Secrets of physician satisfaction: study identifies pressure points and reveals life practices of highly satisfied doctors."I'm working too hard." "Malpractice insurance is killing my practice." "I don't get enough time with my family." "I spend too much time on paperwork and not enough with my patients." Sound familiar? It's no secret that physicians today face myriad challenges and changes--from increased medical malpractice Improper, unskilled, or negligent treatment of a patient by a physician, dentist, nurse, pharmacist, or other health care professional. litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. to shrinking reimbursements, from cost containment cost containment, n the features of a dental benefits program or of the administration of the program designed to reduce or eliminate certain charges to the plan. to privacy, security and patient safety concerns. The country's health care system remains perpetually per·pet·u·al adj. 1. Lasting for eternity. 2. Continuing or lasting for an indefinitely long time. 3. Instituted to be in effect or have tenure for an unlimited duration: in a state of flux Noun 1. state of flux - a state of uncertainty about what should be done (usually following some important event) preceding the establishment of a new direction of action; "the flux following the death of the emperor" flux , and physicians often feel caught in a cyclone cyclone, atmospheric pressure distribution in which there is a low central pressure relative to the surrounding pressure. The resulting pressure gradient, combined with the Coriolis effect, causes air to circulate about the core of lowest pressure in a of new missions and mandates. Research supports that many physicians experience high levels of dissatisfaction with their profession, and that dissatisfaction may be on the rise. The ramifications ramifications npl → Auswirkungen pl of this are quite serious and pose threats to health care providers and patients alike. Physician career dissatisfaction has been found to be associated with physician stress, disruptive disruptive /dis·rup·tive/ (-tiv) 1. bursting apart; rending. 2. causing confusion or disorder. behavior, burnout Burnout Depletion of a tax shelter's benefits. In the context of mortgage backed securities it refers to the percentage of the pool that has prepaid their mortgage. and career exit, medical errors, reduced patient care quality, reduced patient compliance with medical instructions and higher health care costs. (1-9) How can doctors not only survive, but thrive in this ever-changing environment? While some physicians are quick to place blame, fall "victim" and even lash out lash out Verb 1. to make a sudden verbal or physical attack 2. Informal to spend extravagantly Verb 1. due to the challenges they face, others facing the exact same challenges persevere per·se·vere intr.v. per·se·vered, per·se·ver·ing, per·se·veres To persist in or remain constant to a purpose, idea, or task in the face of obstacles or discouragement. , remaining dedicated, determined and closely connected to their passion and commitment to serve. What is their secret? And what can physician executives do to anticipate and help physicians address these emerging challenges? The bigger picture A recent Physician-to-Physician Satisfaction Study conducted by The Center for Health Futures at Florida Hospital in Orlando, Florida The city of Orlando is a major city in central Florida and is the county seat of Orange County, Florida. According to the 2000 census, the city population was 185,951. A 2006 U.S. , in collaboration with the hospital's Physician Support Services support services Psychology Non-health care-related ancillary services–eg, transportation, financial aid, support groups, homemaker services, respite services, and other services and research partners at the University of Central Florida “UCF” redirects here. For other uses, see UCF (disambiguation). UCF is a member institution of the State University System of Florida. UCF was founded in 1963 as Florida Technological University with the goal of providing highly trained personnel to support the Kennedy attempted to answer some of these questions. The study examined a common concern--physician satisfaction--with a new approach. Instead of focusing only on traditional workplace satisfaction indicators, the two-year project took a more holistic Holistic A practice of medicine that focuses on the whole patient, and addresses the social, emotional, and spiritual needs of a patient as well as their physical treatment. Mentioned in: Aromatherapy, Stress Reduction, Traditional Chinese Medicine view--looking at physicians as human beings. It broke down all of the factors both within and outside physicians' work environments that play key roles in their stress levels and ultimately, their career satisfaction. The crux Crux (kr  ks) [Lat.,=cross], small but brilliant southern constellation whose four most prominent members form a Latin cross, the famous Southern Cross. of the survey asked the doctors to rate their satisfaction
