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“For complex surgical procedures, you’re generally better off at teaching hospitals, which usually stay at the forefront of health research. Medical students and residents ask questions, providing more eyes and ears to pay attention and prevent errors. Teaching hospitals have lower complication rates and better outcomes.” —Evan Levine, MD, a cardiologist and the author of What Your Doctor Can’t (or Won’t) Tell You.“Those freestanding ERs popping up all over? They typically don’t have anywhere near the resources of hospital ERs, yet they cost just as much. Go there for small bumps and bruises. For something serious (chest pain, a badly broken bone), get to a trauma center where specialists and surgeons work.” —James Pinckney, MD, an ER doctor, founder of Diamond Physicians in Dallas, Texas. Check out these other 50 secrets an ER staff won’t tell you.Epidural steroid injections for back pain has risky potential complications like neurological problems or paralysis. “Generally, epidural steroid injection isn’t very useful for treatment of chronic back or neck pain,” says Steven Severyn, MD, an anesthesiologist at the Ohio State University Wexner Medical Center.No unnecessary scans. Studies have shown that radiation from CT scans could be responsible for as many as two percent of all cancers in the U.S. “CT scans are much quicker and tend to be less costly than an MRI, but does have the added radiation that MRI’s lack,” says Todd Sontag, DO, a family medicine physician with Orlando Health.Practically all surgeons have an inherent financial conflict of interest. That’s because they are paid approximately ten times more money to perform surgery than to manage your problem conservatively.” —James Rickert, MD, an orthopedic surgeon in Bedford, Indiana.No-certified specialty. If an airline told you that their pilot is the best but he’s not FAA-certified, would you get on the plane? "For the same reason, always check if your surgeon is board-certified in his specialty. Many are not.” Tomas A. Salerno, MD, chief of cardiothoracic surgery at the University of Miami Miller School of MedicineSome surgeons won’t mention procedures they don’t know how to do. "I’ll see patients who were told they needed an open hysterectomy, even though it could be handled laparoscopically. That’s one reason it’s good to get a second opinion.” —Arnold Advincula, MDYears ago, a patient sent his slides to three different pathologists and got three different answers. "I got very upset on hearing that. Now I never rely on just one pathology exam. If your doctor finds something, ask him to send your slides to a nationally recognized reference lab—not just one or two slides but the whole lot—and get a second interpretation.” —Bert Vorstman, MD, a prostate cancer specialist in Coral Springs, FloridaIn medicine, you can get a DUI, go to jail for a couple of hours, and walk out at 7 a.m. the next morning and do a surgery. "You can be accused of sexual misconduct and drug and alcohol abuse in one state and pop over to the next one and get a license. Some state medical boards don’t even thoroughly research your background; they argue that the less-than-$10 fee to access national data is too expensive.” —Marty Makary, MD.Surgeons are control freaks. "When things don’t go our way in the operating room, we can have outbursts. Some of us curse, some throw instruments, others have tantrums.” —Paul Ruggieri, MD, author of Confessions of a Surgeon: The Good, the Bad, and the Complicated ... Life Behind the O.R. DoorsMistakes are probably more common than you would think. "But most of them don’t actually hurt people. I work with residents, and I don’t let them do anything that I can’t fix if they screw it up. If there’s an error that I fix that I’m sure won’t affect the patient at all, I’m not going to say anything about it. That would accomplish nothing except to stress out the patient.” —An orthopedic surgeonSome problems just don’t fix well with surgery, like many cases of back pain. "My advice? Grin and bear it. Some surgeons vehemently disagree. They say, ‘Oh, you have a degenerative disk, and that must be the culprit. Let’s fix it.’ But many people have a degenerative disk with no pain. There isn’t a lot of evidence that we’re helping very many people.” —Kevin B. Jones, MDAlways ask about nonsurgical options and whether there’s anything wrong with waiting a little while. "Surgeons are busy, and they like to operate. A professor from my residency would say, ‘There is nothing more dangerous than a surgeon with an open operating room and a mortgage to pay.’” —Kevin B. Jones, MDTalk to your doctor about donating your blood or asking your family members to donate blood before an elective surgery. "Banked blood is a foreign substance, like an organ, and your body can potentially react adversely. If you can use your own blood or blood from your family, there’s less chance of those reactions." —Kathy Magliato, MD, cardiothoracic surgeon at Saint John’s Health Center in Santa Monica, CaliforniaResidents have to learn how to operate, and it’s required that an attending physician be ‘present'. But ‘present’ doesn’t mean he has to be in the operating room scrubbed in. At an academic institution, ask whether your surgeon will be actively participating in the surgery or just checking in every hour." —Ezriel “Ed” Kornel, MDDuring my six weeks as a surgical intern in the ER, I inadvertently stuck myself twice with contaminated needles...... briefly nodded off in the middle of suturing a leg laceration, accidentally punctured a guy’s femoral artery while trying to draw some blood, and broke up a fight between the family members of a guy who’d come in with a stab wound to the abdomen. I was slugged in the head by a delirious patient in an alcoholic rage, spat upon, coughed on, vomited on, farted on, bled on, and mistaken for an orderly.” —Paul Ruggieri, MDYour doctor should not push you to make a speedy decision about prostate cancer surgery. "Most prostate cancers are extremely slow-growing, and there is so much misleading information out there, so you should take your time.” —Bert Vorstman, MDIf you have pain in your calf after surgery, or if it swells and looks red, call your doctor right away. "Those are the main symptoms of a blood clot, which is a risk of just about every surgery.” —James Rickert, MDThis is what really keeps us up at night. "It’s not making a mistake in the operating room; it’s the noncompliant patients. When patients don’t do what we tell them, bad things can happen.” —Kurian Thott, MD, an ob-gyn in Stafford, VirginiaDon’t ask too many questions. If you ask too many questions, you can be branded as a pain in the neck. "When one extremely hostile relative bombarded me every time I walked in, I developed a tendency not to go in the room. If you have three pages full of questions, show them to the nurse. Say ‘How many of these should I wait to ask the doctor about? How many can you help me with?’” —General surgeon who blogs under the name Skeptical ScalpelAbout 25 percent of operations are unnecessary, but administrators e-mail doctors telling them to do more. "This is not an insurance company putting pressure on doctors; this is not a government regulation. This is private hospitals pushing doctors to generate more money by doing more procedures. It goes on at America’s top hospitals. The Cleveland Clinic has said this system of paying doctors is so ethically immoral that it started paying its doctors a flat salary no matter how many operations they do.” —Marty Makary, MD.Fatigue and impatience have undoubtedly contributed to some mistakes I’ve made in the operating room. "But unless you ask, your surgeon is not going to tell you that he was up all night on call before your procedure and that he may not be in tip-top form.” —Paul Ruggieri, MDI always ask at national conferences of doctors, ‘How many of you know of another doctor who should not be practicing medicine because he is too dangerous?’ "Every hand goes up.” —Marty Makary, MDVery often, plastic surgery patients don’t admit to a previous surgery, and I don’t find out until I’m in there. "I’ll go in on an eyelid or a nose, and it’s just a mess. If you don’t tell us you had lipo, there will be scar tissue, and the fat won’t come out normally. So please be 100 percent honest. There’s no need to be embarrassed. We’ve heard it all, and we don’t judge.” —Andrew Ordon, MD, cohost of the television show The Doctors and a board-certified plastic surgeon.The biggest mistake during recovery is not giving yourself enough of a break. "Give yourself time to heal. If you don’t, you can cause complications and prolong your recovery."—Andrew Ordon, MDIf your doctor wants to give you a stent, always ask: Is this better than medicine? "If you’re not having a heart attack or an unstable angina, you will do equally well with a stent or medicine, studies show. Having something permanently implanted in your body is not a risk-free proposition. There is evidence that thousands of people have had stents they likely did not need." —Marc Gillinov, MD.If I had any kind of serious medical condition, I’d go to a teaching hospital. "You’ll get doctors involved with the latest in medicine. Even for simple cases, if there’s a complication that requires an assist device or a heart transplant, some hospitals may not be able to do it. At a university hospital, you also have the advantage of having a resident or physician bedside 24-7, with a surgeon on call always available." —Tomas A. Salerno, MDBefore any operation, always ask what’s broken and how fixing it will help. "Just because you have a blockage in an artery doesn’t mean you need it fixed, especially if you don’t have symptoms.” —Marc Gillinov, MDSpecialists quietly pad your bill. “Less-well-trained physicians will call in an abundance of consults to help them take care of the patient. If those specialists check on you every day, your bill is being padded and padded. Ask whether those daily visits are necessary.” —Evan Levine, MD.Ask how to recover faster. “Since each day in the hospital costs $4,293 on average, one of the best ways to cut costs is to get out sooner. Find out what criteria you need to meet to be discharged, and then get motivated, whether it’s moving from the bed to a chair or walking two laps around the hospital floor.” —James Pinckney, MD.Second-guess tests. “Fifteen to 30 percent of everything we do—tests, medications, and procedures—is unnecessary, our research has shown. It’s partly because of patient demand; it’s partly to prevent malpractice. When your doctor orders a test, ask why, what he expects to learn, and how your care will change if you don’t have it.” —Marty Makary, MD.“Your surgeon may be doing someone else’s surgery at the same time as yours. We’re talking about complex, long, highly skilled operations that are scheduled completely concurrently, so your surgeon is not present for half of yours or more. Many of us have been concerned about this for decades. Ask about it beforehand.” —Marty Makary, MD.“Hospital toiletries are awful. The lotion is watery. The bars of soap are so harsh that they dry out your skin. There is no conditioner. The toilet paper is not the softest. Come with your own.” —Michele Curtis, MD.Being transferred? Speak up. “If you go to a smaller hospital and it has to transfer you to a different medical center, demand that it ship you to the closest one that can handle your care. What’s happening is that community medical centers are sending patients instead to the big hospital that they’re affiliated with, even if it’s farther away. It happens even when a patient is bleeding to death or having a heart attack that needs emergency care.” —Evan Levine, MD.“Don’t assume the food is what you should be eating. There’s no communication between dietary and pharmacy, and that can be a problem when you’re on certain meds. I’ve had patients on drugs for hypertension or heart failure (which raises potassium levels), and the hospital is delivering (potassium-rich) bananas and orange juice. Then their potassium goes sky high, and I have to stop the meds. Ask your doctor whether there are foods you should avoid.” —Evan Levine, MD.On weekends and holidays, hospitals typically have lighter staffing and less experienced doctors and nurses. Some lab tests and other diagnostic services may be unavailable. If you’re having a major elective surgery, try to schedule it for early in the week so you won’t be in the hospital over the weekend. —Roy Benaroch, MD, a pediatrician and the author of A Guide to Getting the Best Healthcare for Your Child.“Many hospitals say no drinking or eating after midnight the day before your surgery because it’s more convenient for them. But that means patients may show up uncomfortable, dehydrated, and starving, especially for afternoon surgery. The latest American Society of Anesthesiologists guidelines are more nuanced: no fried or fatty foods for eight hours before your surgery and no food at all for six hours. Clear liquids, including water, fruit juices without pulp, soda, Gatorade, and black coffee, may be consumed up to two hours beforehand.” —Cynthia Wong, MD, an anesthesiologist at University of Iowa Healthcare“Get copies of your labs, tests, and scans before you leave the hospital, along with your discharge summary and operative report if you had surgery. It can be shockingly difficult for me to get copies of those things. Even though I have a computer and the hospital has a computer, our computers don’t talk to each other.” —Roy Benaroch, MD.“One time, I ran into a patient I had performed a simple appendectomy on. He thanked me for saving his life, then told me it almost ruined him because he couldn’t pay the bill. Four hours in the hospital, and they charged him $12,000, and that didn’t even include my fee. I showed his bill to some other doctors. We took out an ad in the newspaper demanding change.” —Hans Rechsteiner, MD, a general surgeon in northern Wisconsin.We're Impatient. Your doctor generally knows more than a website. I have patients with whom I spend enormous amounts of time, explaining things and coming up with a treatment strategy. Then I get e-mails a few days later, saying they were looking at this website that says something completely different and wacky, and they want to do that. To which I want to say (but I don't), "So why don't you get the website to take over your care?"--James Dillard, MDNinety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making. Internist, Rochester, Minnesota Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest.--Internist, PhiladelphiaDoctors get paid each time they visit their patients in the hospital, so if you're there for seven days rather than five, they can bill for seven visits. The hospital often gets paid only for the diagnosis code, whether you're in there for two days or ten. Evan S. Levine, MDWhen a parent asks me what the cause of her child's fever could be, I just say it's probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you'd never stop crying. It's just too overwhelming. Pediatrician, Hartsdale, New York60% of doctors don't follow hand-washing guidelines. Source: CDC Morbidity and Mortality Weekly Report96% of doctors agree they should report impaired or incompetent colleagues or those who make serious mistakes, but ...94% of doctors have accepted some kind of freebie from a drug company.Source: New England Journal of Medicine58% doctors would give adolescents contraceptives without parental consent. Source: New England Journal of MedicineYour doctor or nurse may have messed up your meds.Doctors in training look the same as doctors in charge.Your medical records are not confidential. If your charts are an open book, it boosts the odds that sensitive details about your health will slip into the hands of people who could use them against you—employers, ex-spouses, or medical identity thieves, says Deborah Peel, M.D., founder and chairwoman of the nonprofit advocacy group Patient Privacy Rights.Your doctor's hands may be filthy.Toronto doctor reveals secrets of hospital slang. Obese patients are “whales” or “beemers”. Old people are known as FTDs, or “failure to die”ER doctors want you to know ER is just like a horror movie. At first you're excited for every day, then there's lots of blood and screaming and crying and it's terrifying. And there's plenty of riddles, like, 'What exactly did you shove up there?!'" It takes an entire team to make an ER run. They work around the clock with little to no breaks. They care about you and they will fight for you.These are some secrets regarded to doctors including surgeons. They are also human beings and make mistakes. We need to collaborate with them to get the best results for your care. Understand them more.Thanks for reading.Sources:50 Secrets Hospitals Don’t Want to Tell You (But Every Patient Should Know)41 secrets your doctor would never share with you8 Secrets Your Hospital Keeps23 Things ER Employees Want You To KnowToronto doctor reveals secrets of hospital slang

