Enabling Work-life Balance, Health
and Well-being
Summary of MABEL Research to Date and
Future Research Agenda
MABEL workshop – 25 May 2017
Guyonne Kalb
Introduction
 Brief overview of past research
 Future research plans
– A lot can be done based on the data we already have or
will be collecting this year
– But additional data on mental health and stress would
extend the possible research questions
 Seek funding from different sources
– Outside of medical workforce research to access
alternative funding sources
– E.g. as part of a broader research agenda on work-life
balance /gender/mental health in the Australian
population
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Introduction
 Key aims of future research are to inform
policies:
– preventing doctors’ burnout, and suboptimal choices
by women and other doctors with caring
responsibilities or health issues,
– leading to a more efficient and effective workforce,
– thus increasing access to care and quality of care.
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Past research
 Hours worked choices for GPs and Specialists by
gender [2]
 Hours worked choices and public-private work
setting choice for Specialists by gender [1]
 Hours worked choices and on-call (yes/no) choice for
GPs by gender [3]
 Hours worked/participation choice around childbirth
by doctor type and gender (to be finalised)
 Not surprisingly, gender and family composition are
very important in hours and other work choices
 Links to work-life balance and job/life satisfaction
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Past research
 Life/job satisfaction
– By location (few differences)[22]/doctor type (hospital
doctors/specialists in training are less satisfied) [20]
– Work-life balance is an important component
• Only half of GPs have good WLB, less for those
working more hours, with less flexibility, poorer leisure
opportunities, better for women/gen X GPs [21]
– Low job satisfaction associated with: poor health,
trained outside Australia, poor opportunities for
professional development, and long hours [7]
• Potential consequences are indicated by the
association with a preference to reduce work hours and
an intention to leave the medical workforce
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Past research
 Workplace aggression
– Very high: in previous 12 months, verbal or written
aggression (70.6%) & physical aggression (32.3%) [16]
– Low prevalence of environmental interventions such
as: duress alarms, optimised clinician escape in
consulting and treatment areas, and after-hours and
off-site safety strategies [13]
• Particularly in private room settings
– Differs by gender, impacts on job satisfaction, life
satisfaction, self-rated health, participation intentions
[16, 10, 5]
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Future research plans
 Changing expectations (e.g. around work-life balance) of
the next generation with more female doctors may
influence specialty, hours and other work choices
 A healthy and happy workforce is important, so
understanding the factors influencing health (physical and
mental) and job/life satisfaction is paramount
 Key questions are:
– How do gender, having a family, and changing work-life
balance expectations influence medical care?
– How do doctors’ health and well-being influence their
workforce participation, distribution and quality of care?
– What support do doctors need to remain healthy, happy and
productive?
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Future research plans
 We will have 10 waves of data next year, there is a lot
that we can do with that:
– Use the longitudinal aspect to get at causal relationships.
– Some specific questions of interest:
• What is the immediate and long term impact of having a (newborn)
child on workforce participation, specialty choice, and location of
practice? What are the differences by gender and specialty?
• How does workplace and training flexibility influence career paths
and workforce participation?
• Is doctor’s health and well-being changing over time, and why?
• To what extent does poor health and well-being influence hours
worked, rural distribution, specialty choice, medical malpractice
complaints and litigation, practice patterns and provision of low
value care?
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Future research plans
 First two questions can be done without extra data
collection
 Last two questions can be done partly with existing data
but would benefit from additional information through
questions on mental health and stress (similar to those in
Beyondblue survey)
– Currently only overall self-rated health (including physical
and mental health)
– Additional questions like the often used Kessler 10 would
also allow comparison to other populations
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References
1. Cheng TC, Kalb G & Scott A. Public, private, or both? Analysing factors influencing the labour
supply of medical specialists, under review.
2. Kalb G, Kuehnle D, Scott A, Cheng TC & Jeon S-H. What factors affect doctors' hours
decisions: Comparing structural discrete choice and reduced-form approaches, under review.