in 17 different areas of their lives as physicians. Of the 17, 10 items
were rated below average or less satisfying than the average rating for
all 17 items (Table 1). The lower the satisfaction rating, the more
dissatisfied dis·sat·is·fied adj. Feeling or exhibiting a lack of contentment or satisfaction. dis·sat  is·fied physicians were with that item.Perhaps it is no surprise that hospital cost containment efforts topped the list as the source of least satisfaction (Figure 1). But exactly what meaning should executives ascribe as·cribe tr.v. as·cribed, as·crib·ing, as·cribes 1. To attribute to a specified cause, source, or origin: "Other people ascribe his exclusion from the canon to an unsubtle form of racism" to this finding? What can be done to find a better balance between responsible hospital management practices and physicians' sincere wishes to be able to provide the best medical care for their patients? This age-old challenge for physicians and hospitals will no doubt persist in Verb 1. persist in - do something repeatedly and showing no intention to stop; "We continued our research into the cause of the illness"; "The landlord persists in asking us to move" continue some form, and physician executives are caught right in the middle. However, the level of dissatisfaction with this item strongly suggests substantial opportunities for better communication about cost containment measures. Executives should continue to explore innovative ways to engage physicians in these discussions and efforts so that this consistently dissatisfying factor might become a basis for improved mutual understanding and better balance between physicians' passion and management imperatives. The other factors at the top of the list, including the amount and quality of physicians' personal time (Figure 2) as well as opportunities for research and training (Figure 3) were statistically significant and should also be carefully considered as opportunities for improving physicians' lives. How, for example, can physician executives help doctors find more opportunities for the collegiality col·le·gi·al·i·ty n. 1. Shared power and authority vested among colleagues. 2. Roman Catholic Church The doctrine that bishops collectively share collegiate power. and stimulation that result from research and teaching? How can they work with physicians and their families to improve the amount and/or quality of physicians' personal time? Even a slight difference in one or two of these factors could yield great improvements in a physician's outlook and feeling of well-being. Where then can physicians and executives build upon and maximize their successes? The areas that contributed most to doctors' happiness with their lives as physicians seem to focus on the people they work with, the people they live with, and most of all, the people for whom they provide medical intelligence and care (Table 2, Figures 4-6). The higher the satisfaction rating, the more satisfied physicians were with that factor. Physicians were trained to take care of patients. Therefore, it should be no great surprise to anyone that the greatest sources of satisfaction in their work are people. So how can executives take advantage of these bright spots? Are there ways to adjust practice patterns to permit doctors just a bit more of the patient contact they enjoy so much? Can executives help physicians work together to create and maintain better collegiality without attempting to substantially shift how they must spend their time to meet patient care goals and needs? How can executives foster and facilitate more direct patient feedback to physicians? The boiling point boiling point, temperature at which a substance changes its state from liquid to gas. A stricter definition of boiling point is the temperature at which the liquid and vapor (gas) phases of a substance can exist in equilibrium. In addition to understanding the factors that lead to physician satisfaction and dissatisfaction, it is important to examine the pivotal role that stress plays in doctors' daily lives. Physician stress can lead to career dissatisfaction, disruptive behavior, burnout and career exit, substance abuse, health concerns, personal and family problems and in the worst cases, suicide. (10-17) The Center for Health Futures study measured stress with one self-report item, "How would you rate your overall stress level?" The responses ranged from 1 to 9, with 1 being "very low." The average score was 6.0. Researchers compared demographics The attributes of people in a particular geographic area. Used for marketing purposes, population, ethnic origins, religion, spoken language, income and age range are examples of demographic data. such as gender, age, ethnicity ethnicity Vox populi Racial status–ie, African American, Asian, Caucasian, Hispanic , marital status