Q: Which medical specialties give the best balance of income and lifestyle?A: Four articles:Can Doctors Have Work-Life Balance? Medical Students DiscussRoadmap to Choosing a Medical Specialty4 bad reasons why medical students choose a specialtyMedical specialties with the highest burnout ratesCan Doctors Have Work-Life Balance? Medical Students DiscussMEDICAL INSIDERBy Dr. Zachary F. Meisel and Gina SiddiquiNov. 15, 2011If having work-life balance is important to you, then don’t become a doctor. That was Dr. Karen Sibert’s advice to students considering careers in medicine, in a controversial New York Times op-ed last summer. “You can’t have it all,” Sibert wrote, exhorting students — women mostly — to remember that “medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.”If you want to work and be a mother, then you can find a job in journalism or professional cooking or law. But “if you want to be a doctor, be a doctor,” wrote Sibert, an anesthesiologist, concluding: “Patients need doctors to take care of them. Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work.”Sibert’s piece likely sparked countless conversations — and moments of doubt — at medical schools around the country. Ours was no exception. In the wake of Sibert’s column, Gina Siddiqui, a medical student at University of Pennsylvania, where I teach, and I launched our own conversation about being a doctor-in-training and how doctors ultimately fit into the future of health care in the U.S. We recruited other students to participate, including second-years Alexandra Charrow, Derek Mazique and Ofole Mgbako.What follows are excerpts of that roundtable conversation. Driving the debate was the question of whether being a doctor is in some way exceptional, more important to society than any other profession. I started the ball rolling thusly: “What do you guys think is your duty to society, and how do you feel it is different from that of your peers going into other fields? Should all doctors have to work full-time?”The students’ responses:Alexandra Charrow: Implicit in what you’re asking is the question of whether doctors are “special,” so special that we should be required to work additional hours and so integral to society that we have additional duties. For the 60 or so years that physicians have been able to actually cure people there has been an increasing fetishization of the field. Numerous TV shows and movies romanticize the occupation, feeding into a belief that medicine is the grandest and noblest of professions. Medicine is not the only profession with the power and duty to save lives — air traffic controllers save lives every day. Yet how many shows are there about air traffic controllers? We are not alone in our unwavering responsibility, our duties, and our power.Derek Mazique: The complexity of medicine, the physician shortage, and the rise of managed care almost guarantee that physicians are no longer the only decision-makers in the room. So now, I think physicians are decidedly “less special.” Are they skilled and necessary for the average consumer? Yes, but so is their accountant.Ofole Mgbako: Through my experiences with people living with HIV, I realized that the way people readily share the most intimate details of their lives and entrust their bodies with physicians is unlike any other profession. Each interaction with a patient is based on an unspoken covenant, a belief that the doctor not only will do no harm, but also will try to relieve suffering. I believe this basic, universal interaction between patient and physician engenders a greater responsibility on the part of physicians. It is difficult to speak to how much this dynamic sets us apart from the teachers, the lawyers, the scientists, the politicians. However, this dynamic does set us apart to some degree.Regardless of how much more “exceptional” doctors may be — indeed, Sibert’s original argument was that doctors not only play a special role in society, but also that there are necessarily too few of them to justify any of us choosing to be a part-time doctor — our student moderator, Gina Siddiqui, concluded that forcing physicians to work longer isn’t necessarily the right answer. “I don’t know if it’s feeling special or a strong sense of duty or what, but on balance, I think most doctors will choose to work more, and coercing more hours out of those that don’t is unlikely to do much good for patients,” Siddiqui says. “For the record, I think everyone should think his or her job is special, just like every mom should think her kid is special.”Given the students’ debate, I wondered further whether their views on the exceptionalism of doctors — and on the importance of work-life balance — were affecting their choice of specialty, particularly in light of the deepening primary care physician shortage. I asked them: “Do salary and lifestyle play a role?”Their responses:D.M.: Both my parents are in primary care, and seeing them practice has been a powerful example of how the field has changed. Perhaps most telling for me is how the current primary care situation is a perfect storm of low reimbursement and doctor burnout. Both of my parents have had to increase the number of patients they see — for my mother who is in private practice, that’s the only way she can keep the lights on. I didn’t go into medicine in order to emerge as a strictly lifestyle physician … but I did go into medicine expecting to forge meaningful relationships with my patients and to perform my intellectual craft to the utmost. Primary care in its current iteration makes these goals seem even more difficult. Of course, money is a factor, but these expectations of a personally fulfilling medical career also steer my decision-making process.A.C.: Personally, I recognize the pressure and fear … that either my family values or career choices will have to change. I often meet physicians who tell me it’s possible to have both a family and a career, but for the most part, they are men with wives who have made the tough decision to work part-time for them. The women I have met have painted a more pragmatic picture — you can have what you want, just not all of it.D.M.: All of us have been fixated on the profession, the role of lifestyle when picking a specialty, and our own particular experiences as medical students. But at the end of the day, our concern for the patient should be paramount, and it’s also worth exploring the effects that these choices will have on them. If a surgeon spends less time in the operating room, will he or she show a greater error rate and will more patients be harmed? If doctors work shorter shifts and hand off patients more, will discontinuity of care lead to a spike in adverse drug events and complications?A.C.: This reminds me of the arguments hashed out concerning reduced residency work hours. Certainly there are many who still claim an 80-hour max workweek has reduced quality of care. However, others would argue that extra sleep, spending time with family, and eating regularly make up for reduced hours. I imagine that at some number of hours of experience, the quality of care reaches a plateau. With people working well into their 60s, 70s, and 80s, perhaps it is better to allow physicians to slow the rate at which they accumulate expertise