Work week duration' workfamily balance and difficulties encountered by female physicians and pharmac

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Work week duration. work-family balance and
difficulties encountered by female physicians and
pharmacists Results from the French SESMAT study

• Estryn-Behar Madeleine . Aune Isabelle. Fry
  Clémentine. Machet Gérard. Doppia Max-André.
  Lassaunière Jean-Michel. Muster Dominique.
  Pelloux Patrick. Prudhomme Christophe. Guetarni
  Khalil.
• Occupational health physician. SCMT.
  Hôtel-Dieu. Parvis Notre-Dame. 75010 Paris France

2008 BMA-AMA-CMA International Conference on
Doctors' Health - London
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The French SESMAT study

• Introduction France encounter specific
  difficulties attracting physicians to some
  specialities. It is even more difficult to
  attract female physicians in these specialities.
• Methods A comprehensive questionnaire was
  prepared using established scales measuring
  various aspects of working conditions,
  satisfaction and health of salaried physicians
  and pharmacists.
• It was available online and the two major
  associations of physicians promoted its use.
• SPSS 12 software

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The French SESMAT study

• Initial sample 3196 physicians filled in the
  questionnaire.
• among them 47.1 were
  female physicians.
• Representative sample
• To avoid bias, 1924 physicians were randomly
  selected from the total data base, with quotas,
  to match the demographic characteristics of the
  French physicians population (Ministry
  statistics department - Drees)
• Gender 42.5 female.
• Age 8.2 lt 35 years old, 33.8 35-44 years
  old. 34.5 45-54 years old and 23.6 55 years old
  and over
• Regions Distribution of physicians according
  to the 23 administrative regions
• Specialities Distribution of physicians
  according to specialities was also respected.
• This representative sample was used to compare
  with each specialities subgroup of physicians.

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Results Intent to leave the profession
Think about giving up completely sometimes a
month. sometimes a week or daily plt0.05
5
Think about giving up completely sometimes a
month. sometimes a week or daily plt0.05
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Results Burnout
The percentage of female physicians with a high
burnout score (CBI) is higher than male bur not
with MBI
Maslach burnout inventory reduced version
Copenhagen burnout inventory
ns
plt0.001
N 796 1073
N 724 1067
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Results Intent to leave the profession
Frequent intent to leave their profession (think
about giving up completely sometimes a month.
sometimes a week or daily) 16.5 of female
physicians 18.1 of male physicians ns non
significant difference
N 802 1091
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• Factors linked with burnout and intent to leave
  the profession
• Some are more prevalent
• among female physicians
• Other are more prevalent
• among male physicians

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Results socio-demographic characteristics
Slightly more young physicians among female
physicians plt0.01
More female physicians alone or alone with
child(ren) plt0.001
N 812 1095
N 818 1104
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Results Work duration
81.0 of male physicians work 45 hours or more
per week 58.4 of female physicians
plt0.001
40.6 of male physicians work 5 nights or more
per month 20.9 of the representative sample

plt0.001
N 730 996
N 680 911
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Results Personal life
Sport practice is infrequent for male and female
physicians ns
9.8 smoke sometimes 15.3 smoke every day
(F/M ns)
Meal break on working day plt0.01
Female Male Sometimes 56.9
49.7 Never 15.1 15.8
Fruits or vegetables portions per day plt0.001
Female Male 3 or more / day 46.0
35.1 0, 1 or 2 / day 54.0 64.9
N 812 1101
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Results socio-demographic characteristics
Score of work/family conflict plt0.001
Professional life was an obstacle to giving birth
plt0.001
plt0.001
N 811 1098
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Score of work/family conflict according to
workweek duration
Score of work/family conflict among female
physicians plt0.001
plt0.001
N 99 267 540
N 99 267 540
N 180 244 249
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Score of work/family conflict according to
number of nightwork per month
Score of work/family conflict among female
physicians plt0.001
plt0.001
0 1or2 3 to 7 8 and