marital status, n the legal standing of a person in regard to his or her marriage state. and number of children as well as work environment factors like specialty, physician satisfaction, hours worked and payment sources to determine which items differentiated those with higher versus lower levels of stress. What led to stress? It was not gender, marital status, race/ethnicity or payer source. In fact, variables related to physician satisfaction with their personal lives predicted levels of stress well beyond that accounted for by personal, demographic and work-related characteristics. Hours worked per week and age also came into play. "Physician satisfaction was by far at the top of the list," said researcher Brian Fisak with the Department of Psychology at the University of Central Florida. "It predicted stress almost three times as much as hours worked per week, the second factor on the list." When it came to age, the study revealed that older physicians experienced the least amount of stress. Specifically, physicians over the age of 59 reported lower levels when compared to younger physicians. "The more senior physicians may benefit from increased financial stability, decreased workloads and well-established practices within the community," commented researcher Herdley Paolin, director of Physician Support Services at Florida Hospital. Levels of stress for those younger than 45 and those between 45 and 59 did not differ significantly. As might be expected, physicians who worked a greater number of hours per week reported higher levels of stress. In addition, highly stressed physicians were less satisfied with the quality of their personal time, workload, personal growth and family issues. Based on the survey findings, it also appears that doctors' satisfaction with their personal lives may indeed serve as a buffer between stressors and the experience of stress or strain. "When physician satisfaction goes up, stress levels go down," notes Fisak. A game of "Survivor" The survey not only examined factors that lead to doctors' satisfaction and stress, but also took a hard look at the role experience plays and how satisfaction levels may change across various career stages. No doubt, life has become more difficult for physicians over the past 25 years. It may be possible to get an idea of how things have changed by looking at which factors are more satisfying to physicians at different points in their careers. Overall, late-career physicians (21 or more years) rated themselves significantly higher in satisfaction than middle (12-20 years) or early career (less than 12 years) doctors. Other research has documented a similar phenomenon. (18) Some experts speculate that this may be partly due to a "survival" function--physicians who have found more ways to maintain their satisfaction are more likely to survive an entire career as a physician. They argue that the apparently higher satisfaction of doctors in later career stages results from "weeding weed 1 n. 1. a. A plant considered undesirable, unattractive, or troublesome, especially one growing where it is not wanted, as in a garden. b. Rank growth of such plants. 2. out" the less satisfied physicians. (19) Others suggest that physicians are not merely victims of their circumstances CIRCUMSTANCES, evidence. The particulars which accompany a fact. 2. The facts proved are either possible or impossible, ordinary and probable, or extraordinary and improbable, recent or ancient; they may have happened near us, or afar off; they are public or but can and do learn coping mechanisms coping mechanism Psychiatry Any conscious or unconscious mechanism of adjusting to environmental stress without altering personal goals or purposes . According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. this view, physicians discover and learn through the course of their careers how to adapt to their environments and keep in closer touch with the values that attracted them in the first place. (20) Finally, toward the end of one's career, some experts argue, financial stability has already been established, children are out of college and these "freedom factors" may contribute to higher levels of satisfaction. (21) Among other factors, doctors currently at later career stages developed their expectations about a satisfying medical career decades before physicians who are now early in their careers. So, how they rate their satisfaction may be, in part, related to those expectations. For example, in the "Physician-to-Physician" study, physicians early in their careers were less satisfied with the availability of hospital and office resources than doctors in the middle or later stages of their careers. This may reveal that expectations developed during medical school about the equipment and staff that should ideally be available do not square with the somewhat harsher realities new physicians face in practice. It may also indicate that doctors with more