in order to make their lifelong commitments to their specialty more sustainable. If doctors are able to fulfill other life obligations early in their career, they might be willing to stay in the profession longer, allowing society many years to benefit from a skilled physician’s services.O.M.: What’s interesting to me is the tension between being a balanced, content physician who explores his or her interests outside of medicine and being an extremely driven workaholic who gives up family time and other hobbies in order to be engrossed by work. Thus, in addition to the monetary concerns Derek brought up, I think more medical students will be drawn to specialties that allow them the flexibility to explore other aspects of themselves in addition to medicine: in addition to [being] future doctors, my peers are journalists, writers, musicians, entrepreneurs and engineers.As a teacher of medicine, I was inspired and not a little bit relieved that the students in our program had given so much thought to their training and the way their own values were shaping their decisions as up-and-coming physicians. But the question remained, How does the role of the individual doctor fit into the greater context of American health?Our student moderator concluded with another shrewd observation about the state of our country’s health: that our well-being is bound largely to our environment, and not only to the quality or quantity of the health care we receive. “Looking back on our discussion, I am struck by how the increasing sophistication of medicine hasn’t made a single one of us feel a greater sense of control over health outcomes,” Siddiqui says. “The more we learn about the causes of disease, the more interrelated we realize our work is with farmers, urban planners and school counselors. In this environment, our aspirations to heal are bound less to our office hours and more to the communities we cannot afford to be strangers to.”I am not surprised that the students pushed back against Sibert’s essay. This discussion could have easily become about self-determination and the right to determine the shape of one’s own career. But, instead, these students challenged Sibert by using humility and introspection — which bodes well for their future patients.Dr. Meisel is a practicing emergency physician and assistant professor of emergency medicine at the Perelman School of Medicine at the University of Pennsylvania. He is medical editor of the LDI Health Economist from the Leonard Davis Institute of Health Economics. Follow him on Twitter at @zacharymeisel.Roadmap to Choosing a Medical SpecialtyHow to Explore your InterestsPreclinical YearsConsider one or two of the following:Talk to your advising dean Academic AdvisingAttend student interest group events View All GroupsEngage in clinical research Medical Scholars Research ProgramSeek out a faculty or alumni mentor Educators-4-Care | Educators-4-Care | Stanford Medicine Stanford Medicine Alumni AssociationSeek out shadowing experiencesVisit the School of Medicine Career Center Stanford University School of MedicineTake the AAMC Careers in Medicine self assessment Careers In MedicineTalk to residency program directors http://med.stanford.edu/gme/prog...Attend grand roundsJoin the national professional associations for potential specialtiesCheck out the medical journals of potential specialtiesRead a book – these were written to help you choose a specialty:The Ultimate Guide to Choosing a Medical Specialty, by Brian S. Freeman, MDHow to Choose a Medical Specialty, by Anita D. Taylor On Becoming a Doctor, by Tania HellerClinical Rotations• Talk in depth with your attending physicians and residents – ask the tough questions• Try to get a sense of the culture in each specialty• Think about whether you can you see yourself fitting in there• Take notes in a journal on your impressions from your clinical rotationsFor more information visit the Stanford Academic Advising website:Academic Advising Developed by Alissa Totman for Stanford School of Medicine Academic Advising & the Office of Medical Student Wellness, Spring 20154 bad reasons why medical students choose a specialtyJESSICA FREEDMAN, MD | EDUCATION | DECEMBER 27, 2012“I love the hours.”“I want to be just like Dr. Smith. He has a sweet practice.”“I want to make a ton of money.”“I want to make a ton of money.”These are some bad reasons why medical students choose a specialty. Most medical students decide what specialty to pursue when they are in their mid to late 20s. While we all think we are pretty wise and informed by that time, often we are fairly immature in our thinking and don’t fully consider the “big picture” when deciding what we are going to do for the remainder of our lives and careers. Medical students can also be in a proverbial ‘bubble” during medical school, busy studying and spending long hours in the hospital, with little time outside of the “medical world.”This, too, can lead to a warped perspective that doesn’t involve the “real world” or consideration of what life might be like after training. In deciding on a specialty, do not base your decision on “bad reasons,” which include more than those above:1. You want to make a lot of money. Maybe you also want to join a field with “status.” Most medical students have loans and, therefore, have a practical reason for a high-paying specialty choice. However, as you have likely heard before, money alone won’t make you happy. You will be practicing your specialty for the rest of your life and even if you decide to become a plastic surgeon because of the big bucks often associated with the practice, if you don’t enjoy the types of procedures and patients it entails, you might be miserable despite your big bank account. I had one student who was eager to have a big home, take fancy vacations, and generally live a life of luxury. After doing his research and seeing all of the glossy ads in local magazines for cosmetic surgeons, he realized this would be a great choice to reach his goals. He shadowed a community doctor who had a thriving cosmetics practice and performed many cosmetic surgeries, botox, and other “beauty enhancements.” After shadowing this doctor for a week, the student decided he would not enjoy caring for this patient population. However, he reasoned that he could deal with it if he was making a lot of money since he could spend his leisure time as he wished. However, after considering that most of his waking hours would be spent in the operating room or the office, he realized that perhaps he should consider another specialty.By the same token, many medical school students are, by nature, very competitive and want to join a specialty that has a “wow factor.” They are concerned – will people be impressed when they hear what I do? Will I be saving lives? Status alone won’t carry you through a long career. You must, at a very basic level, enjoy the work you do. Also, as you mature, your values may change. In your late 20s, spending long hours in the hospital may seem glamorous and appealing, but as you get older and have family and other responsibilities you may not want to work as intensely as some specialties demand.. Keep in mind that stereotypical heroic specialties such as neurosurgery, emergency medicine, trauma surgery, and oncology often require a tremendous amount of emotional stamina, leaving little for your personal life.2. You love the hours and want a specialty that is “easy.” Many students choose a specialty thought to have ‘easy hours.’ The fields that come to mind are the E-ROAD specialties – emergency medicine (EM), radiology, ophthalmology, anesthesiology, and dermatology. The hours related to these specialties often aren’t that “easy, however.” Anesthesiologists, for example, routinely wake up at about 5 AM because operating rooms open early. Even though full-time emergency physicians put in about 35 – 40 hours per week, they work odd hours – evenings, nights, and weekends. Emergency physicians often spend their “off time” recuperating or “bouncing back” from late shifts. Odd hours can take a toll in the long term, something that’s difficult to understand when you are young. One student, who was always a night owl, considered a career in EM, figuring that she could “handle” the circadian rhythm disturbances. But, after doing her EM rotation, she saw how wiped out some of the attending physicians were and decided this would not be the best long-term choice for her overall health and well-being.3. You were impressed by someone in a particular specialty, and you want to be just like that person. You are on your surgery rotation, and you meet a person who represents the type of physician you want to be in the future. She is swift in the OR and deals with unexpected complications with aplomb. Yet she is also kind, compassionate, and deeply invested in her patients and their outcomes. She is also a real team player who treats everyone on her team with warmth and support. You want to be like her when you grow up so you decide to meet with her to discuss the idea of becoming a surgeon. At that meeting, she tells you that working in academic medicine has many demands. She must publish, participate in hospital committees, teach, do research, and attend grand rounds even when not presenting. You tell her that all you hope to do is practice community medicine, so she suggests you gain exposure to the field of surgery “in the community.” During your winter break, you shadow a community surgeon. The work doesn’t seem nearly as exciting as the work in an academic setting. The surgeon has busy, but lonely, days filled with OR time, outpatient visits, and administrative work. Confused, you consider what other specialties might interest you.During medical school, most of the people you meet and your clinical rotations will take place in academic hospital settings. Yet the majority of medical school graduates will not practice in these arenas; most will practice in community settings. The reality is that specialties are practiced very differently in different settings, and many students select a specialty based on their understanding of how it is practiced only in an academic medical setting. It is important, when you meet the doctor you hope to become, therefore, to be sure to really talk to her, find out exactly what her career entails, and “test out” your specialty in those settings in which you are most likely to practice.4. You don’t really want to practice the specialty you are choosing or you plan to practice for only a short time. I sometimes hear students say, “Well, I don’t really want to practice that specialty. My goal is to get out of clinical medicine or just practice one part of the specialty.” For example, some students think if they pursue EM, they can graduate and just work day or urgent care shifts. Or, someone may pursue a residency in several disciplines with the intent of gaining clinical experience and then “going into industry.” Others may choose a specialty that would make them a good candidate to become talk show hosts. While some people are successful when pursuing careers that are tangentially or barely related to medicine, most are not. If you know as a premedical or medical student that you really don’t want to practice medicine, perhaps you should give your medical school seat to someone else and consider what other careers might be more fulfilling.So how should you decide on a field to pursue? Whatever your reasons for choosing a specialty, you need to fundamentally enjoy its subject matter, the disease processes, the type of practice, and the patients for whom you will be caring. Ideally, you also want a career that will have longevity.In making a decision, it is essential that you view your life in the future. Fast forward 20 years. Where do you want to be? How do you hope to be practicing? Find role models who are older than you. Ask them what they like or don’t like about their specialties. Would they make a different choice now that they have a more mature perspective? Many people who practice primary care have great lifestyles and can also practice for a long time because the practice is not the most physically or emotionally rigorous. In general, outpatient medical practice and specialties, which some medical students consider “boring” since they lack the “excitement” of others, allow doctors to work for a long time.To achieve the same goal, many doctors try to leave the “intense part of their specialty for something less vigorous; for example, orthopedic surgeons may practice solely outpatient sports medicine, and ob/gyns sometimes leave the OR to practice only outpatient gynecology. Emergency physicians may transition from main emergency department work to outpatient urgent care. In deciding on a specialty, do your research, explore how your desired specialty is practiced in many settings and, most of all, be honest with yourself.Jessica Freedman is founder of MedEdits, also on Facebook and TwitterMedical specialties with the highest burnout ratesJAN 15, 2016Work-related burnout is a pervasive problem among physicians—and it’s worsening across all specialties, according to a recent national study. Learn how burnout has increased in just three years and which specialties reported the highest rates of burnout. Where does yours fall on the list?The rise of burnout in medicinePhysician burnout experts at the AMA and the Mayo Clinic conducted a survey of 6,880 physicians to “evaluate the prevalence of burnout and physicians’ satisfaction with work-life balance compared to the general U.S. population relative to 2011 and 2014,” according to the study, which was recently published in Mayo Clinic Proceedings.“In 2011, we conducted a national study measuring burnout and other dimensions of well-being in U.S. physicians as well as the general U.S. working population. At the time of that study, approximately 45 percent of U.S. physicians met criteria for burnout,” the study authors wrote.When a follow-up survey was conducted in 2014, 54.4 percent of physicians reported at least one sign of burnout. Physicians also reported lower rates of satisfaction with work-life balance in 2014 compared to a similar sample of physicians in 2011. All physicians in the study were assessed using questions on the Maslach Burnout Inventory.Which specialties have the highest burnout rates?“Substantial variation in the rate of burnout was observed by specialty, with the highest rates observed among many specialties at the front line of access to care,” the study authors noted.Compared to 2011, burnout rates were higher for all specialties in 2014. In fact, nearly a dozen specialties experienced more than a 10 percent increase in burnout over those three years:Family medicine (51.3 percent of physicians reported burnout in 2011 versus 63.0 percent in 2014)General pediatrics (35.3 percent versus 46.3 percent)Urology (41.2 percent versus 63.6 percent)Orthopedic surgery (48.3 percent versus 59.6 percent)Dermatology (31.8 percent versus 56.5 percent)Physical medicine and rehabilitation (47.4 percent versus 63.3 percent)Pathology (37.6 percent versus 52.5 percent)Radiology (47.7 percent versus 61.4 percent)General surgery subspecialties (42.4 percent versus 52.7 percent).Authors of the study also observed “substantial variation” in satisfaction rates based on specialty. In 2014, physicians across all specialties reported lower satisfaction with work-life balance, except for physicians in general surgery and OB/GYN.“Burnout among physicians also varied by career stage, with the highest rate among midcareer physicians,” according to the study.While burnout rates varied among physicians based on their career stages and specialties, authors of the study noted that burnout still proved to be more prevalent among physicians than the general U.S. working population. This is “a finding that persisted after adjusting for age, sex, hours worked and level of education,” they wrote.Read the full study for more observations on burnout.Also, don’t miss these resources on burnout and physician wellnessLearn the 7 signs of burnout and how to prevent them in your practice.Review these burnout busters to increase physician satisfaction.Check out this online module to learn how to measure and respond to burnout in your practice and a second module to discover how to increase physician resiliency.The AMA’s STEPS Forward collection also offers modules to improve elements of your practice that can be risk factors for burnout, such as improving work flow through team documentation, expanded rooming and discharge protocols, pre-visit planning, and synchronized prescription renewal.

