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The Impact of the Changing Health Care Environment on the Health and Well-Being of Faculty at Four Medical Schools

Schindler, Barbara A. MD; Novack, Dennis H. MD; Cohen, Diane G.; Yager, Joel MD; Wang, Dora MD; Shaheen, Nicholas J. MD, MPH; Guze, Phyllis MD; Wilkerson, LuAnn EdD; Drossman, Douglas A. MD

Institutional Issues

Purpose Increased pressure for clinical and research productivity and decreased control over the work environment have been reported to have adverse impacts on academic faculty in limited studies. The authors examined whether work-related stressors in academic medicine negatively affected the physical and mental health, as well as life and job satisfaction, of academic medical school faculty.

Method A 136-item self-administered anonymous questionnaire modified from a small 1984 study was distributed to 3,519 academic faculty at four U.S. medical schools following institutional review board approval at each school. Validated scales measuring depression, anxiety, work strain, and job and life satisfaction; a checklist of common physical and mental health symptoms; and questions about the impact of institutional financial stability, colleague attrition, and other work-related perceptions were used. Responses were analyzed by sex, academic rank, age, marital status, faculty discipline, and medical school.

Results Responses were received from 1,951 full-time academic physicians and basic science faculty, a 54.3% response rate. Twenty percent of faculty, almost equal by sex, had significant levels of depressive symptoms, with higher levels in younger faculty. Perception of financial instability was associated with greater levels of work strain, depression, and anxiety. Significant numbers of faculty acknowledged that work-related strain negatively affected their mental health and job satisfaction, but not life satisfaction or physical health. Specialties were differentially affected.

Conclusions High levels of depression, anxiety, and job dissatisfaction—especially in younger faculty—raise concerns about the well-being of academic faculty and its impact on trainees and patient care. Increased awareness of these stressors should guide faculty support and development programs to ensure productive, stable faculty.

Dr. Schindler is vice dean for educational and academic affairs and professor of psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Dr. Novack is associate dean for medical education and professor of medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Ms. Cohen is program director, Standardized Patient Program, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Dr. Yager is vice chair for education and academic affairs and professor of psychiatry, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico.

Dr. Wang is assistant professor of psychiatry, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico.

Dr. Shaheen is associate professor of medicine and epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.

Dr. Guze is chief of medicine, Greater Los Angeles Veterans Administration Medical Center, and professor and executive vice chair, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.

Dr. Wilkerson is senior associate dean for medical education, David Geffen School of Medicine at UCLA, Los Angeles, California.

Dr. Drossman is professor of medicine and psychiatry, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Schindler, vice dean for educational and academic affairs, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129; telephone: (215) 991-8561; fax: (215) 843-0214; e-mail: 〈Barbara.Schindler@drexelmed.edu〉.

© 2006 Association of American Medical Colleges