experience learn more about how to adapt to cost and time pressures and/or how to acquire the resources they desire. Life practices of highly satisfied physicians When all is said and done, physicians themselves hold many of the answers to their own career challenges. Since some physicians, facing the same challenges as their colleagues, find higher levels of satisfaction, it stands to reason that doctors do have some degree of control over how they feel about and cope with the obstacles and pressures. To find out how physicians might help themselves, the study's researchers conducted in-depth, semi-structured interviews A semi-structured interview is a method of research used in the social sciences. While a structured interview has a formalized, limited set questions, a semi-structured interview is flexible, allowing new questions to be brought up during the interview as a result of what the with 26 of the more highly satisfied physicians. The doctors interviewed were selected to represent all those who responded to the survey in terms of gender, race and ethnicity, medical specialty medical specialty Any specialty that provides non-interventional Pt management, ie with drugs, or with minimum intervention–eg, balloon catheterization Examples Internal medicine–allergy and immunology, cardiology, gastroenterology, hematology/oncology, and career stage. The interviews were designed to identify specific and concrete things that those highly satisfied physicians do--choices they made and strategies they implemented both in their personal and professional lives--that might explain their satisfaction. In all, researchers collected 108 "life practices" of highly satisfied physicians. These were then organized in ten types (Table 3). Developing a new game plan Practical applications hold the key to meaningful change. So, how can physician executives translate all of these findings into a plan of action that addresses both prevention and intervention? What specific strategies will foster greater physician satisfaction leading to improved collegiality, retention and recruitment? No one has all the answers. However, based directly on the survey and interview results, here are a few initial suggestions and recommendations for physician executives to explore further: * Help physicians recognize the detrimental det·ri·men·tal adj. Causing damage or harm; injurious. det  ri·men effects of working
excessive hours and involve them in developing creative solutions and
systems that encourage and allow them to find ways to realistically
limit the number of hours they work.* Develop more predictable and consistent physician scheduling systems. * Encourage physicians to focus on their personal growth and on ways to enhance the quality of their personal time. Make interventions and offer services that foster this, such as therapy, retreats and workshops. * Create collaborative arrangements whereby late-career physicians gradually reduce their overall workload, easing into retirement while at the same time, help to reduce the workload burden on early- and mid-career physicians. * Develop cost-and labor-effective mentoring programs that pair older, highly satisfied physicians with younger physicians to help them develop strategies to cope with stress. * Conduct career advice workshops during which later-career physicians offer guidance on specific approaches to career planning for early- and mid-career doctors. * Help physicians find ways to enhance the quality of their personal relationships and family life. Provide practical services that assist them with family challenges: on-site daycare centers, links to qualified child care providers and resources, flexible hours, etc. Make family therapy and related interventions readily available and accessible to physicians. Find creative ways to involve physicians' children and spouses in various activities. * Identify opportunities and encourage physician participation in research and training. * Adjust practice patterns to allow more patient contact. * Facilitate more patient feedback to physicians. * Offer and build awareness of stress prevention and management programs. Make them accessible and an acceptable part of the organization's culture. * Provide physician wellness programs targeted to doctors' specific needs and develop incentives to encourage use. Provide easy, flexible access to on-site or nearby exercise facilities. While the daily challenges doctors face can no doubt be daunting daunt tr.v. daunt·ed, daunt·ing, daunts To abate the courage of; discourage. See Synonyms at dismay. [Middle English daunten, from Old French danter, from Latin at times, they have choices and control over their own destinies. Perhaps one of the physicians interviewed for the study, a mid-career general surgeon General surgeon A physician who has special training and expertise in performing a variety of operations. Mentioned in: Appendectomy , said it best: "I wish