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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey

Authors: Allison Milner, Katrina Witt, Matthew J. Spittal, Marie Bismark, Melissa Graham, Anthony D. LaMontagne

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Psychosocial job stressors, such as low control and high demands, have been found to influence the health and wellbeing of doctors. However, past research in this area has relied on cross-sectional data, which limits causal inferences about the influence of psychosocial job stressors on health. In this study, we examine this relationship longitudinally while also assessing whether the relationship between psychosocial job stressors and health is modified by gender.

Methods

The data source was seven annual waves of the Medicine in Australia: Balancing Employment and Life (MABEL) survey. The outcome was self-rated health (measured using the SF-12), and key exposures reflected job control, job demands, work-life balance variables, employment arrangements, and aggression experienced at work. We used longitudinal fixed and random effects regression models to assess within and between-person changes in health.

Results

Excessive job demands, low job control, feelings of not being rewarded at work, and work-life imbalance were associated with higher within-person odds of poorer self-rated health. Gender differences were apparent. For female doctors, work arrangements and work-life imbalance were associated with poorer self-rated health whilst task-based job stressors were associated with poorer self-rated health in male doctors.

Conclusions

These results suggest the importance of addressing adverse working environments among doctors.

Trial registration

Not applicable.
Appendix
Available only for authorised users
Literature
1.
Kay MP, Mitchell GK, Del Mar CB. Doctors do not adequately look after their own physical health. Med J Aust. 2004;181(7):368–70.PubMed
2.
Milner A, Maheen H, Bismark M, Spittal MJ. Suicide by health care professionals: a retrospective mortality study in Australia, 2001–2012. MJA. 2016;205(6):260–5.PubMed
3.
Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, Shanafelt TD. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Academic medicine : journal of the Association of American Medical Colleges. 2014;89(3):443–51.CrossRef
4.
Bragard I, Dupuis G, Fleet R. Quality of work life, burnout, and stress in emergency department physicians: a qualitative review. European journal of emergency medicine: official journal of the European Society for Emergency Medicine. 2015;22(4):227–34.CrossRef
5.
Tyssen R. Health problems and the use of health services among physicians: a review article with particular emphasis on Norwegian studies. Ind Health. 2007;45(5):599–610.CrossRefPubMed
6.
Tyssen R, Røvik JO, Vaglum P, Grønvold NT, Ekeberg Ø. Help-seeking for mental health problems among young physicians: is it the most ill that seeks help? Soc Psychiatry Psychiatr Epidemiol. 2004;39(12):989–93.CrossRefPubMed
7.
Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet (London, England). 2009;374(9702):1714–21.CrossRef
8.
Saijo Y, Chiba S, Yoshioka E, Kawanishi Y, Nakagi Y, Itoh T, Sugioka Y, Kitaoka-Higashiguchi K, Yoshida T. Effects of work burden, job strain and support on depressive symptoms and burnout among Japanese physicians. Int J Occup Med Environ Health. 2014;27(6):980–92.CrossRefPubMed
9.
Buddeberg-Fischer B, Klaghofer R, Stamm M, Siegrist J, Buddeberg C. Work stress and reduced health in young physicians: prospective evidence from Swiss residents. Int Arch Occup Environ Health. 2008;82(1):31–8.CrossRefPubMed
10.
Vanagas G, Bihari-Axelsson S. Interaction among general practitioners age and patient load in the prediction of job strain, decision latitude and perception of job demands. A cross-sectional study. BMC Public Health. 2004;4:59.CrossRefPubMedPubMedCentral
11.
Firth-Cozens J. Individual and organizational predictors of depression in general practitioners. Br J Gen Pract. 1998;48(435):1647–51.PubMedPubMedCentral
12.
13.
Sutherland VJ, Cooper CL. Job stress, satisfaction, and mental health among general practitioners before and after introduction of new contract. BMJ (Clinical research ed). 1992;304(6841):1545–8.CrossRef
14.
Frank E, Dingle AD. Self-reported depression and suicide attempts among U.S. women physicians. Am J Psychiatr. 1999;156(12):1887–94.PubMed
15.
Li J, Yang W, Cho S-i. Gender differences in job strain, effort-reward imbalance, and health functioning among Chinese physicians. Soc Sci Med. 2006;62(5):1066–77.CrossRefPubMed
16.