Q: Which medical specialty allows for good work/family balance?A: Four articles:Can Doctors Have Work-Life Balance? Medical Students DiscussRoadmap to Choosing a Medical Specialty4 bad reasons why medical students choose a specialtyMedical specialties with the highest burnout ratesCan Doctors Have Work-Life Balance? Medical Students DiscussMEDICAL INSIDERBy Dr. Zachary F. Meisel and Gina SiddiquiNov. 15, 2011If having work-life balance is important to you, then don’t become a doctor. That was Dr. Karen Sibert’s advice to students considering careers in medicine, in a controversial New York Times op-ed last summer. “You can’t have it all,” Sibert wrote, exhorting students — women mostly — to remember that “medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.”If you want to work and be a mother, then you can find a job in journalism or professional cooking or law. But “if you want to be a doctor, be a doctor,” wrote Sibert, an anesthesiologist, concluding: “Patients need doctors to take care of them. Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work.”Sibert’s piece likely sparked countless conversations — and moments of doubt — at medical schools around the country. Ours was no exception. In the wake of Sibert’s column, Gina Siddiqui, a medical student at University of Pennsylvania, where I teach, and I launched our own conversation about being a doctor-in-training and how doctors ultimately fit into the future of health care in the U.S. We recruited other students to participate, including second-years Alexandra Charrow, Derek Mazique and Ofole Mgbako.What follows are excerpts of that roundtable conversation. Driving the debate was the question of whether being a doctor is in some way exceptional, more important to society than any other profession. I started the ball rolling thusly: “What do you guys think is your duty to society, and how do you feel it is different from that of your peers going into other fields? Should all doctors have to work full-time?”The students’ responses:Alexandra Charrow: Implicit in what you’re asking is the question of whether doctors are “special,” so special that we should be required to work additional hours and so integral to society that we have additional duties. For the 60 or so years that physicians have been able to actually cure people there has been an increasing fetishization of the field. Numerous TV shows and movies romanticize the occupation, feeding into a belief that medicine is the grandest and noblest of professions. Medicine is not the only profession with the power and duty to save lives — air traffic controllers save lives every day. Yet how many shows are there about air traffic controllers? We are not alone in our unwavering responsibility, our duties, and our power.Derek Mazique: The complexity of medicine, the physician shortage, and the rise of managed care almost guarantee that physicians are no longer the only decision-makers in the room. So now, I think physicians are decidedly “less special.” Are they skilled and necessary for the average consumer? Yes, but so is their accountant.Ofole Mgbako: Through my experiences with people living with HIV, I realized that the way people readily share the most intimate details of their lives and entrust their bodies with physicians is unlike any other profession. Each interaction with a patient is based on an unspoken covenant, a belief that the doctor not only will do no harm, but also will try to relieve suffering. I believe this basic, universal interaction between patient and physician engenders a greater responsibility on the part of physicians. It is difficult to speak to how much this dynamic sets us apart from the teachers, the lawyers, the scientists, the politicians. However, this dynamic does set us apart to some degree.Regardless of how much more “exceptional” doctors may be — indeed, Sibert’s original argument was that doctors not only play a special role in society, but also that there are necessarily too few of them to justify any of us choosing to be a part-time doctor — our student moderator, Gina Siddiqui, concluded that forcing physicians to work longer isn’t necessarily the right answer. “I don’t know if it’s feeling special or a strong sense of duty or what, but on balance, I think most doctors will choose to work more, and coercing more hours out of those that don’t is unlikely to do much good for patients,” Siddiqui says. “For the record, I think everyone should think his or her job is special, just like every mom should think her kid is special.”Given the students’ debate, I wondered further whether their views on the exceptionalism of doctors — and on the importance of work-life balance — were affecting their choice of specialty, particularly in light of the deepening primary care physician shortage. I asked them: “Do salary and lifestyle play a role?”Their responses:D.M.: Both my parents are in primary care, and seeing them practice has been a powerful example of how the field has changed. Perhaps most telling for me is how the current primary care situation is a perfect storm of low reimbursement and doctor burnout. Both of my parents have had to increase the number of patients they see — for my mother who is in private practice, that’s the only way she can keep the lights on. I didn’t go into medicine in order to emerge as a strictly lifestyle physician … but I did go into medicine expecting to forge meaningful relationships with my patients and to perform my intellectual craft to the utmost. Primary care in its current iteration makes these goals seem even more difficult. Of course, money is a factor, but these expectations of a personally fulfilling medical career also steer my decision-making process.A.C.: Personally, I recognize the pressure and fear … that either my family values or career choices will have to change. I often meet physicians who tell me it’s possible to have both a family and a career, but for the most part, they are men with wives who have made the tough decision to work part-time for them. The women I have met have painted a more pragmatic picture — you can have what you want, just not all of it.D.M.: All of us have been fixated on the profession, the role of lifestyle when picking a specialty, and our own particular experiences as medical students. But at the end of the day, our concern for the patient should be paramount, and it’s also worth exploring the effects that these choices will have on them. If a surgeon spends less time in the operating room, will he or she show a greater error rate and will more patients be harmed? If doctors work shorter shifts and hand off patients more, will discontinuity of care lead to a spike in adverse drug events and complications?A.C.: This reminds me of the arguments hashed out concerning reduced residency work hours. Certainly there are many who still claim an 80-hour max workweek has reduced quality of care. However, others would argue that extra sleep, spending time with family, and eating regularly make up for reduced hours. I imagine that at some number of hours of experience, the quality of care reaches a plateau. With people working well into their 60s, 70s, and 80s, perhaps it is better to allow physicians to slow the rate at which they accumulate expertise in order to make their lifelong commitments to their specialty more sustainable. If doctors are able to fulfill other life obligations early in their career, they might be willing to stay in the profession longer, allowing society many years to benefit from a skilled physician’s services.O.M.: What’s interesting to me is the tension between being a balanced, content physician who explores his or her interests outside of medicine and being an