N 428 144 76 75
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Work/family conflicts among physicians and
Burnout and intent to leave
Burnout (CBI) and Work family conflict
plt0.001
Intent to leave and Work family conflict
plt0.001
X 2.5 for male physicians
X 5 for male physicians
X 3 for female physicians
X 2 for female physicians
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Results Work situation
Half of male and female physicians have low or
medium score of influence at work ns
More male physicians attend 10 days of continuous
education last 12 months
plt0.001
N 818 1105
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Results Work content
Worried about making mistakes often or always
62.3 of male physicians 52.5 of female
physicians
Half of male and female physicians have a high
quantitative demand score ns
plt0.001
N 762 1049
N 816
1102
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Results Team functionning
Dissatisfied with their opportunities to give
their patients the care they need 48.6 of
female physicians 47.6 of male physicians
Dissatisfied with psychological support at work
68.1 of female physicians 66.5 of the male
physicians
plt0.05
plt0.05
N 800 1077
N 748 1082
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Results Team functionning
More male physicians are dissatisfied with
handover shift plt0.001
Slightly more female physicians have a low
quality of team work score plt0.05
N 794 1084
N 772 1048
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Quality of teamwork among emergency
physicians and Burnout and intent to leave
Burnout (CBI) and Quality of teamwork
plt0.001
Intent to leave and Quality of teamwork plt0.001
X 2 for male and female physicians
X 3 for male physicians
X 2.5 for female physicians
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Results Relations at work
No difference between physicians for declaration
of tense relations with members of care team
(colleagues. nurses. head nurse)
More male physicians have tense relations with
administration plt0.05
N 793 1091
N 682 942
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Results Relations at work
No difference between physicians for declaration
of being subjected to harassment by their
superiors
N 798 1078
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Multivariate analysis of factors linked with
Burnout (CBI) among Female and Male Physicians

• Total (N 1286)
  Female (N507) Male (N608)
• Adj. OR p 95 CI
  Adj. OR p Adj. OR p
• Medium Work/ Fam. conflicts 2.68
  1.76-4.08 2.09 3.18
  
• High Work/ Family conflicts 4.87
  3.20-7.41 4.78 4.51
• Work 5 nights per month or
  1.64
  
• High quantitative demand 3.45
  1.40-8.53 2.18 1.91
• Low quality of teamwork 2.11
  1.47-3.04 1.77 2.03
• Frequent harassment by sup.
  1.75
• Worried ab. making mistakes 1.76
  1.33-2.31 1.58
• Low influence at work
  
  1.83
• Low satisfaction with pay 1.31
  1.00-1.71
  1.59
• No sport practice 1.42
  1.05-1.93
• Gender Female/Male 2.50
  1.90-3.31

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Multivariate analysis of factors linked with
intent to leave the profession among Female and
Male Physicians
Total (N1547)
Female (N619) Male (N946)
Adj. OR p 95 CI Adj. OR p
Adj. OR p Low quality of teamwork 2.72
1.71-4.32 4.15 2.87
High burnout score (Maslach) 2.31
1.69-3.16 2.27 2.42
High burnout score (CBI) 1.64
1.19-2.25 1.85 1.66
No continuous education 12m. 2.05
1.24-3.39 2.67 1.77
ns(0.06) Musculosqueletal disorders
1.72
Tense relat. w. administr. 1.52
1.13-2.05 1.78
Worried about mistakes 1.56
1.13-2.15 2.48 Low influence at work
1.68 1.12-2.54 Low
satisfaction with pay 1.35
1.01-1.82 2.38 Proposal for a job
within care 1.65 1.19-2.29
1.87 Proposal for a job
outside care 2.07 1.32-3.25
2.11 Age 55 years old or
3.67 1.77-7.60
3.72 5.04
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Conclusion

• European regulations regarding work week
  duration are difficult to implement and lead to a
  vicious circle. Physicians turnover increases
  the demand on those who stay, increasing their
  intent to leave
• Excessive job demands and high Work/ Family
  Conflicts are linked with burnout as well as with
  difficulties in organising ones life in order to
  become pregnant or to have sufficient time to
  raise children for men and women
• Team functioning has to be improved between all
  those who take care of the same group of patients
  (physicians, Nurses, nursing aidsand
  particularly relates to female physicians
• More staff communication facilitates all patient
  care and reduces adverse or violent events in any
  clinical situation
• Reduction of work/family conflicts has to be high
  on the agenda, through improved work schedules

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Thank you
http//www.presst-next.fr/SESMAT/
madeleine.estryn-behar_at_sap.aphp.fr
2008 BMA-AMA-CMA International Conference on
Doctors' Health - London