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Characteristics of medical organizations have a substantial effect on physician satisfaction and well-being

Today, more than 80 percent of doctors are in group practices, many of which belong to independent practice associations and physician-hospital organizations. The characteristics of the organization in which physicians practice have a substantial effect on their level of stress, job satisfaction, and physical and mental health.

Organizational settings that are both "physician friendly" and "family friendly" seem to result in greater physician well-being. Doctors fare better in organizations where they are not compensated for individual productivity, are not under time stress, have more control over clinical issues, and are able to balance family life with their work, according to a recent study that was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00032). Lead author, Eric S. Williams, Ph.D., of the University of Alabama, and members of the Career Satisfaction Study Group analyzed survey data on practice and physician characteristics, physician job satisfaction, and perceived stress from a national sample of 171,000 clinically active primary care doctors. All the drivers of perceived stress came from practice characteristics and not from physician or patient characteristics. Job stress in turn influenced job satisfaction and physicians' physical and mental health.

Greater stress was associated with more perceived time pressure. Lower job satisfaction was associated with perceived time pressure, a greater emphasis on productivity (seeing more patients per hour), and more control or involvement with administrative issues. Lower levels of stress and greater job satisfaction came from greater levels of control over workplace and clinical issues and more organizational support for balancing work and family life. Perceived stress exerted a stronger influence on physician physical and mental health than job satisfaction. How many hours doctors worked per week was unrelated to job satisfaction or stress.

See "Physician, practice, and patient characteristics related to primary care physician physical and mental health: Results from the Physician Worklife Study," by Dr. Williams, Thomas R. Konrad, Ph.D., Mark Linzer, M.D., and others, in the February 2002 Health Services Research 37(1), pp. 121-143.

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