Vanagas G, Bihari-Axelsson S. The factors associated to psychosocial stress among general practitioners in Lithuania. Cross-sectional study. BMC Health Serv Res. 2005;5:45.CrossRefPubMedPubMedCentral
17.
Cooper CL, Rout U, Faragher B. Mental health, job satisfaction, and job stress among general practitioners. BMJ: British Medical Journal. 1989;298(6670):366–70.CrossRefPubMedPubMedCentral
18.
Kuusio H, Heponiemi T, Aalto AM, Sinervo T, Elovainio M. Differences in well-being between GPs, medical specialists, and private physicians: the role of psychosocial factors. Health Serv Res. 2012;47(1 Pt 1):68–85.CrossRefPubMed
19.
Ruitenburg MM, Frings-Dresen MH, Sluiter JK. The prevalence of common mental disorders among hospital physicians and their association with self-reported work ability: a cross-sectional study. BMC Health Serv Res. 2012;12(1):292.CrossRefPubMedPubMedCentral
20.
Elovainio M, Salo P, Jokela M, Heponiemi T, Linna A, Virtanen M, Oksanen T, Kivimaki M, Vahtera J. Psychosocial factors and well-being among Finnish GPs and specialists: a 10-year follow-up. Occup Environ Med. 2013;70(4):246–51.CrossRefPubMed
21.
Joyce CM, Scott A, Jeon S-H, Humphreys J, Kalb G, Witt J, Leahy A. The “Medicine in Australia: Balancing Employment and Life (MABEL)” longitudinal survey - Protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res. 2010;10(1):1–10.CrossRef
22.
Taylor T, Scott A, Leahy A. MABEL User Manual: Wave 7 Release. Melbourne: Institute of Applied Economic and Social Research, University of Melbourne; 2015.
23.
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.CrossRefPubMed
24.
Subramanian SV, Huijts T, Avendano M. Self-reported health assessments in the 2002 World Health Survey: how do they correlate with education? Bull World Health Organ. 2010;88:131–8.CrossRefPubMed
25.
Fishta A, Backe EM. Psychosocial stress at work and cardiovascular diseases: an overview of systematic reviews. Int Arch Occup Environ Health. 2015;88(8):997–1014.CrossRefPubMedPubMedCentral
26.
Smith TW, Ruiz JM. Psychosocial influences on the development and course of coronary heart disease: current status and implications for research and practice. J Consult Clin Psychol. 2002;70(3):548–68.CrossRefPubMed
27.
Bonde JPE. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med. 2008;65(7):438–45.CrossRefPubMed
28.
Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRefPubMed
29.
De Witte H. Job insecurity: Review of the international literature on definitions, prevalence, antecedents and consequences. SA J Ind Psychol. 2005;31(4). doi:10.​4102/​sajip.​v31i4.​200.
30.
ABS. Underemployed Workers, Australia, September 2013. Cat. No. 6265.0. Canberra: Australian Bureau of Statistics; 2013.
31.
Wooldridge JM: Advanced panel data methods. In: Introductory Econometrics: A Modern Approach, 6th Edition. Boston: Cengage Learning; 2016: 434–498.
32.
Dieleman JL, Templin T. Random-Effects, Fixed-Effects and the within-between Specification for Clustered Data in Observational Health Studies: A Simulation Study. PLoS One. 2014;9(10):e110257.CrossRefPubMedPubMedCentral
33.
Greene WH. Econometric Analysis. Upper Saddle River: Pearson/Prentice Hall; 2008.
34.
Kohler U, Kreuter F. Data analysis using stata. College Station: Stata Press; 2009.
35.
Gunasekara FI, Richardson K, Carter K, Blakely T. Fixed effects analysis of repeated measures data. Int J Epidemiol. 2014;43(1):264–9.CrossRefPubMed
36.
Hausman JA. Specification tests in econometrics. Econometrica. 1978;46:1251–71.CrossRef
37.
Walsh J. Gender, the Work-Life Interface and Wellbeing: A Study of Hospital Doctors. Gender, Work & Organization. 2013;20(4):439–53.CrossRef
38.
Mechaber HF, Levine RB, Manwell LB, Mundt MP, Linzer M. Part-Time Physicians…Prevalent, Connected, and Satisfied. J Gen Intern Med. 2008;23(3):300–3.CrossRefPubMedPubMedCentral
39.
Blaxland M: Mothers and mutual obligation: policy reforming the good mother. In: The good mother: Contemporary motherhoods in Australia. Goodwin S, Huppatz K. Sydney: Sydney University Press; 2010:131–152.
40.
Mache S, Bernburg M, Vitzthum K, Groneberg DA, Klapp BF, Danzer G. Managing work–family conflict in the medical profession: working conditions and individual resources as related factors. BMJ Open. 2015;5(4).
41.
Schurer S, Kuehnle D, Scott A, Chai Cheng T. One Man’s Blessing, Another Woman’s Curse? Family Factors and the Gender-Earnings Gap of Doctors. Industrial Relations. 2016;55(3):385–414.
42.
43.
Metadata
Title
The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey
Authors
Allison Milner
Katrina Witt
Matthew J. Spittal
Marie Bismark
Melissa Graham
Anthony D. LaMontagne
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2554-z

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