Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce.

Objective: To evaluate factors associated with work-home conflicts (W-HCs) of US surgeons and their potential personal and professional consequences.

Design: Cross-sectional study.

Participants: Members of the American College of Surgeons.

Main outcome measures: Burnout, depression, quality of life, alcohol use, career satisfaction, and career decisions (ie, reduce work hours or leave current practice).

Results: Of 7197 participating surgeons, 3754 (52.5%) had experienced a W-HC in the previous 3 weeks. On multivariate analysis, hours worked per week, having children, sex, and work location (Veterans Administration or academic center) were independently associated with an increased risk for W-HC (all P < .01), while some factors (increased age and subspecialty field) reduced the risk. Surgeons with a recent W-HC were more likely to have symptoms of burnout (36.9% vs 17.1%; P < .001), depression (50.9% vs 28.1%; P < .001), alcohol abuse/dependency (17.2% vs 14.4%; P = .003), and were less likely to recommend surgery as a career option to their children (46.0% vs 54.4%; P < .001). Work-home conflicts were also independently associated with surgeons reporting a moderate or higher likelihood of planning to reduce clinical work hours (odds ratio, 1.769) and leave their current practice in the next 24 months for a reason other than retirement (odds ratio, 1.706) after controlling for other personal and professional factors.

Conclusions: Integrating personal and professional lives is a substantial challenge for US surgeons. Conflict in this balance appears to be a major factor in their decision to reduce work hours and/or move to a new practice, with potential substantive manpower implications for the surgical workforce.