioning clinical teams, good leaders/mentors, and supportive family/social networks. Conclusions Our results indicated organizations could (1) better understand surgeons’ values, like autonomy; (2) provide more time for satisfiers, like patient relationship building; (3) minimize stressors, like time and financial pressures; and (4) at all levels focus on (4a) building teams and leaders and (4b) giving surgeons time and space for healthy family/social lives. Next steps include developing an assessment tool for individual institutions to build “joy improvement plans” and to inform surgical associations’ advocacy efforts.

Fertility, Family, and a Career in Surgery—Time to Change the Narrative

“…These career pressures extend into residency, with its heavy clinical load and research obligations, and into independent practice, where administrative burdens take us away from what attracted us to surgery in the first place-the joys of procedural mastery and the rewards of changing patients' lives through our knowledge and skills. 5 The impact of family building on career development is not unique to medicine and surgery. It exists across society and affects all genders.…”

“…Concurrently, the career pressures of medicine begin early in medical school, fostered within a stringent medical training system that offers little flexibility. These career pressures extend into residency, with its heavy clinical load and research obligations, and into independent practice, where administrative burdens take us away from what attracted us to surgery in the first place—the joys of procedural mastery and the rewards of changing patients’ lives through our knowledge and skills …”