Do Nephrologists Have More (or Less) Fun? A Lifestyle Report

• Survey fielded to 292,251 US physicians

• Total respondents: 29,025 US physicians across 25 specialty areas

• Fieldwork conducted by Medscape from 1/12/2012-1/27/2012

• Data collected via third-party online survey collection site

** Respondents were entered into a sweepstakes to win an Apple iPad 2 16GB Wi-Fi Enabled Device awarded to 5 physicians.

How Happy Are Nephrologists With Their Lives Outside of Work?

According to a 2006 report from the Pew Research Center, 34% of Americans say that they are "very happy," 50% "pretty happy," and 15% "not too happy."^[1] Medscape asked US physicians how happy they were with their lives outside of medicine and to rate their level of happiness on a scale of 1 to 5, with 1 being the least happy and 5 being the happiest. The average happiness score for all physicians who responded was 3.96, which is on the cheerful side. Nephrologists were less happy; with a score of 3.90, they were tied for seventh place with diabetes and critical care physicians.

What Are Nephrologists' Favorite Pastimes?

Nephrologists did not differ from physicians in general and rated their top 5 pastimes as exercise/physical activity, travel, reading, food and wine, and cultural events. Surfing the Web came sixth; it was a favorite pastime of almost 34% of nephrologists. Among the most interesting pastimes enjoyed by nephrologists were working on patents, making movies, learning Gemara, and aerobatics. Others liked simple pleasures, including hanging out with children and grandchildren, food and beer, and Michigan football.

Where Do Nephrologists Volunteer?

In the Medscape survey, about 62% of nephrologists reported participating in some form of volunteerism, whereas 37% rarely, if ever, volunteer. In the overall response to the Medscape survey, the unhappiest physicians, according to self-rating, were those who didn't volunteer, followed by those who tutored or did counseling.

Doing any type of volunteer work was associated with a self-rated happiness score higher than the overall average score of 3.96. Of note, in a 2000 survey published in Archives of Family Medicine, physicians who viewed benevolence as a guiding principle in their lives reported greater professional satisfaction.^[2]

Where Do Most Nephrologists Lean on the Political Spectrum?

A May 2011 poll by Rasmussen Reports found that 29% of US voters characterize themselves as both fiscal and social conservatives, and only 10% said that they are liberal in both areas.^[3] In the Medscape poll, when asked about their political leanings, about 28.6% of nephrologists defined themselves as being both socially and fiscally conservative -- a higher percentage than in the general US population. About 27% of nephrologists described their views as being liberal in both areas, which was slightly ahead of the percentage of left-leaning Americans in the Rasmussen report. When broken down further, 69% of nephrologists say that they are fiscally conservative and almost as many -- 67% -- describe themselves as social liberals.

Where Do Nephrologists Vacation?

With an average of 13 paid vacation days per year, Americans do far worse than those in other developed countries (eg, Italy, 42; France, 37; Germany, 35; United Kingdom, 28; Canada, 26; Japan, 25).When they go on vacation, according to a 2009 survey from US Travel Association, Americans like to visit friends and relatives, go sightseeing or to beaches, visit museums, and go to national or state parks.^[4]

Nephrologists do better than most Americans in amount of vacation time. Almost 20% of them take more than 4 weeks, and about the same proportion takes 1-2 weeks, which puts them in the top 10 for amount of time taken off by specialists who responded to our survey. Reflecting the generally higher income among nephrologists than that of the average American, the top 2 favorite vacations for these physicians are foreign travel (56.7%) and beaches (44.2%). Then, 20% prefer road trips, followed closely by luxury hotels and spas and cruises. In the write-in responses, most nephrologists said that they liked to visit their family or play golf. When asked what he did on vacation, one driven nephrologist complained, "Not much, since it is always work."

What Percentage of Nephrologists Are Married? Single?

Among nephrologists who responded to the Medscape survey, over 85% are currently married, a rate higher than that reported by all physicians (81%). Nephrologists also report a lower divorce and separation rate (3.4%) than all physicians who responded (5.7%).

The percentage of married nephrologists in this survey is far higher than the marriage rate in the general US population. In fact, the current US Census found a drop in the percentage of married Americans over the past 40 years, from 72% in 1970 to just 48% in 2011.^[5] This parallels a recent Pew Research Center finding that only 51% of US adults are currently married.^[6] The report also found that the current marriage rate for people under 30 was only 20%. Of interest, in the general Medscape survey, nearly one half of all physicians in that same young age group reported being married.