3. Broadway B, Kalb G, Li J & Scott A. 2017. Do Financial Incentives Influence GPs' Decisions
to Do After-hours Work? A Discrete Choice Labour Supply Model. Health Economics, DOI:
10.1002/hec.3476
4. Schurer S, Kuehnle D, Scott A & Cheng TC. 2016. A man's blessing or a woman's curse?
The family-earnings gap of doctors. Industrial Relations: A Journal of Economy and Society.
55(3): 385-414.
5. Hills, DJ. 2016. Associations between Australian clinical medical practitioner exposure to
workplace aggression and workforce participation intentions. Australian Health Review. 40:
36–42.
6. Cheng TC, Powdthavee N & Oswald AJ. 2015. Longitudinal evidence for a midlife nadir in
human beings: Results from four data sets. The Economic Journal, DOI: 10.1111/ecoj.12256.
7. Joyce C & Wang WC. 2015. Job satisfaction among Australian doctors: the use of latent
class analysis. Journal of Health Services Research & Policy, 20(4): 224-230.
8. Joyce CM, Wang WC & Cheng TC. 2015. Changes in doctors' working hours: A longitudinal
analysis. Medical Care Research and Review, 72(5): 605-621.
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References
9. Joyce C, Wang WC & McDonald H. 2015. Retirement patterns of Australian doctors aged
65 years and older. Australian Health Review, 39(5:) 582-587.
10. Hills D & Joyce C. 2014. Workplace aggression in clinical medical practice: Associations
with job satisfaction, life satisfaction and self-rated health. Medical Journal of Australia,
201(9): 535-540.
11. Hills D & Joyce C. 2013. Personal, professional and work factors associated with
Australian clinical medical practitioners' experiences of workplace aggression. Annals of
Occupational Hygiene, 57(7), 898-912.
12. Hills D & Joyce C. 2013. A review of research on the prevalence, antecedents,
consequences and prevention of workplace aggression in clinical medical practice.
Aggression and Violent Behavior: A Review Journal, 18(5), 554-569.
13. Hills D, Joyce C & Humphreys J. 2013. Workplace aggression prevention and
minimisation in Australian clinical medical practice - a national study. Australian Health
Review, 37(5): 607-613.
14. Scott A, Witt J, Humphreys J, Joyce C, Kalb G, Jeon SH & McGrail M. 2013. Getting
doctors into the bush: General practitioners preferences for rural location. Social Science
and Medicine, 96: 33–44.
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References
15. Cheng TC, Scott A, Jeon S, Kalb G, Humphreys J & Joyce C. 2012. What factors influence the
earnings of general practitioners and medical specialists? Evidence from the Medicine in Australia:
Balancing Employment and Life survey. Health Economics, 21(11): 1300-1317.
16. Hills D, Joyce C & Humphreys J. 2012. A national study of workplace aggression in
Australian clinical medical practice. Medical Journal of Australia, 197(6): 336-340.
17. McGrail M, Humphreys J, Joyce C & Scott A. 2012. International medical graduates
mandated to practice in rural Australia are highly unsatisfied: Results from a national survey
of doctors. Health Policy, 108(2): 133-139.
18. Sivey P, Scott A, Witt J, Joyce C & Humphreys J. 2012. Junior doctors' preferences for
specialty choice. Journal of Health Economics, 31(6): 813–823.
19. Hills D, Joyce C & Humphreys J. 2011. Prevalence and prevention of workplace aggression
in Australian clinical medical practice. Australian Health Review, 35(3): 253-261.
20. Joyce C, Schurer S, Scott A, Humphreys J & Kalb G. 2011. Australian doctors' satisfaction
with their work: Results from the MABEL longitudinal survey of doctors. Medical Journal of
Australia, 194(1): 30-33.
21. Shrestha D & Joyce C. 2011. Aspects of work-life balance of Australian general practitioners:
Determinants and possible consequences. Australian Journal of Primary Health, 17:40-47.
22. McGrail M, Humphreys J, Scott A, Joyce C & Kalb G. 2010. Professional satisfaction in
general practice: Does it vary by size of community? Medical Journal of Australia, 193(2): 9498.
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