Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Probability of Early Retirement Among Emergency Physicians

  • Shin, Jaemyeong (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Yun Jeong (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Jong Kun (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Dong Eun (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Moon, Sungbae (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Choe, Jae Young (Department of Emergency Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Won Kee (Medical Research Collaboration Center in Kyungpook National University Hospital & Kyungpook National University School of Medicine) ;
  • Lee, Hyung Min (Department of Emergency Medicine, Korea University Guro Hospital) ;
  • Cho, Kwang Hyun (Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University)
  • Received : 2018.03.28
  • Accepted : 2018.05.17
  • Published : 2018.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction. Methods: A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram. Results: Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors. Conclusions: To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

Keywords

References

  1. Jovanovic B. Job matching and the theory of turnover. J Polit Econ 1979;87(5 Pt 1):972-990. https://doi.org/10.1086/260808
  2. Landon BE, Aseltine R Jr, Shaul JA, Miller Y, Auerbach BA, Cleary PD. Evolving dissatisfaction among primary care physicians. Am J Manag Care 2002;8(10):890-901.
  3. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 2012;172(18):1377-1385. https://doi.org/10.1001/archinternmed.2012.3199
  4. Smith-Coggins R, Broderick KB, Marco CA. Night shifts in emergency medicine: the american board of emergency medicine longitudinal study of emergency physicians. J Emerg Med 2014; 47(3):372-378. https://doi.org/10.1016/j.jemermed.2014.04.020
  5. Estryn-Behar M, Doppia MA, Guetarni K, Fry C, Machet G, Pelloux P, et al. Emergency physicians accumulate more stress factors than other physicians-results from the French SESMAT study. Emerg Med J 2011;28(5):397-410. https://doi.org/10.1136/emj.2009.082594
  6. Keller KL, Koenig WJ. Sources of stress and satisfaction in emergency practice. J Emerg Med 1989;7(3):293-299. https://doi.org/10.1016/0736-4679(89)90367-3
  7. Lee YK, Lee CC, Chen CC, Wong CH, Su YC. High risk of 'failure' among emergency physicians compared with other specialists: a nationwide cohort study. Emerg Med J 2013;30(8):620-622. https://doi.org/10.1136/emermed-2012-201440
  8. Lee HM, Cho KH, Yang HJ, Kim IB, Lee KJ, Han SB, et al. 2015 Korean Society of Emergency Physician Survey (KEPS): major changes from 2010 to 2015. J Korean Soc Emerg Med 2016; 27(5 Suppl):25-40 (Korean).
  9. National Emergency Medical Center. Annual statistical report of emergency medicine 2015 [cited 2016 Sep 25]. Available from: http://www.e-gen.or.kr/nemc/statistics_annual_report.do (Korean).
  10. Ginde AA, Sullivan AF, Camargo CA Jr. Attrition from emergency medicine clinical practice in the United States. Ann Emerg Med 2010;56(2):166-171. https://doi.org/10.1016/j.annemergmed.2009.11.002
  11. Feldman DC. The decision to retire early: a review and conceptualization. Acad Manag Rev 1994;19(2):285-311. https://doi.org/10.5465/amr.1994.9410210751
  12. Nho WY, Kim JK. Emergency physician turnover in private clinics. J Korean Soc Emerg Med 2011;22(6):716-727 (Korean).
  13. Doan-Wiggins L, Zun L, Cooper MA, Meyers DL, Chen EH. Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians. Acad Emerg Med 1995;2(6):556-563. https://doi.org/10.1111/j.1553-2712.1995.tb03261.x
  14. Lloyd S, Streiner D, Hahn E, Shannon S. Development of the emergency physician job satisfaction measurement instrument. Am J Emerg Med 1994;12(1):1-10. https://doi.org/10.1016/0735-6757(94)90187-2