doctors had a little more time to slow down and reflect on what they're doing and why. Reality is reality, and we just gotta got·ta Informal Contraction of got to: I gotta go home. deal with it. Change your attitude and move on. Look around at the people you are treating, and you can kind of get some inspiration from that." Richard Bogue is the senior research fellow and director of The Center for Health Futures at Florida Hospital. He can be reached at 407-646-7120 or at Richard.Bogue@flhosp.org. Founded in 1996, the Center develops and conducts research, evaluation and demonstration projects to disseminate dis·sem·i·nate v. dis·sem·i·nat·ed, dis·sem·i·nat·ing, dis·sem·i·nates v.tr. 1. To scatter widely, as in sowing seed. 2. best health care practices. [ILLUSTRATION OMITTED] John Guarneri, MD, FACOG FACOG Fellow of the American College of Obstetricians and Gynecologists. FACOG abbr. Fellow of the American College of Obstetricians and Gynecologists , is president-elect of the medical staff at Florida Hospital and has been president of the medical staff at Winter Park Memorial Hospital. He has practiced obstetrics and gynecology obstetrics and gynecology Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. in Winter Park, Florida Winter Park is a city in Orange County, Florida, United States. The population was 24,090 at the 2000 census. According to the U.S. Census Bureau's 2006 estimates, the city had a population of 28,083. for the past 25 years. [ILLUSTRATION OMITTED] Monica Reed, MD, is senior medical officer for Florida Hospital's seven-campus facility in Orlando, Florida. [ILLUSTRATION OMITTED] Kenneth W. Bradley, MBA MBA abbr. Master of Business Administration Noun 1. MBA - a master's degree in business Master in Business, Master in Business Administration , is senior vice president of Florida Hospital and administrator at Winter Park Memorial Hospital, a Florida Hospital. He can be reached at 407-646-7495. [ILLUSTRATION OMITTED] Jay M. Hughes, MD, is a retired internist internist /in·tern·ist/ (in-ter´nist) a specialist in internal medicine. in·ter·nist n. A physician specializing in internal medicine. . He was formally medical director of quality for Philip Crosby Associates and continues to teach quality management principles and implementation to outpatient facilities throughout the country. [ILLUSTRATION OMITTED] References: 1. Deckard G, Meterko M, & Field D. "Physician burnout: an examination of personal, professional and organizational relationships." Medical Care, 32 (3):745-54, July, 1994. 2. Di Matteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz R., McGlynn EA, Kaplan S Kaplan may refer to one of the following:
immune adherence to medical treatment: Results from the Medical Outcomes Study." Health Psychology, 12 (2):93-102, March 1993. 3. Jones, J.W., Barge, B.N., Steffy, B.D., Fay, L.M., Kunz, L.K., & Wuebker, L.J. "Stress and medical malpractice: organizational risk assessment and intervention." Journal of Applied Psychology Journal of Applied Psychology is a publication of the APA. It has a high impact factor for its field. It typically publishes high quality empirical papers. www.apa. , 23(4):727-35, Nov. 1988. 4. Landon BE, Reschovsky J, & Blumenthal D. "Changes in career satisfaction among primary care and specialist physicians, 1997-2001." Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 289(4):442-9, Jan. 2003. 5. Ong LM, DeHaes JC, Hoos AM, & Lammes FB. "Doctor-patient communication: a review of the literature." In DA Pendleton & JC Hasler (eds.), in Doctor-patient communication. London: Academic Press. 1995. 6. Roter DL, Hall JA, & Katz, NR. "Relations between physicians' behaviors and analogue (electronics) analogue - (US: "analog") A description of a continuously variable signal or a circuit or device designed to handle such signals. The opposite is "discrete" or "digital". patients' satisfaction, recall and impressions." Medical Care, 25(5):437-51, May 1987. 7. Stewart MA, Brown JB, Donner A, McWhinney IR, Oates J, & Weston W. Final report: The impact of patient-centered care on patient outcomes on family practice. London, Ontario: Thames Valley This article is about the Thames Valley in southern England. For New Zealand's Thames Valley region, see Thames Valley, New Zealand, or for the ITV region in the United Kingdom, see ITV Thames Valley. Practice Research Unit, 1996. 8. Van Dulmen AM, & Bensing JM "Health promoting effects of the physician-patient encounter." Psychology, Health & Medicine, 7, 2002. 9. Zuger A. "Dissatisfaction with medical practice." The New England Journal of Medicine The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. , 350(1):69-75, Jan 2004. 10. Boxer boxer, breed of medium-sized, muscular working dog perfected in Germany in the 19th cent. but whose origins may be traced back in Europe to the 16th cent. It stands from 21 to 25 in. (53.3–63.5 cm) high at the shoulder and weighs from 60 to 75 lb (27. PA, Burnett C, & Swanson N. "Suicide and occupation: a review of the literature." Journal of Occupational and Environmental Medicine, 37(9):745-54, July 1995. 