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Study explores physician job satisfaction and quality of care and outcomes for managed care patients with pain and depression

For primary managed care patients with pain or depression, their physician's job satisfaction is associated with some of their perceptions of quality of care, but not health outcomes. That's the conclusion of a study supported by the Agency for Healthcare Research and Quality (HS11712) and led by University of Washington researcher, David Grembowski, Ph.D. His team surveyed 1,514 patients with pain only, 575 patients with depressive symptoms only, and 761 patients with pain and depressive symptoms, who visited 261 primary care physicians (PCPs) in private practices in Seattle.

The researchers measured intensity of managed care controls for each patient and measured physician job satisfaction at baseline via a six-item scale. They asked patients in a 6-month followup survey to rate quality of care provided by the PCP, patient trust and confidence in the physician, and continued relationship with the PCP. They examined the correlation of these factors with changes in pain and depressive symptoms at followup.

Patients with pain and depression had greater trust and confidence in their PCPs when those doctors were more satisfied with their jobs. Patients with pain only were less likely to change doctors in the followup period when their PCPs reported more job satisfaction. Patients who had depression whose physicians were satisfied rated their care more highly than those of dissatisfied physicians. Finally, physician job satisfaction was not associated with patient health outcomes such as bothersome pain symptoms, depression symptoms, or their interference in carrying out daily activities.

See "Managed care, physician job satisfaction, and the quality of primary care," by Dr. Grembowski, David Paschane, M.S., Paula Diehr, Ph.D., and others, in the Journal of General Internal Medicine 20, pp. 271-277.

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