Life Balance

BACKGROUND Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields. METHODS We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. RESULTS Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout. CONCLUSIONS Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.

This article reviews aspects of contemporary theory and research on work-life balance. It starts by exploring why work-life balance has become an important topic for research and policy in some countries and after outlining traditional perspectives examines the concept of balance and its implications for the study of the relation between work and the rest of life. A model outlining the causes, nature and consequences of a more or less acceptable work-life balance is presented and recent research is cited to illustrate the various dimensions. Finally, the topic is linked to the field of work and organizational psychology and a number of theoretical and conceptual issues of relevance to research in Europe are raised.

The effects of selected high‐performance practices and working hours on work–life balance are analysed with data from national surveys of British employees in 1992 and 2000. Alongside long hours, which are a constant source of negative job‐to‐home spillover, certain ‘high‐performance’ practices have become more strongly related to negative spillover during this period. Surprisingly, dual‐earner couples are not especially liable to spillover — if anything, less so than single‐earner couples. Additionally, the presence of young children has become less important over time. Overall, the results suggest a conflict between high‐performance practices and work‐life balance policies.

Locating work–life balance discourse in time and place The huge recent growth in attention to ‘work–life balance’(WLB) dilemmas in academic, political, professional and popular literature might give the impression that this is, at best, a new area of concern, or at worst, a passing fad. This would, however, be misleading. The WLB metaphor is a social construct located within a particular period of time and originating in a Western context, but dilemmas relating to the management of paid work alongside other parts of life, especially family, have been the focus of research for several decades (see, e.g., Rapoport and Rapoport, 1965). Research on this topic has always reflected social, economic and workplace developments and concerns, shifting in response to new trends. For example, as the numbers of women entering the labour force grew, from the 1960s, research in certain contexts tended to focus on ‘working mothers’ or dual earner families, while concerns about stress and burnout associated with workplace changes in the 1980s and 1990s were reflected in research and debate about work–family conflict (Lewis and Cooper, 1999). The terminology used to refer to these issues continues to evolve in response to current concerns. In particular, a shift from ‘work–family’ and ‘family-friendly policies’ with their implicit focus on women, especially mothers, to ‘work–life’, the precursor of the more recent ‘work–life balance’ (WLB) discourse began in the 1990s. This linguistic shift reflected a broader and more inclusive way of framing the debate to engage men and women with and without children or other caring commitments and was partly a response to backlash against work–family policies by those without obvious family obligations.

Purpose – The purpose of this paper is to examine the literature relating to retention of good employees and the role that work‐life balance (WLB) issues have in an employee's decision to stay or leave an organisation. The paper begins with a brief overview of the seminal material in the more generic management literature and then tailors the discussion to the hospitality and tourism industry using literature from the hospitality and tourism journals. Design/methodology/approach – The paper provides an overview of the key employee turnover literature within the hospitality and tourism industry for those academics researching in this area, with specific attention given to the role of WLB issues in the turnover decision‐making process. The paper also provides a theoretical and practical framework for industry to develop strategies for reduced employee turnover, with a focus on the role that balancing work and family plays in these strategies. Findings – The key findings emerging from this literature review focus on job attitudes such as job satisfaction and organisational commitment, personal attributes such as positive and negative affectivity, the role of WLB in employee turnover and, finally, the strategies provided to alleviate high turnover rates. Originality/value – Recommendations to management are presented for both government and organisational consideration. These recommendations include the need for legislation on maximum, as well as minimum working hours, good role models at the workplace, flexible working hours and arrangements, sound recruitment and training opportunities and company family friendly work policies.

OBJECTIVE: To explore factors associated with physician career satisfaction, work–life balance, and burnout focusing on differences across age, gender, and specialty. METHODS: A cross-sectional, mailed, self-administered survey was sent to a national sample of 2,000 randomly-selected physicians, stratified by specialty, age, and gender (response rate 48%). Main outcome measures included career satisfaction, burnout, and work–life balance. Scales ranged from 1 to 100. RESULTS: Both women and men report being highly satisfied with their careers (79% compared with 76%, P<.01), having moderate levels of satisfaction with work–life balance (48% compared with 49%, P=.24), and having moderate levels of emotional resilience (51% compared with 53%, P=.09). Measures of burnout strongly predicted career satisfaction (standardized β 0.36–0.60, P<.001). The strongest predictor of work–life balance and burnout was having some control over schedule and hours worked (standardized β 0.28, P<.001, and 0.20–0.32, P<.001, respectively). Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work–life balance, or burnout. CONCLUSION: This national physician survey suggests that physicians can struggle with work–life balance yet remain highly satisfied with their career. Burnout is an important predictor of career satisfaction, and control over schedule and work hours are the most important predictors of work–life balance and burnout. LEVEL OF EVIDENCE: II

Although the term work–family/life balance is widely employed, an agreed definition of this term has proved elusive. Instead, an array of definitions and measures populate the literature. The variety of work–life definitions and measures provide limited value for both the theoretical advancement of the construct and for practical human resource (HR) interventions. In this article, we review six conceptualisations of work–life balance found in the literature: (1) multiple roles; (2) equity across multiple roles; (3) satisfaction between multiple roles; (4) fulfilment of role salience between multiple roles; (5) a relationship between conflict and facilitation; and (6) perceived control between multiple roles. Based on our review of this research we identify the two primary features of the work–life balance definitions and propose a new definition of this construct.

This article examines current debates about gender equality, work-life balance and flexible working. We contrast policymakers’ and organizational discourses of flexible working and work‐life balance with managers’ and employees’ talk about these issues within their organizations. We show how, despite the increasingly gender-neutral language of the official discourses, in the data studied participants consistently reformulate the debates around gendered explanations and assumptions. For example, a ‘generic female parent’ is constructed in relation to work‐life balance and flexible working yet participants routinely maintain that gender makes no difference within their organization. We consider the effects of these accounts; specifically the effect on those who take up flexible working, and the perceived backlash against policies viewed as favouring women or parents. We argue that the location of work‐life balance and flexibility debates within a gender-neutral context can in practice result in maintaining or encouraging gendered practices within organizations. Implications of this for organizations, for policymakers and for feminist researchers are discussed.

Work–life balance has come to the forefront of policy discourse in developed countries in recent years, against a backdrop of globalization and rapid technological change, an ageing population and concerns over labour market participation rates, particularly those of mothers at a time when fertility rates are falling (Organization for Economic Co-operation and Development [OECD], 2004). Within the European Union the reconciliation of work and family has become a core concern for policy and encouraged debate and policy intervention at national levels.

Many contemporary studies of ‘work–life balance’ either ignore gender or take it for granted. We conducted semi-structured interviews with men and women in mid-life (aged 50 to 52 years) in order to compare their experiences of work–life balance. Our data suggest that gender remains embedded in the ways that respondents negotiate home and work life. The women discussed their current problems juggling a variety of roles (despite having no young children at home), while men confined their discussion of such conflicts to the past, when their children were young. However, diversity among men (some of whom ‘worked to live’ while others ‘lived to work’) and women (some of whom constructed themselves in relation to their families, while others positioned themselves as ‘independent women’) was apparent, as were some commonalities between men and women (both men and women constructed themselves as ‘pragmatic workers’). We suggest ways in which gender-neutral theories of work–life balance may be extended.