11. Cann W. & de Bellorsche J. (Eds.) Drink, drugs and dependence: from science to clinical practice. London: Routledge, 2002. 12. Deckard G, Meterko M, & Field D. "Physician burnout: an examination of personal, professional and organizational relationships." Medical Care, 32,1994. 13. Firth-Cozens J, & Payne R. (Eds.) "Stress in health professionals: psychological and organizational causes and interventions." New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Wiley, 1999. 14. National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health, n.pr an institute of the Centers for Disease Control and Prevention that is responsible for assuring safe and healthful working conditions and for developing standards of safety and health. , "Mortality by occupation, industry, and cause of death: 24 reporting states, 1984-1988." DHHS DHHS Department of Health & Human Services (US government) DHHS Dana Hills High School (Dana Point, California) DHHS Deaf and Hard of Hearing Services DHHS Deaf and Hard of Hearing Services Publication No. 97-114, 1997. 15. Pattani A, Canstantinovinci N, & Williams S. "Who retires early from the NHS NHS abbr. National Health Service NHS (in Britain) National Health Service because of ill health and what does it cost? A national cross sectional sec·tion·al adj. 1. Of, relating to, or characteristic of a particular district. 2. Composed of or divided into component sections. n. survey." British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world.[2] It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other , 322(7280):208-9, Jan. 27, 2001. 16. Rimpela AH, Nurminen MM, Pulkkinen PO, Rimpela MK, & Valkonen T. "Mortality of doctors: do doctors benefit from their medical knowledge?" Lancet lancet /lan·cet/ (lan´set) a small, pointed, two-edged surgical knife. lan·cet n. , 1(8254):507-IL, Jan 10, 1987. 17. Wall TD, Bolden RI, Borrill CS, Carter AJ, Golya DA, Hardy GE, and others. "Minor psychiatric psy·chi·at·ric adj. Of or relating to psychiatry. psychiatric adjective Pertaining to psychiatry, mental disorders disorders in NHS trust National Health Service Trusts (NHS Trusts) provide many services of the National Health Service in England and Wales. They are not trusts in the legal sense but are in effect public sector corporations. staff: occupational and gender differences." British Journal of Psychiatry psychiatry (səkī`ətrē, sī–), branch of medicine that concerns the diagnosis and treatment of mental, emotional, and behavioral disorders, including major depression, schizophrenia, and anxiety. , 171:519-23, Dec. 1997. 18. Clark AE, Oswald AJ, & Warr P. "Is job satisfaction U-shaped in age?" Journal of Occupational and Organizational Psychology, 69, 1996; Wetterneck TB, Linzer M, McMurray JE, Douglas J, Schwartz MD, Bigby J, Gerrity MS, Pathman DE, Karlson D, & Rhodes E. "Worklife and satisfaction of general internists." Archives of Internal Medicine The Archives of Internal Medicine is a bi-monthly international peer-reviewed professional medical journal published by the American Medical Association. Archives of Internal Medicine , 162(6):649-56, March 25, 2002; Leigh JP, Kravitz RL, Schembri M, Samuels SJ, & Mobley S "Physician career satisfaction across specialties." Archives of Internal Medicine, 162(14):1577-84, July 22, 2002. 19. Chopra SS, Sotile WM, & Sotile MO. "Physician burnout." JAMA JAMA abbr. Journal of the American Medical Association , 291, February 4, 2004; Wetterneck TB, Linzer M, McMurray JE, Douglas J, Schwartz MD, Bigby J, Gerrity MS, Pathman DE, Karlson D, & Rhodes E. "Worklife and satisfaction of general internists." Archives of Internal Medicine, 162(6):649-56, March 25, 2002; Leigh JP, Kravitz RL, Schembri M, Samuels SJ, & Mobley S. "Physician career satisfaction across specialties." Archives of Internal Medicine, 162 July 22, 2002. 20. Spickard A Jr., Gabbe SG, & Christensen JF. "Mid-career burnout in generalist gen·er·al·ist n. A physician whose practice is not oriented in a specific medical specialty but instead covers a variety of medical problems. generalist and specialist physicians: Definitions, risk factors and prevention." Vanderbilt Medical Center, Center for Professional Health (2001) [Available through http://www.mc.vanderbilt.edu/document #739]; Murray A, Montgomery JF, Chang H, Rogers WH, Inui T, & Safran DG. "Doctor discontent: A comparison of physician satisfaction in different delivery system settings, 1986 and 1997." Journal of General Internal Medicine, 16(7):452-9, July, 2001. 21. Sibbald B, Bojke C, & Gravelle H. "National survey of job satisfaction and retirement intentions among general practitioners general practitioner n. Abbr. GP A physician whose practice consists of providing ongoing care covering a variety of medical problems in patients of all ages, often including referral to appropriate specialists. in England." BMJ BMJ n abbr (= British Medical Journal) → vom BMA herausgegebene Zeitschrift , 326(7379):22, Jan. 4, 2003; Dychtwald K & Kadlec D. The Power Years. New York: John Wiley John Wiley may refer to:
By Richard J. Bogue, PhD, John G. Guarneri, MD, Monica Reed, MD, Kenneth Bradley and Jay Hughes Hughes was born in Sacramento, California. He attracted attention in 1897 when he threw a three hit shutout during a west coast exhibition game against the famed Baltimore Orioles, a , MD RELATED ARTICLE: Survey Details Researchers surveyed 1,849 active Florida Hospital medical staff members from throughout this large, seven-hospital, community health system resulting in 705 completed surveys (a 38 percent response rate). Those who responded closely mirrored the gender, race/ethnicity and age breakdowns of physicians throughout the country. Thirty-three specialties were represented. A slightly higher proportion of primary care physicians (45.5 percent) responded. The main body of the survey asked doctors to rate their satisfaction in 17 different areas of their lives as physicians. These factors were selected and synthesized syn·the·sized adj. 1. Relating to or being an instrument whose sound is modified or augmented by a synthesizer. 2. Relating to or being compositions or a composition performed on synthesizers or synthesized instruments. after an extensive literature review on the subject. Based upon the survey responses, these factors were then grouped into two categories: what makes physicians less satisfied and what makes them more satisfied. The Physician-to-Physician Satisfaction Survey also assessed physician stress, and the researchers probed the characteristics that best explained varying physician stress levels. In addition to examining stress, the survey respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. were broken into three career stages to better determine the role experience may play in their satisfaction. Finally, to help provide practical interventions and better understand what can be done to positively engage and empower empower verb To encourage or provide a person with the means or information to become involved in solving his/her own problems physicians to change the "negative" as well as to put more of the "positive" into their lives, the researchers conducted in-depth interviews with 26 of the more "highly satisfied" physicians. The study gleaned their individual "life practices" and secrets to satisfaction.
Table 1: What Factors Make Doctors LESS Satisfied?
Overall Average Percent Percent
Satisfaction Rating Rating Rating
Factor (scale of 1-9) Low (1-3) Medium (4-6)
Cost containment efforts 5.04 19.7% 49.8%
by the hospital
Amount and quality of 5.29 25.1% 35.7%
personal time
Opportunities for research 5.36 20.9% 38.0%
& teaching
Approaches to utilization 5.44 12.9% 50.9%
review by the hospital
Autonomy over non-medical 5.45 20.0% 40.4%
decisions
Income 5.66 18.2% 39.9%
Administrative 5.80 17.3% 36.5%
responsibilities
Organizational climate/ 5.80 16.0% 37.0%
culture of the hospital
Workload 5.85 14.0% 41.3%
Autonomy over medical 6.00 16.5% 32.9%
decisions
2005 The Center for Health Futures
Figure 1 Physician Satisfaction with Hospital Cost Containment Efforts
(Scale of 1 to 9)
No Response 7.9%
Low (1-3) 19.7%
High (7-9) 22.6%
Medium (4-6) 49.8%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Figure 2 Physician Satisfaction with Amount and Quality of Personal Time
(Scale of 1 to 9)
No Response 1.6%
Low (1-3) 25.1%
Medium (4-6) 35.7%
High (7-9) 37.6%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Figure 3 Physician Satisfaction with Opportunities for Research and
Training (Scale of 1 to 9)
No Response 8.2%
Low (1-3) 20.9%
Medium (4-6) 38%
High (7-9) 32.9%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Table 2: What Factors Make Doctors MORE Satisfied?
Satisfaction Percent Percent
Rating (scale Rating Rating
Factor of 1-9) High (7-9) Medium (4-6)
Relationships with patients 7.45 81.1% 15.2%
Relationships with colleagues 6.98 68.9% 25.5%
Family issues 6.97 67.5% 23.1%
Personal growth 6.7 63.4% 27.2%
Freedom to provide quality care 6.3 57.2% 30.1%
Availability of office & 6.18 50.2% 38.6%
hospital resources
Prestige for role as physician 6.1 49.1% 36.2%
2005 The Center for Health Futures
Figure 4 Physician Satisfaction with Patient Relationships (Scale of 1
to 9)
No Response 1.6%
Low (1-3) 2.1%
Medium (4-6) 15.2%
High (7-9) 81.1%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Figure 5 Physician Satisfaction with Colleague Relationships (Scale of 1
to 9)
No Response 1.1%
Low (1-3) 4.4%
Medium (4-6) 25.5%
High (7-9) 68.9%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Figure 6 Physician Satisfaction with Family Issues (Scale of 1 to 9)
No Response 2.1%
Low (1-3) 7.2%
Medium (4-6) 23.1%
High (7-9) 67.5%
[c] 2005 Center for Health Futures
Note: Table male from pie chart.
