Abstract
BackgroundUS healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator. Further, many health care organizations also have an academically oriented mission. Physician involvement in research and teaching may lead to more positive workplace attitudes, with subsequent decreases in turnover and beneficial impact on patient care. This article aimed to understand the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among internal medicine physicians in the Veterans Health Administration (VHA).MethodsA cross-sectional survey was conducted with inpatient attending physicians from 36 Veterans Affairs Medical Centers. Participants were surveyed regarding demographics, practice settings, workplace staffing, perceived quality of care, and job attitudes. Job attitudes consisted of three measures: overall job satisfaction, intent to leave the organization, and burnout. Analysis used a two-level hierarchical model to account for the nesting of physicians within medical centers. The regression models included organizational-level characteristics: inpatient bed size, urban or rural location, hospital teaching affiliation, and performance-based compensation.ResultsA total of 373 physicians provided useable survey responses. The majority (72%) of respondents reported some level of teaching involvement. Almost half (46%) of the sample reported some level of research involvement. Degree of research involvement was a significant predictor of favorable ratings on physician job satisfaction and intent to leave. Teaching involvement did not have a significant impact on outcomes. Perceived quality of care was the strongest predictor of physician job satisfaction and intent to leave. Perceived levels of adequate physician staffing was a significant contributor to all three job attitude measures.ConclusionsExpanding opportunities for physician involvement with research may lead to more positive work experiences, which could potentially reduce turnover and improve system performance.
Highlights
US healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator
Physicians reported job attitudes that were more favorable when they perceived greater levels of physician staffing on the unit, but the perception of having sufficient registered nurse staffing was non-significant with attitudes
While a great deal of literature has focused on nurse staffing and hours per patient day as they relate to patient outcomes, less attention has been spent on physician staffing in relation to patient outcomes
Summary
US healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator. Many health care organizations have an academically oriented mission. Physician involvement in research and teaching may lead to more positive workplace attitudes, with subsequent decreases in turnover and beneficial impact on patient care. This article aimed to understand the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among internal medicine physicians in the Veterans Health Administration (VHA). Physician job satisfaction has recently emerged as a key performance indicator for US healthcare organizations. Job attitudes among physicians are linked to both healthcare system performance and workforce sustainability [1]. Despite the potential benefits of research involvement, the number of physicians conducting research as part of their regular work activities appears to be declining [9]. Institutional factors can limit research mentoring and support for physician-scientists [12, 13]
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