1. Introduction
Over the past 20 years, work–life balance (WLB), burnout, and physicians’ well-being have gained significant attention in the medical community [
1]. Despite the wide adoption of the WLB concept, an agreed and precise definition has yet to be established [
2]. It first emerged with the entry of women into the workforce and later expanded to include both genders [
1]. As the work demands increased, individuals had to take on more responsibilities, which led to heavier workloads and longer working hours. This, combined with the rise of telecommunication and the internet, made managing relationships, personal lives, and family responsibilities more difficult [
1]. Work–life conflict is now one of the most emerging psychosocial risk factors in the workplace, according to the European Agency for Safety and Health at Work Research [
3].
Healthcare practitioners are more likely to suffer from work–life conflict due to their longer working hours than the general population [
4]. In fact, about 50–60% of physicians experience symptoms of burnout in the United States, with a worsening trend in burnout and physicians’ satisfaction with the WLB over time [
5,
6]. Several studies have shown an increased risk of work–life conflict in physicians of younger age and in certain specialties [
7,
8]. These stressors directly affect their mental health and could lead to a myriad of issues, including depression, emotional exhaustion, anxiety, drug abuse, and even suicide [
9]. In addition, studies have shown a connection between work–life conflict and medical errors [
10]. Despite numerous studies on discussing physicians’ work–life balance worldwide, the literature is limited in regards to physicians in the Middle East.
Over the past two decades, research on physicians’ job satisfaction (JS) has grown in importance [
8,
11]. The outcomes of JS extend beyond physicians’ well-being to their mental health, the quality of care given to patients, and their satisfaction [
12]. In addition, the conflict between work and family also has a negative impact on physicians’ JS, which may reflect on the doctor–patient relationship [
8]. In light of the detrimental impact work–life conflict has on individuals’ lives, combined with the increased risk of physicians suffering from it and the limited data on the levels of WLB and JS among physicians in Jordan and the Middle East, the aim of the study was to assess the status of WLB, JS, and life satisfaction (LS) among physicians practicing in Jordan. This was achieved by analyzing the three indices in addition to how various demographic, professional, and academic correlates impacted each one.
4. Discussion
The main finding of our study was that around two-thirds of participants had a work–life conflict. In addition, approximately four out of ten physicians had frequent work interference with personal life. The WLB was lower in females, those who were single, those with a higher number of working hours, and those with a higher number of on-call days. On the other hand, the WLB was higher for those who were older, who had a higher number of children, increased years of practicing medicine, private sector workers, consultants, and those with a monthly income of more than JOD 2000. Regarding specialties, obstetrics and gynecology, followed by family medicine, general surgery, and internal medicine, showed a lower WLB. Regarding JS and LS, they were higher among those who were older, married, consultants, working in the private sector, had more children, had an increased number of years practicing medicine, and had a monthly income of more than JOD 2000. JS and LS were lower in participants with increased working hours and an increased number of calls. JS was higher among males, but there was no difference in overall LS between the genders. JS and LS increased with an increase in the WLB.
In a systematic review in the Middle East, Chemali et al. reported that the burnout prevalence range was between 40 and 60% among healthcare workers [
16]. Jordan exhibited even greater prevalence values than those reported in the previous literature. According to a cross-sectional study of 481 resident physicians in Jordan, 77% of them were found to have burnout [
17]. Similarly, Al-Taher et al. found that 53.6% of Jordanian resident physicians had a high grade of emotional exhaustion, with 82.4% exceeding the 24 h shift length [
18]. Moreover, it was found that physicians had a greater likelihood of exhibiting higher burnout scores and less WLB than the general population in the United States [
4,
5]. Given that there have been no previous studies on WLB, JS, or LS in our area, it is difficult to compare our findings with the literature.
The negative consequences of work–life conflict and low quality of life among healthcare employees, particularly resident physicians, are well documented and include an increase in the likelihood of medical errors, burnout, lower care quality, and patient dissatisfaction [
19,
20,
21,
22]. In a review by Amoafo et al., they found that younger-aged physicians, females, and negative marital status were predictors of burnout [
7]. Our study showed similar findings since younger-aged, single, or female physicians had a lower WLB. In addition, resident physicians had the least WLB, JS, and LS compared with other positions. This is especially alarming since previous research has demonstrated that a lack of WLB during postgraduate medical training has a negative effect on physicians’ learning, progression, and well-being [
23]. As the ramifications of the lifestyle of healthcare practitioners persist, married doctors experience an increased work–family conflict, especially in internal medicine, surgery, obstetrics and gynecology, and pediatrics departments [
8]. As a result, it is more difficult for young physicians to get married, have children, and maintain a work–family balance [
8].
A recent review showed there has been a shift in obstetrics and gynecology in recent years, as a growing number of women express a desire for a better WLB [
24]. In addition, it has been reported previously that the obstetrics and gynecology field has one of the lower rates of burnout in the medical profession [
5]. However, our study found that the lowest WLB and JS were reported by obstetrics and gynecology, followed by family medicine. In addition, a previous study on Jordanian resident physicians found that being an obstetrics and gynecology resident had the highest burnout levels and was a significant predictor of higher levels of burnout [
17]. This could be due to the irregular working hours, paperwork, delays in referrals to specialists and test results, lack of respect and appreciation, lack of support, complex patients, and lack of WLB [
5,
25].
As expected, increasing WLB was positively correlated with JS and LS, as reported by previous studies [
26]. In general, JS was higher than LS, which could be explained by the fact that despite working their desired job, nearly a half of the participants had a monthly income of JOD 500–1000 (USD 700–1400) and worked an increased number of hours. This, in turn, negatively affected their lifestyles and time spent with their families. A previous study showed that lower wages were one of the most important factors affecting JS [
27], which is comparable to our results, as JS and LS were higher in those with a monthly income of more than JOD 2000. Our study found that males had higher JS, and there was no difference in LS, which contradicts the findings of several prior studies that found no differences between females and males in terms of JS [
28,
29,
30].
The main strength of our study is that it is the first in-depth article to tackle WLB among physicians in Jordan. In addition, the survey assessed various validated scales, including the WLB score, the JS score, and the LS score. We included physicians at multiple levels, as well as workers from different working sectors, allowing us to estimate the desired scores and generalize our findings. Moreover, using a validated and self-administered questionnaire reduced the interviewer bias. Therefore, we believe that our findings could accurately reflect the overall WLB, JS, and LS in Jordan. The authors acknowledge that this study is not without limitations. The study’s cross-sectional design limits our ability to determine causal effects. Nevertheless, most of our results are consistent with causal relations asserted by previously published research. In addition, a non-random convenience sampling method was used to recruit participants due to the low participation rate. Moreover, because our study relied on self-reported data, response bias was a limitation. Our research was focused on the five main disciplines (general surgery, obstetrics and gynecology, internal medicine, orthopedics, and family medicine); thus, our conclusions may not apply to other specialties or subspecialties. Further additional regional studies to elucidate these concerns in greater depth are required.
Our study demonstrates that work–life conflict is highly prevalent among Jordanian physicians and highlights the significance of WLB in supporting physicians’ well-being and performance. Priority should be given to expanding national initiatives to investigate and reduce work-related stress by enhancing medical professionals’ mental health and working environments. This is especially important since the negative impact of poor WLB and increased stress extends beyond the doctor himself to putting the patients at risk of unintentional harm, increasing the number of errors made by the doctors, and affecting the ongoing education process of the resident physicians. Further studies studying the implementation of initiatives aimed at improving WLB should be conducted.