Table 3
Life Practice Category Example
Designing a Satisfying "I never ran my own practice from the business
Medical Practice: side. I let them worry about the hiring,
Implementing choices firing and the business side so I can
about how to organize concentrate on what I do best--taking care of
and operate the practice patients."
of medicine itself -- Late-Career Pediatrician
Engaging with Patients: "I do home visits on my lunch break.... I love
Taking steps to connect seeing patients in their home setting. That is
with, understand, and the best way. I started doing home visits, and
create positive it healed me. I could relate to what others
sentiments within are going though ... some of the physicians I
patients and their work with think I am crazy going to the homes.
families I tell them you just have to open your eyes.
You don't have to be in a box."
-- Early-Career Internal Medicine & Geriatric
Physician
Regulating Thoughts and "When my cheek starts feeling flushed, I know
Feelings: Observing how my stress level is getting too high, and I
one is responding to need to do something now ... then I do
stress and taking steps something to relax."
to over-come it -- Early-Career Physical Medicine and
Rehabilitation Physician
Seeking Balance in Life: "If you get out of the United States and visit
Making a point of having outside countries, and you go and do surgery
other interests and outside of this country and see their medical
activities to help way of doing things, you come back and you
balance the challenges refresh yourself, and you remind yourself that
of being a physician it could be a lot worse."
-- Mid-Career Podiatrist
Engaging with Family "I try to keep on a regular schedule so I have
Members: Setting a set time with my family. When I'm on call, I
boundaries around family don't make plans, I don't try to get away with
time, protecting those going out and then get called in ... so I
boundaries, and making don't disappoint my family. Last night I went
the most of family time to Cub Scouts with my oldest son ... two of my
three kids are in karate. Friday night we're
all home. That is a family night."
-- Early-Career Emergency Medicine Physician
Connecting to a Larger "I think the spiritual life is important, too-
Purpose: Practices that -believing in something higher than yourself,
imbue one's life with a knowing that I am never going to be given
larger purpose, such as something more than I can handle. I have great
meditation, prayer or faith in that. I am the person I am because
taking good care of God made me that way."
one's employees -- Early-Career Family Medicine/Urgent Care
Physician
Enjoying Creativity in "I liked drawing and the art part of
the Art of Medicine: architecture, but not the engineering part
Finding the that went with it. But I still liked the
opportunities in medical science in it and gravitated toward medicine.
practice to stimulate I wanted to be a pediatrician and loved my
one's creative and pediatrics rotation. But when I did my
artistic potential obstetrics rotation, I knew I bad found my
home. It became an outlet for my artistic
talent. My creative side is to do surgery. I
have a good ability to see and think in three
dimensions, which is very applicable to
surgery. And that has been my forte. My career
has focused on doing minimally invasive
surgery. It is a creative outlet. In fact, the
nurses all kid me because I put extra effort
into trying to make all the scars look pretty.
That's the artist in me."
-- Mid-Career OB/GYN
Exercising the Body: "When I built my office, I put in a gymnasium
Physical exercise, good so I've got an exercise opportunity. Typically
nutrition and adequate I'll come in the morning, and I've got a buddy
rest balance against that I meet up with. We do a little weight
stress and depression. lifting and do a little running to kinda get
the blood flowing in the morning before we
start to see patients."
-- Mid-Career Surgeon
Engaging with Community: "I think the issue is to stay long enough in
Establishing manageable one community. If you're living in the
ways to meet and community you work in, and you're
accomplish things with participating in your church, you get the
neighbors and other strokes ... you took care of my nephew, and
community members he's doing well.' There's stability in living
and working in a community and being part of
the community."
-- Mid-Career Pediatrician
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