Frequency of satisfaction and dissatisfaction with practice among rural-based, group-employed physicians and non-physician practitioners

Abstract

BackgroundWidespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition.MethodsWe linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect.ResultsOf the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one’s likelihood of being in the lowest quintile of dissatisfaction; heavier workload and greater intolerance of uncertainty reduced that likelihood. Practitioner demographics and most practice unit characteristics did not manifest any independent effect.ConclusionsMutable factors, such as workload, work meaningfulness, relational needs, uncertainty/ambiguity tolerance, and risk-taking attitudes displayed the strongest association with practitioner satisfaction/dissatisfaction, independent of demographics and practice unit characteristics. Organizational efforts should be dedicated to a redesign of group-employment models, including more equitable division of clinical labor, building supportive peer networks, and uncertainty/risk tolerance coaching, to improve the quality of work life among rural practitioners.

Burnout and Job and Career Satisfaction in the Physician Assistant Profession: A Review of the Literature

“…Like Whitebird et al, Freeborn, Hooker, and Pope, in their study of primary care clinicians, found that a higher proportion of PAs and NPs were satisfi ed with their careers, compared to physicians (93 percent versus 82 percent) [12,51]. Waddimba's study of rural clinicians demonstrated that being a PA or NP had a modest positive association with job satisfaction [52]. Among the NHSC PAs and NPs that Pathman, Konrad, and Hooker surveyed, a higher proportion of PAs than NPs were satisfi ed with their practice (72 percent versus 63 percent) [48].…”

Cross-sectional survey on job satisfaction and its associated factors among doctors in tertiary public hospitals in Shanghai, China

“…Scholars from different countries such as the USA, the UK and Germany have tried to deal with problems concerning job dissatisfaction 14–16. For example, scholars in the USA noted that workload, work meaningfulness, relational needs, tolerance and risk-taking attitudes were associated with job satisfaction 14. Researchers in the UKindicated that whether physicians can fully use their training was a key factor influencing their job satisfaction 15.…”

Evaluation of Lifelong Work Satisfaction among Former Postal Service Workers

“…The comparison with the existing literature suggests that our findings are plausible. Previous studies have also connected work satisfaction and wellbeing at work with job control, job support and feelings of organizational justice (e.g., Lindfors et al 2007;Meyers et al 2019;Pagán 2013;Waddimba et al 2016). However, we found no significant differences in WLS pathways among white-collar and blue-collar workers or among men and women.…”

“…Work satisfaction has been the topic of active scientific inquiry (Berglund et al 2017;Bussing et al 1999;Kadefors et al 2016;Pagán 2013). Previous quantitative studies demonstrate that work-related resources (Stynen et al 2017), job support (Pagán 2013) and job control (Allan et al 2018;Chao et al 2015;Lindfors et al 2007;Meyers et al 2019;Waddimba et al 2016) are positive predictors of work satisfaction. Similarly, work engagement (Meyers et al 2019;Shimazu & Schaufeli 2009) and work status (Navarro & Salverda 2019;Tay & Harter 2013;Virtanen et al 2003) play a significant role in work satisfaction of workers in various sectors.…”