Does a Nephrologist's Marital Status Affect Level of Happiness?

According to a Pew Research Center report, 43% of married people reported that they were "very happy," compared with only 24% of those who were unmarried.^[1] A study (albeit an older one) of a large sample of medical and dental professionals and their spouses reported that 85% were satisfied with their marriages and that high levels of marital satisfaction were associated with high levels of work satisfaction, low levels of work stress, and fewer psychiatric symptoms.^[7]

For marital status, the highest happiness score (out of 5) was reported by nephrologists in a first marriage (3.98), followed by those who had remarried (3.9), whether in a first or subsequent marriage. The scores then dropped to 3.6 for both those who were single and those who were living alone or divorced. Nephrologists were single and living with a domestic partner seemed to be less happy (3.45), and those who were in the difficult state of separation reported being fairly distressed (2.0)

How Do Nephrologists Rate Their Own Physical Health?

In our survey, physicians were asked to rate their physical health on a scale of 1 to 5, with 5 being very healthy and 1 being in poor health. The healthiest specialists by this self-rating were dermatologists, plastic surgeons, endocrinologists, orthopaedists, and cardiologists. The 5 least healthy were general surgeons, psychiatrists, ob/gyns, pediatricians, and critical care physicians.

Nephrologists who responded to the Medscape survey rated their health as better than the average physician in every age group except for those between 51 and 60 years; this group reported an average health score of 4.06, compared with the overall average of 4.12. Nephrologists older than 60 years, however, rated their health as better (4.33) than both the average physician in this age group (4.09) and their younger nephrologist peers (aged 31 to 60 years), whose self-reported health varied from 4.05 to 4.17.

How Many Nephrologists Are Overweight?

According to statistics from the Centers for Disease Control and Prevention (CDC), in 2008 40% of US men were overweight and 32% were obese.^[8] As for physicians in general, a 2004 study^[9] found that 38% of male physicians were overweight and 8% were obese.

The Medscape survey suggests an improvement in physicians' weight, but it still could be better, even among nephrologists. Approximately 33% of nephrologists reported being overweight, which was also the average of all physicians who responded to the survey. About 5.4% of nephrologists reported obesity, which was also similar to the average among all physician respondents.

Of note, physicians' own body weight may influence how they talk to their patients about weight. A 2012 study in Obesity reported that physicians with a normal body mass index were more likely to engage their obese patients in weight-loss discussions than were overweight or obese physicians (30% vs 18%).^[10] In a Medscape discussion on overweight physicians, a primary care physician wrote, "We are all fallible. Physicians need to address this directly when communicating with their patients -- why they choose to remain fat or to smoke -- so they can be credible."

How Often Do Nephrologists Exercise?

According to the CDC, between 1999 and 2009 the percentage of men aged 18 years or older who met the 2008 federal aerobic activity and muscle-strengthening guidelines increased from 19% to 22%.^[8] These guidelines recommend moderate to vigorous aerobic activity performed in episodes of at least 10 minutes, and preferably spread throughout the week. Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week.

According to the Medscape survey, nephrologists in general do as well as the average physician, and the older they get, the more they exercise. In their 50s, 33% of nephrologists are exercising 4 or more times a week. This drops off after age 61 years, but even in later years, 70% of nephrologists are exercising more than twice a week.

What Types of Sports and Exercise Do Nephrologists Engage in the Most?

Aerobic activities are by far the most popular exercises; over 67% of nephrologists and 71% of all physicians engage in this form of exercise. More than 28% of nephrologists chose weight training as their second most favored exercise, and 14% to 17.7% chose competitive, winter, and wilderness sports. About 8.8% of nephrologists did yoga, tai chi, or other Eastern practices, which was less the 14.6% of all physicians who do so. Among write-in responses, nephrologists expressed major interest in horseback riding and soccer.

Do Nephrologists Smoke?

Although the national quit rate has increased slightly over the past few years, according to a 2011 Harris Interactive poll, 18% of Americans still smoke.^[11] Among nonsmokers, the physicians who answered our survey -- including nephrologists -- lead the national pack: Only about 1% of nephrologists say that they smoke. About 7% are ex-smokers.

How Often Do Nephrologists Drink Alcohol?

As reported in a 2010 Gallup poll, 67% of US adults drink alcohol, a rate that has been "remarkably stable" since this began to be tracked in 1939.^[12] According to the Medscape survey, nephrologists are a bit behind both the national population and most physicians, with 64.2% reporting that they drink and over 35% not drinking at all. They also tend not to overindulge: Over one half of those who drink report having fewer than 1 drink per day, and approximately 11% report having 1-2 per day. Only 1.8% of nephrologists admit to more than 2 drinks daily.

