Medical school faculty members don’t like their jobs as much as they used to, and their professional despair could trickle down to medical students, according to a report in the January issue of Academic Medicine.
The study, “The Impact of the Changing Health Care Environment on the Health and Well-Being of Faculty at Four Medical Schools,” used 2001 survey responses from 1,457 academic physicians, and found that about one-fifth of them, men and women nearly equally, displayed at least some symptoms of clinical depression, up from 14 percent in a survey of academic physicians in 1984. Nationally, about 11 percent of women and 7 percent of men report symptoms of depressions. Little previous data on the mental health of academic physicians existed for comparison, but the study did find that younger faculty members -- those under 35 – reported higher levels of anxiety and less job satisfaction than older faculty members.
The study suggests that a paucity of time available for mentoring and research is putting academic physicians on edge. The only similar survey of academic doctors was the 1984 sample. In that survey, the physicians reported about the same length of work week -- 60.4 hours then as compared to 60.8 hours now. But in the 2001 survey, as compared to 1984, physicians reported spending almost twice as much of their time, 40.7 percent, with patients, about half as much of their time, 14.7 percent doing research, and 15.2 percent of their time teaching and supervising students and residents, down from 21 percent. The study says that disgruntled respondents reported anticipating a more balanced life in academia.
Barbara Schindler, vice dean for educational and academic affairs at the Drexel University medical school and lead author of the study, said that managed care has a lot to do with physician’s woes. “It puts so much pressure to manage patients in a time effective way, there’s no time to mentor,” Schindler said. “You have to see X patients to get malpractice insurance, you’re constantly cutting corners.” Schindler added that, as dean, she regularly struggles to get busy physicians to take office time for students.
Academic physicians did, however, report taking about 15 vacation days in the last year, as opposed to 11.4 days reported in the 1984 survey.
According to the study, the increasing stress that physicians reported is a sign of the times. Beyond dealing with managed care and escalating malpractice premiums, the study found a small, but statistically significant correlation between how faculty members judged the financial health of their institutions, and their level of anxiety. The study says the results raise “the concern that current medical students are being taught by faculty who are increasingly stressed and dispirited.” More than a quarter of faculty members reported frequently thinking about leaving academia. The study says the discontent is not surprising, given the increased demands for clinical and research productivity. It also notes the decreased support for teaching as a major factor, even though academic physicians reported spending more time teaching now than in 1984, 11.4 percent of their time as opposed to 8 percent. Schindler said it’s the mentoring that academic doctors are really missing.
Still, the study said that faculty members generally reported high levels of life satisfaction, and suggested that, though increasingly unhappy with the workplace, younger faculty members reported doing a better job setting aside time for family and friends and getting to the gym. The authors also noted that being married “mitigated some of the negative effects of the academic environment.” Ninety-percent of all respondents were married or in stable relationships.
Schindler said she originally expected older faculty members, who have seen better days, to be more upset with the current predicament, but the opposite was true. “Maybe they’ve seen so many cases, that they can more efficiently deal with the time pressure,” she said.
Or maybe older faculty members have simply learned a better coping strategy:
Almost twice as many (45 percent) older faculty members – 56 years old and up – as younger faculty members – aged 27-45 – reported drinking alcohol several times a week.