Physician marriage survey reveals sex and specialty differences in marital satisfaction factors

Abstract

Physician marriage is a valuable indicator of how vocational factors (e.g. work hours, stressors) impact satisfaction in relationships and physician wellness overall. Previous studies suggest that gender and specialty influence marriage satisfaction for physicians, though these often come from limited, local, cohorts. A cross-sectional survey was designed and distributed to publicly available email addresses representing academic and private practice physician organizations across the United States, receiving 321 responses (253 complete). Responses included data on demographics, medical specialty, age at marriage, stage of training at marriage, number of children, and factors leading to marital satisfaction/distress. A multivariable ordinal logistic regression was conducted to find associations between survey variables and marriage satisfaction. Survey results indicated that 86.5% of physicians have been married (average age at first marriage was 27.8 years old), and the rate of first marriages ending is at least 14.7%. Men had significantly more children than women. Physicians married at least once averaged 1.98 children. "Other" specialty physicians had significantly more children on average than psychiatrists. Marrying before medical school predicted practicing in private practice settings. Job stress, work hours, children, and sex were most frequently sources of marital distress, while strong communication, finances, and children were most frequently sources of marital stability. Sex differences were also found in distressing and stabilizing marital factors: Female physicians were more likely to cite their spouse's work hours and job stress as sources of marital distress. Finally, surgery specialty and Judaism were associated with higher marriage satisfaction, whereas possession of an M.D. degree was associated with lower marriage satisfaction. This study elucidated new perspectives on physician marriage and families based on specialty, practice setting, and stage of training at marriage. Future studies may focus on factors mediating specialty and sex's impact on having children and marriage satisfaction. To our knowledge, this study is the first physician marriage survey which integrates multiple factors in the analysis of physician marriages.

Keywords: Children; Physician marriage; Physician wellness; Survey.

Figure 1

Overview of respondents’ marital characteristics. Visualization of distribution of currently married, ever married, never married, and not currently married respondents. Physicians are 27.8 years old on average at their first marriage and 26.1% are currently married to another physician. One out of nine physicians ever-married physicians have been married multiple times, and seven out of eight ended first marriages were a result of divorce, rather than death of the spouse. Over half of unmarried physicians are in romantic relationships.

Figure 2

Specialty and average total number of children physicians had across all marriages. “Other” specialty physicians were found to have more children, on average, than psychiatry specialization physicians.

Figure 3

Practice setting with respect to stage of training at marriage. Physicians married before medical school were significantly more likely to practice in a private practice setting compared to physicians married during medical school or residency, who were more likely to practice in an academic setting (p = .03, χ² = 19.7).

Figure 4

Factors contributing to marital distress (a) and marital stabilization (b). In descending percentage of respondents, stress from the physician’s job, the physician’s work hours, children, and sex were the most selected distressing factors for marriage. Strong communication, finances, children, and the spouse’s work hours were the most selected stabilizing factors for marriage. Respondents could select multiple options for each question.

Figure 5

Percent of female and male physicians selecting factors contributing to marital distress (a) and marital stability (b). Female physicians were significantly more likely than male physicians to cite their spouse’s job and work hours as sources of distress. Male physicians were significantly more likely than female physicians to select work hours and other family members as sources of stability and significantly less likely to select their spouse’s work hours as a source of stability.

Figure 6

Factors contributing to marital distress (a) and marital stability (b) based on percentage of respondents in each specialty. Surgeons were significantly more likely than psychiatrists to select children as a source of stability.

Figure 7

Results of the ordinal logistic regression. Binary, nominal, and ordinal variables were coded to generate coefficients with a dependent variable of physician marriage satisfaction.