Docs Can't Get No Satisfaction?

“I can’t get no satisfaction,” sang the Rolling Stones. And so it goes for many of the physicians who contact me!

I was struck by the fact that the word "satisfaction" in connection with work was used in two recent conversations with physicians. It made me curious: Just what is job satisfaction? How is it defined by the folks who study this kind of stuff? And why is it so hard to come by in clinical practice these days?

I did a little research into the topic and came up with the following factoids. Let's see if you agree:

• Income is rarely an important factor in job satisfaction.

• On the other hand, feeling inadequately compensated is correlated with unhappiness at work.

• High workload and long hours are associated with job dissatisfaction.

• Stress on the job, loss of autonomy and lack of interpersonal collaboration correlate well with job dissatisfaction.

• The opposite is also true -- good working relationships among staff, colleagues, and supervisors produce a satisfying work environment.

• Imbalance between one's professional and personal life contributes significantly to job dissatisfaction.

What I did notice in my exploration is that there is very little recent research into physician job satisfaction. I found articles reporting on it from India, Germany, Egypt and the U.K., but next to nothing about our unhappy doctors in the U.S.

I came across a limited number of meaningful quotes (and they are all a big "duh"):

"Results indicated physicians' satisfaction with their current position was related to their perceptions of their autonomy, workload, work/private life conflict, pay, and community satisfaction. In addition, all predictors except workload had an impact on physicians' satisfaction with the current career."

-- "Determinants of Job Satisfaction and Turnover Among Physicians," by Kaplan, Dustin, M.S., San Jose State University (2009).

"Office managed care was generally not associated with physician job or referral satisfaction. Of the physician compensation, financial incentive, and care management variables that we examined, only being a salaried employee was associated with physician job dissatisfaction. The number of physicians in the medical office had the strongest association with physician job dissatisfaction. These findings imply that the source of dissatisfaction is being an employed physician in a large medical group, which may be more likely to impose bureaucratic controls that limit physician autonomy. Primary physicians may have greater job satisfaction in smaller, less bureaucratic offices that protect their autonomy in work schedules and clinical decision-making."

-- The Journal of the American Board of Family Practice 16:383-393 (2003), "Managed Care and Primary Physician Satisfaction," David Grembowski, PhD, Cornelia M. Ulrich, PhD, David Paschane, MS, Paula Diehr, PhD, Wayne Katon, MD, Diane Martin, PhD, Donald L. Patrick, PhD, MSPH and Christine Velicer, MS.

Maybe there's much less physician job dissatisfaction in the U.S. than the blogs, the media and my selective conversations with physicians would lead us to believe. Perhaps this is a topic not worth studying.

What are your thoughts?