How Do Nephrologists Gauge the State of Their Personal Finances?

As of December 2011, a Gallup poll reported that 52.5% of Americans considered themselves to be thriving, 43.7% were struggling, and 3.7% were suffering.^[13] Our Medscape survey indicates that many nephrologists also perceive themselves as having financial difficulties. Over 34% of nephrologists in active practice who responded said that they had no or minimal savings for their age and stage of life. Only slightly over 11% of practicing nephrologists believe that their savings are more than adequate.

Such responses could reflect the more difficult economic climate for the younger generation of physicians. Of note, 89% of nephrologists in our survey who are semi-retired and all who were retired believe that they have adequate or more than adequate savings for their stage in life, but these represent a very small segment of the nephrologists who responded.

Are Nephrologists Religious/Spiritual?

According to a 2008 Pew report, 88% of Americans believe in God or a universal spirit.^[14] In our Medscape poll, instead of asking about specific religious affiliations, we wanted to know whether physicians have a spiritual belief, regardless of active participation. When asked whether they have any religious or spiritual belief, over 81% of nephrologists reported that they do, with 44% of them actively practicing their faith. The remaining 18.8% had no belief system.

Of note, in our survey, men and women differed little in terms of having or not having a belief and actively or not actively practicing. In the Pew report, however, men were significantly more likely than women to claim no religious affiliation: nearly 20% vs roughly 13%, respectively.

What Would Nephrologists Do if They Were Told They Had a Terminal Illness?

In a 2011 poll by National Journal and the Regence Foundation,^[15] 71% of the general population felt that quality of life was more important than length of life, 23% felt it was important to extend life with every intervention available, and only 6% didn't know or didn't answer the question. Nephrologists, according to our poll, were more ambivalent, with about 21% of those in most age groups being uncertain about how they would respond if they were told they had a terminal illness. Over 60% of nephrologists said that they would choose quality over length of life, and only about 14% were certain about being treated aggressively.

However, the responses varied by age. The percentage of nephrologists who would choose more aggressive treatments increased over the course of life, from 10.4% at age 31-40 years to 25% in those between 51 and 60 years of age. The percentage of those over older than 61 years who chose aggressive treatment plummeted to 7.7%, but this was a very small sample.

When the responses were filtered by religious or spiritual belief, only 12.7% of nephrologists with no beliefs and 10% of those who have a belief but no active practice would choose aggressive treatment. Nearly 19% of those who actively practice religion would choose to be treated aggressively.

Do Nephrologists Use Social Media?

No surprise: The use of social media drastically decreases with increasing age of the nephrologist. Only about 14% of nephrologists between 31 and 40 years of age do not use it, while about 46% of those over 61 are not engaged in any social media. Facebook is the most popular medium in all age groups, being used by over 69% of those younger than 30 years and nearly 37% of those between 61 and 70 years of age. Use of LinkedIn, the network that provides professional contacts and connections, varies from about 17% to 26% among all age ranges. Of interest, the highest use of Twitter by nephrologists (11.5%) is seen among those between 50 and 60 years of age.

How Many US Nephrologists Are Citizens, and How Many Came From Other Countries?

About 47% of the nephrologists who answered Medscape's questions about citizenship were born in the United States, and about 10% came here as children. Approximately 43% came to the United States as adults -- a proportion that is much higher than the rate of 26.3% for physicians that the Migration Policy Institute reported in 2007. In this report, Asia was the origin of the greatest proportion of foreign-born physicians -- around 22% -- followed by Europe/Canada/Oceania at about 16%. Africa contributed about 12%, and Latin America 6%.^[16]

What Cars Do Nephrologists Drive?

In 2011, the top 3 highest selling cars in the United States were made by non-US companies: Toyota, Nissan, and Honda, with Ford coming in fourth.^[17] Nephrologists who answered the Medscape survey also listed foreign-made cars in their top 5: Honda (19.9%), Toyota (17.4%), BMW (12%), Lexus (10.4%), and Mercedes-Benz (4.73%). Audi came in sixth. US automaker Chevrolet didn't show up until seventh place and was chosen by only 3.2% of nephrologists.

What Are Nephrologists' Favorite Nonmedical Mobile Apps?

Author affiliation: Carol Peckham, Director of Editorial Development, Medscape from WebMD

Disclosure: Carol Peckham has disclosed no relevant financial relationships.

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