Culture Barrier May Affect Surgeon Job Satisfaction

Culture BarrierA new study suggests that surgeons who treat a high proportion of Hispanic patients tend to be less happy with their jobs than their peers -- a difference, researchers say, that may have much to do with language and cultural barriers.

They also say the findings underscore a need for more minorities in the field of surgery.

The study, reported in the Annals of Surgery, analyzed data for 762 U.S. surgeons surveyed in 2008 on the factors that influenced their job satisfaction.

Overall, the No. 1 determinant was time spent with patients, said senior researcher Satish P. Deshpande, of Western Michigan University in Kalamazoo.

That is, the more time surgeons felt they had to talk with patients, the more satisfied they were with their careers. They were also happier if they felt they delivered a high quality of care, or had relatively little anxiety over malpractice suits -- but those factors were closely related to how much time the surgeons had to spend with their patients.

On the flip side, surgeons tended to be less satisfied with their job when they treated a high proportion of Hispanic patients. There was no similar pattern seen when it came to black or Asian patients.

However, Deshpande cautioned, "you need to be careful interpreting that finding."

One possibility is that surgeons with a high proportion of Hispanic patients also have a high number of uninsured patients, making money an issue.

Because the researchers were analyzing answers to a past survey, they could not ask the respondents for more detail.

But Deshpande pointed out that in the survey results, job satisfaction was generally high among surgeons who said they had access to translation services for patients who spoke a different language.

"So we think most of it has to do with language and cultural issues," Deshpande said.

An implication, he said, is that having more translation services and an ethnically diverse hospital staff would be helpful.

The findings also underline a need for more minority surgeons, according to Deshpande -- who noted that studies have shown that African-American and Hispanic patients often prefer a doctor of their own ethnicity because they feel communication is easier.

"That's something that really needs to be looked at," Deshpande said. "We do need more minorities (in surgical specialties), and more women as well."

The latest U.S. census figures show the nation's Hispanic population grew 43 percent between 2000 and 2010, and remains the fastest growing minority.

In this study, only 6 percent of surgeons were Hispanic or African-American, while only 9 percent were women.

And in general, Deshpande said, there are few women and minorities on medical school faculties, limiting the number of role models for minority students.

Encouraging more minorities to become surgeons may be especially important at a time when there's a shortage of surgeons in general, according to Deshpande.

The study's original objective was to understand factors influencing job satisfaction and burnout, so that more surgeons can be recruited and retained.

"There's a limited number of surgeons, and a growing demand for them," he said, adding that there are about 80 million aging Baby Boomers who will put a growing strain on surgical services nationwide.

Since surgical training takes 8 to 12 years, any surgeon shortage would not be remedied quickly.

"You're not going to turn on the tap and suddenly have more surgeons," Deshpande said. "So we need to be thinking about this now."

There have been some efforts to boost the number of minorities in the field of surgery. A study last year found that a program called the Diverse Surgeons Initiative, which helps young minority surgeons advance their surgical skills, seemed to help some get into academic positions.

Of 42 who had completed all their training as of 2009, 57 percent were on faculty in departments of surgery, a higher proportion than the national average of fifth-year residents.

SOURCE: Annals of Surgery, online March 29, 2011.

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