How Work Environment Impacts Physician Happiness: Eight Factors
Merritt Hawkins Team | September 14, 2017
Among the many factors that can influence job satisfaction, none has more impact than one’s work environment. For physicians, who already have some of the highest levels of workplace stress, the impacts are often proportionally greater than for the population at large. Studies drawn from several national surveys reveal a range of workplace factors that influence physician happiness.
Relationships with colleagues: Perceived healthy or positive working relationships between physicians and their colleagues, as well as with clinical and administrative staff, are associated with higher levels of career satisfaction. In general, physicians report higher levels of satisfaction when they feel valued and recognized for their contributions by practice or hospital administrators; when they work in a constructive teamwork-oriented atmosphere; and, when they have adequate opportunities for promotion and advancement.
Patient care quality: Physicians’ perceived ability to deliver quality patient care is positively associated with higher reported levels of satisfaction. Conversely, physicians report feeling dissatisfied when they feel unable to deliver high-quality care and meet their patients’ needs.
Academic affiliation: Physicians affiliated with an academic medical school reported higher levels of career satisfaction—and were less likely to leave their practice within two years—compared to physicians who work in other practice models or environments.
Practice structure: Physicians in practices with only one or two others generally reported lower satisfaction and a greater likelihood of separating from the practice within two years. Another related factor that can influence physician satisfaction is the degree of ownership in the practice—less is more.
Geographic location: Physicians in rural areas generally reported higher degrees of satisfaction than their counterparts in non-rural areas. But, among rural physicians, those who are a significant distance away from a referral center (e.g., a rural community hospital) reported lower levels of satisfaction due to their relative isolation and corresponding lack of readily available professional resources.
Patient population: There is not a strong relationship between physician satisfaction and patient population characteristics; however, physicians working with large numbers of uninsured patients are less likely to report career satisfaction.
Autonomy and control: The ability to make independent clinical decisions and exercise control over work content and schedules strongly corresponds with reported higher levels of satisfaction among physicians. Physicians who exercise greater control over referrals to colleagues and specialists and who have autonomy when making clinical decisions also report higher levels of satisfaction. Lower levels of satisfaction were associated with increased administrative responsibilities and time spent supervising residents.
Income: Many studies associate higher levels of professional satisfaction with higher income; this applies to physicians as well. However, at least one study has shown that physicians in the highest income brackets report a slight decrease in satisfaction, possibly resulting from the greater stress associated with maintaining those higher incomes. In addition to absolute income, the perception of earning a “fair” income turns out to be one of the strongest indicators of overall satisfaction among physicians.
Policymakers and health delivery systems are actively using these and other related findings to determine how to improve professional satisfaction among physicians while also enhancing patient care.
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