  15. Tziner A, Rabenu E, Radomski R, Belkin A. Work stress and turnover intentions among hospital physicians: the mediating role of burnout and work satisfaction. J Work Organ Psychol 2015; 31(3):207-213.
  16. Heponiemi T, Kouvonen A, Vanska J, Halila H, Sinervo T, Kivimaki M, et al. Health, psychosocial factors and retirement intentions among Finnish physicians. Occup Med (Lond) 2008;58(6): 406-412. https://doi.org/10.1093/occmed/kqn064
  17. Brown SP, Peterson RA. Antecedents and consequences of salesperson job satisfaction: meta-analysis and assessment of causal effects. J Mark Res 1993;30(1):63-77. https://doi.org/10.2307/3172514
  18. American Board of Emergency Medicine. Longitudinal Study of Emergency Physicians; 2014 [cited 2018 May 19]. Available from: https://www.abem.org/public/docs/default-source/default-document-library/2014-five-year-survey.pdf?sfvrsn=0.
  19. Sachau DA. Resurrecting the motivation-hygiene theory: herzberg and the positive psychology movement. Hum Resour Dev Rev 2007;6(4):377-393. https://doi.org/10.1177/1534484307307546
  20. Adams GA, Beehr TA. Turnover and retirement: a comparison of their similarities and differences. Pers Psychol 1998;51(3): 643-665. https://doi.org/10.1111/j.1744-6570.1998.tb00255.x
  21. Moreno-Jimenez B, Galvez-Herrer M, Rodriguez-Carvajal R, Sanz Vergel AI. A study of physicians' intention to quit: the role of burnout, commitment and difficult doctor-patient interactions. Psicothema 2012;24(2):263-270.
  22. Hahn SR. Physical symptoms and physician-experienced difficulty in the physician-patient relationship. Ann Intern Med 2001;134(9 Pt 2):897-904. https://doi.org/10.7326/0003-4819-134-9_Part_2-200105011-00014
  23. Kim JK, Kim YJ, Seo KS, Ryoo HW, Kam S, Park JY, et al. Job stress, job satisfaction and occupational commitment among Korean emergency physicians. J Korean Soc Emerg Med 2010; 21(2):246-258 (Korean).
  24. Chen KC, Hsieh WH, Hu SC, Lai PF. A survey of the perception of well-being among emergency physicians in Taiwan. Ci Ji Yi Xue Za Zhi 2017;29(1):30-36.
  25. Verelst S, Moonen PJ, Desruelles D, Gillet JB. Emergency department visits due to alcohol intoxication: characteristics of patients and impact on the emergency room. Alcohol Alcohol 2012;47(4):433-438. https://doi.org/10.1093/alcalc/ags035
  26. Hann M, Reeves D, Sibbald B. Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. Eur J Public Health 2011;21(4):499-503. https://doi.org/10.1093/eurpub/ckq005
  27. Cydulka RK, Korte R. Career satisfaction in emergency medicine: the ABEM Longitudinal Study of Emergency Physicians. Ann Emerg Med 2008;51(6):714-722. https://doi.org/10.1016/j.annemergmed.2008.01.005
  28. Project of the ABIM Foundation; ACP-ASIM Foundation; European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med 2002;136(3):243-246. https://doi.org/10.7326/0003-4819-136-3-200202050-00012
  29. Cohen JJ, Cruess S, Davidson C. Alliance between society and medicine: the public's stake in medical professionalism. JAMA 2007;298(6):670-673. https://doi.org/10.1001/jama.298.6.670
  30. Working Party of the Royal College of Physicians. Doctors in society. Medical professionalism in a changing world. Clin Med (Lond) 2005;5(6 Suppl 1):S5-S40. https://doi.org/10.7861/clinmedicine.5-1-5

Cited by

  1. ‘Should I stay or should I go now?’: A qualitative study of why UK doctors retire vol.54, pp.9, 2018, https://doi.org/10.1111/medu.14157
  2. Identifying contemporary early retirement factors and strategies to encourage and enable longer working lives: A scoping review vol.15, pp.3, 2020, https://doi.org/10.1111/opn.12313
  3. Just when I thought I was out, they pull me back in: the older physician in the COVID-19 pandemic vol.32, pp.10, 2018, https://doi.org/10.1017/s1041610220000599
  4. The age‐old question: Thematic analysis of focus groups on physician experiences of aging in emergency medicine vol.2, pp.4, 2018, https://doi.org/10.1002/emp2.12499