extremely driven workaholic who gives up family time and other hobbies in order to be engrossed by work. Thus, in addition to the monetary concerns Derek brought up, I think more medical students will be drawn to specialties that allow them the flexibility to explore other aspects of themselves in addition to medicine: in addition to [being] future doctors, my peers are journalists, writers, musicians, entrepreneurs and engineers.As a teacher of medicine, I was inspired and not a little bit relieved that the students in our program had given so much thought to their training and the way their own values were shaping their decisions as up-and-coming physicians. But the question remained, How does the role of the individual doctor fit into the greater context of American health?Our student moderator concluded with another shrewd observation about the state of our country’s health: that our well-being is bound largely to our environment, and not only to the quality or quantity of the health care we receive. “Looking back on our discussion, I am struck by how the increasing sophistication of medicine hasn’t made a single one of us feel a greater sense of control over health outcomes,” Siddiqui says. “The more we learn about the causes of disease, the more interrelated we realize our work is with farmers, urban planners and school counselors. In this environment, our aspirations to heal are bound less to our office hours and more to the communities we cannot afford to be strangers to.”I am not surprised that the students pushed back against Sibert’s essay. This discussion could have easily become about self-determination and the right to determine the shape of one’s own career. But, instead, these students challenged Sibert by using humility and introspection — which bodes well for their future patients.Dr. Meisel is a practicing emergency physician and assistant professor of emergency medicine at the Perelman School of Medicine at the University of Pennsylvania. He is medical editor of the LDI Health Economist from the Leonard Davis Institute of Health Economics. Follow him on Twitter at @zacharymeisel.Roadmap to Choosing a Medical SpecialtyHow to Explore your InterestsPreclinical YearsConsider one or two of the following:Talk to your advising dean Academic AdvisingAttend student interest group events View All GroupsEngage in clinical research Medical Scholars Research ProgramSeek out a faculty or alumni mentor Educators-4-Care | Educators-4-Care | Stanford Medicine Stanford Medicine Alumni AssociationSeek out shadowing experiencesVisit the School of Medicine Career Center Stanford University School of MedicineTake the AAMC Careers in Medicine self assessment Careers In MedicineTalk to residency program directors http://med.stanford.edu/gme/programs/documents/Program_Contacts_MASTER.pdfAttend grand roundsJoin the national professional associations for potential specialtiesCheck out the medical journals of potential specialtiesRead a book – these were written to help you choose a specialty:The Ultimate Guide to Choosing a Medical Specialty, by Brian S. Freeman, MDHow to Choose a Medical Specialty, by Anita D. Taylor On Becoming a Doctor, by Tania HellerClinical Rotations• Talk in depth with your attending physicians and residents – ask the tough questions• Try to get a sense of the culture in each specialty• Think about whether you can you see yourself fitting in there• Take notes in a journal on your impressions from your clinical rotationsFor more information visit the Stanford Academic Advising website:Academic Advising Developed by Alissa Totman for Stanford School of Medicine Academic Advising & the Office of Medical Student Wellness, Spring 20154 bad reasons why medical students choose a specialtyJESSICA FREEDMAN, MD | EDUCATION | DECEMBER 27, 2012“I love the hours.”“I want to be just like Dr. Smith. He has a sweet practice.”“I want to make a ton of money.”“I want to make a ton of money.”These are some bad reasons why medical students choose a specialty. Most medical students decide what specialty to pursue when they are in their mid to late 20s. While we all think we are pretty wise and informed by that time, often we are fairly immature in our thinking and don’t fully consider the “big picture” when deciding what we are going to do for the remainder of our lives and careers. Medical students can also be in a proverbial ‘bubble” during medical school, busy studying and spending long hours in the hospital, with little time outside of the “medical world.”This, too, can lead to a warped perspective that doesn’t involve the “real world” or consideration of what life might be like after training. In deciding on a specialty, do not base your decision on “bad reasons,” which include more than those above:1. You want to make a lot of money. Maybe you also want to join a field with “status.” Most medical students have loans and, therefore, have a practical reason for a high-paying specialty choice. However, as you have likely heard before, money alone won’t make you happy. You will be practicing your specialty for the rest of your life and even if you decide to become a plastic surgeon because of the big bucks often associated with the practice, if you don’t enjoy the types of procedures and patients it entails, you might be miserable despite your big bank account. I had one student who was eager to have a big home, take fancy vacations, and generally live a life of luxury. After doing his research and seeing all of the glossy ads in local magazines for cosmetic surgeons, he realized this would be a great choice to reach his goals. He shadowed a community doctor who had a thriving cosmetics practice and performed many cosmetic surgeries, botox, and other “beauty enhancements.” After shadowing this doctor for a week, the student decided he would not enjoy caring for this patient population. However, he reasoned that he could deal with it if he was making a lot of money since he could spend his leisure time as he wished. However, after considering that most of his waking hours would be spent in the operating room or the office, he realized that perhaps he should consider another specialty.By the same token, many medical school students are, by nature, very competitive and want to join a specialty that has a “wow factor.” They are concerned – will people be impressed when they hear what I do? Will I be saving lives? Status alone won’t carry you through a long career. You must, at a very basic level, enjoy the work you do. Also, as you mature, your values may change. In your late 20s, spending long hours in the hospital may seem glamorous and appealing, but as you get older and have family and other responsibilities you may not want to work as intensely as some specialties demand.. Keep in mind that stereotypical heroic specialties such as neurosurgery, emergency medicine, trauma surgery, and oncology often require a tremendous amount of emotional stamina, leaving little for your personal life.2. You love the hours and want a specialty that is “easy.” Many students choose a specialty thought to have ‘easy hours.’ The fields that come to mind are the E-ROAD specialties – emergency medicine (EM), radiology, ophthalmology, anesthesiology, and dermatology. The hours related to these specialties often aren’t that “easy, however.” Anesthesiologists, for example, routinely wake up at about 5 AM because operating rooms open early. Even though full-time emergency physicians put in about 35 – 40 hours per week, they work odd hours – evenings, nights, and weekends. Emergency physicians often spend their “off time” recuperating or “bouncing back” from late shifts. Odd hours can take a toll in the long term, something that’s difficult to understand when you are young. One student, who was always a night owl, considered a career in EM, figuring that she could “handle” the circadian rhythm disturbances. But, after doing her EM rotation, she saw how wiped out some of the attending physicians were and decided this would not be the best long-term choice for her overall health and well-being.3. You were impressed by someone in a particular specialty, and you want to be just like that person. You are on your surgery rotation, and you meet a person who represents the type of physician you want to be in the future. She is swift in the OR and deals with unexpected complications with aplomb. Yet she is also kind, compassionate, and deeply invested in her patients and their outcomes. She is also a real team player who treats everyone on her team with warmth and support. You want to be like her when you grow up so you decide to meet with her to discuss the idea of becoming a surgeon. At that meeting, she tells you that working in academic medicine has many demands. She must publish, participate in hospital committees, teach, do research, and attend grand rounds even when not presenting. You tell her that all you hope to do is practice community medicine, so she suggests you gain exposure to the field of surgery “in the community.” During your winter break, you shadow a community surgeon. The work doesn’t seem nearly as exciting as the work in an academic setting. The surgeon has busy, but lonely, days filled with OR time, outpatient visits, and administrative work. Confused, you consider what other specialties might interest you.During medical school, most of the people you meet and your clinical rotations will take place in academic hospital settings. Yet the majority of medical school graduates will not practice in these arenas; most will practice in community settings. The reality is that specialties are practiced very differently in different settings, and many students select a specialty based on their understanding of how it is practiced only in an academic medical setting. It is important, when you meet the doctor you hope to become, therefore, to be sure to really talk to her, find out exactly what her career entails, and “test out” your specialty in those settings in which you are most likely to practice.4. You don’t really want to practice the specialty you are choosing or you plan to practice for only a short time. I sometimes hear students say, “Well, I don’t really want to practice that specialty. My goal is to get out of clinical medicine or just practice one part of the specialty.” For example, some students think if they pursue EM, they can graduate and just work day or urgent care shifts. Or, someone may pursue a residency in several disciplines with the intent of gaining clinical experience and then “going into industry.” Others may choose a specialty that would make them a good candidate to become talk show hosts. While some people are successful when pursuing careers that are tangentially or barely related to medicine, most are not. If you know as a premedical or medical student that you really don’t want to practice medicine, perhaps you should give your medical school seat to someone else and consider what other careers might be more fulfilling.So how should you decide on a field to pursue? Whatever your reasons for choosing a specialty, you need to fundamentally enjoy its subject matter, the disease processes, the type of practice, and the patients for whom you will be caring. Ideally, you also want a career that will have longevity.In making a decision, it is essential that you view your life in the future. Fast forward 20 years. Where do you want to be? How do you hope to be practicing? Find role models who are older than you. Ask them what they like or don’t like about their specialties. Would they make a different choice now that they have a more mature perspective? Many people who practice primary care have great lifestyles and can also practice for a long time because the practice is not the most physically or emotionally rigorous. In general, outpatient medical practice and specialties, which some medical students consider “boring” since they lack the “excitement” of others, allow doctors to work for a long time.To achieve the same goal, many doctors try to leave the “intense part of their specialty for something less vigorous; for example, orthopedic surgeons may practice solely outpatient sports medicine, and ob/gyns sometimes leave the OR to practice only outpatient gynecology. Emergency physicians may transition from main emergency department work to outpatient urgent care. In deciding on a specialty, do your research, explore how your desired specialty is practiced in many settings and, most of all, be honest with yourself.Jessica Freedman is founder of MedEdits, also on Facebook and TwitterMedical specialties with the highest burnout ratesJAN 15, 2016Work-related burnout is a pervasive problem among physicians—and it’s worsening across all specialties, according to a recent national study. Learn how burnout has increased in just three years and which specialties reported the highest rates of burnout. Where does yours fall on the list?The rise of burnout in medicinePhysician burnout experts at the AMA and the Mayo Clinic conducted a survey of 6,880 physicians to “evaluate the prevalence of burnout and physicians’ satisfaction with work-life balance compared to the general U.S. population relative to 2011 and 2014,” according to the study, which was recently published in Mayo Clinic Proceedings.“In 2011, we conducted a national study measuring burnout and other dimensions of well-being in U.S. physicians as well as the general U.S. working population. At the time of that study, approximately 45 percent of U.S. physicians met criteria for burnout,” the study authors wrote.When a follow-up survey was conducted in 2014, 54.4 percent of physicians reported at least one sign of burnout. Physicians also reported lower rates of satisfaction with work-life balance in 2014 compared to a similar sample of physicians in 2011. All physicians in the study were assessed using questions on the Maslach Burnout Inventory.Which specialties have the highest burnout rates?“Substantial variation in the rate of burnout was observed by specialty, with the highest rates observed among many specialties at the front line of access to care,” the study authors noted.Compared to 2011, burnout rates were higher for all specialties in 2014. In fact, nearly a dozen specialties experienced more than a 10 percent increase in burnout over those three years:Family medicine (51.3 percent of physicians reported burnout in 2011 versus 63.0 percent in 2014)General pediatrics (35.3 percent versus 46.3 percent)Urology (41.2 percent versus 63.6 percent)Orthopedic surgery (48.3 percent versus 59.6 percent)Dermatology (31.8 percent versus 56.5 percent)Physical medicine and rehabilitation (47.4 percent versus 63.3 percent)Pathology (37.6 percent versus 52.5 percent)Radiology (47.7 percent versus 61.4 percent)General surgery subspecialties (42.4 percent versus 52.7 percent).Authors of the study also observed “substantial variation” in satisfaction rates based on specialty. In 2014, physicians across all specialties reported lower satisfaction with work-life balance, except for physicians in general surgery and OB/GYN.“Burnout among physicians also varied by career stage, with the highest rate among midcareer physicians,” according to the study.While burnout rates varied among physicians based on their career stages and specialties, authors of the study noted that burnout still proved to be more prevalent among physicians than the general U.S. working population. This is “a finding that persisted after adjusting for age, sex, hours worked and level of education,” they wrote.Read the full study for more observations on burnout.Also, don’t miss these resources on burnout and physician wellnessLearn the 7 signs of burnout and how to prevent them in your practice.Review these burnout busters to increase physician satisfaction.Check out this online module to learn how to measure and respond to burnout in your practice and a second module to discover how to increase physician resiliency.The AMA’s STEPS Forward collection also offers modules to improve elements of your practice that can be risk factors for burnout, such as improving work flow through team documentation, expanded rooming and discharge protocols, pre-visit planning, and synchronized prescription renewal.