Growing discontent of Swiss doctors, 1998-2007

Abstract

Work satisfaction of doctors is a useful indicator of the functioning of the health-care system. We documented the work satisfaction of doctors nine years apart, before and after the implementation of several health-care reforms (limitation of working hours for medical trainees, restrictions on new doctors' offices, new reimbursement fee schedule, greater administrative controls). Two surveys of all doctors working in the Canton of Geneva, Switzerland (1998: 1146 respondents, 2007: 1546 respondents). The doctors filled in a 17-item questionnaire rating their satisfaction with different aspects of their professional life, each on a scale between 1 and 7. For each item, proportions of highly satisfied (scores 6-7) and highly dissatisfied (scores 1-2) doctors were compared over time. The proportion of doctors who were highly satisfied decreased significantly for 15 out of 17 items between 1998 and 2007. Meanwhile, 'time available for family, friends, or leisure' improved, and 'opportunity for continuing education' remained stable. Proportions of highly satisfied respondents decreased the most for 'enjoyment of work' (-17.2%), 'autonomy in treating your patients' (-15.8%), 'autonomy in referring patients to a specialist' (-14.0%), 'relations with patients' (-13.9%) and 'global satisfaction with current work situation' (-13.3%). The proportion of respondents who were highly dissatisfied (score 1-2) increased the most for 'administrative burden' (+8.9%) and 'social status and respect' (+5.0%). Doctors' satisfaction with most aspects of their professional lives has decreased sharply during the past decade. This trend may be linked, tentatively, with specific policy changes.