Physician Satisfaction

Physician satisfaction is associated with quality of care, particularly as measured by patient satisfaction. The strongest factors associated with physician satisfaction are not personal income, but rather the ability to provide high-quality care to patients. Physicians are most satisfied with their practice when they can have an ongoing relationship with their patients, the freedom to make clinical decisions without financial conflicts of interest, adequate time with patients, and sufficient communication with specialists (DeVoe et al., 2002). Landon and colleagues (2003) found that rather than declining income, the strongest predictor of decreasing satisfaction

Table 1-1 What Patients Want in a Physician

• Understands and supports me.

• Is always honest and direct.

• Acts as a partner in maintaining my health.

• Treats serious and nonserious conditions.

• Attends to my emotional as well as physical health.

• Encourages me to lead a healthier lifestyle.

• Can help with any problem.

• Is someone I can stay with as I grow older.

Modified from Stock Keister MC, Green LA, Kahn NB, et al. What people want from their family physician. Am Fam Physician 2004;69:2310.

in practice is loss of clinical autonomy. This includes the inability to obtain services for their patients, control their time with patients, and the freedom to provide high-quality care.

In an analysis of 33 specialties, Leigh and associates (2002) found that physicians in high-income "procedural" specialties, such as obstetrics-gynecology, otolaryngology, ophthalmology, and orthopedics, were the most dissatisfied. Physicians in these specialties and those in internal medicine were more likely than family physicians to be dissatisfied with their careers. Among the specialty areas most satisfying was geriatrics. Because the population older than 65 years in the United States has doubled since 1960 and will double again by 2030, it is important that we have sufficient primary care physicians to care for them. The need for and the rewards of this type of practice must be communicated to students before they decide how to spend the rest of their professional lives. Overall, 70% of U.S. physicians are satisfied with their career, with 40% being very satisfied and only 20% dissatisfied (Leigh et al., 2002).

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