Physician Dissatisfaction Research Articles

Cost-Effectiveness of Vibrant System vs. Linaclotide in Chronic Idiopathic Constipation.

Chronic idiopathic constipation (CIC) is a common disorder that has a large unmet clinical need, affecting 8.0-12.0% of the US population and disproportionately affecting female individuals more than male individuals. Patients and physicians are equally dissatisfied with over-the-counter and prescription treatments. Physician dissatisfaction is at 78%. CIC has a significant negative impact on quality of life (QoL). The objective of this analysis was to compare the total cost and QoL of the Vibrant System vs. linaclotide, over 1-3years of treatment. Markov models were utilized to project 1-3-year US costs and health outcomes (quality adjusted life years, QALYs) comparing theVibrant System to the current standard of care pharmacologic therapy (linaclotide). One model examined direct (D) costs plus QALYs. Direct (D) costs included list price of product and medical treatment costs due to adverse events. Costs (D) were as of 2024; derived from themedical literature. A second model examined D as well as indirect (I)costs (absenteeism, presenteeism) [D + I] and QALYs. Longitudinal 12-month persistence prescription data for linaclotide was obtained from IQVIA claims data. The Vibrant System persistence data was derived from post market collection. One-way sensitivity analyses were also performed. Years1-3 direct costs were lower with Vibrant System with improved QALYs. Cumulative D + I data analysis for the Vibrant System at 12months, and for years2 and 3 show increased cost savings from $345 to $3866 with improved effectiveness. On the basis of lower costs and improved QALYs, the Vibrant System should be considered a first-line therapy for CIC and should be covered by insurers.

The Necessity of Type and Screen Result Prior to Proceeding to Operating Room for Scheduled Cesarean Delivery in a Low Hemorrhage Risk Population [ID 2683392

INTRODUCTION: Delays in the operating room (OR) on labor and delivery are common. This leads to inefficiency, patient, and physician dissatisfaction and financial ramifications. One root cause of OR delays involves waiting for type and screen results prior to wheels into the OR. Our objective was to determine whether a type and screen result is necessary prior to wheeling into the OR. METHODS: This was an IRB-approved retrospective cohort study conducted at a single state sponsored academic institution. Chart review was performed identifying all patients who had a scheduled cesarean delivery (CD) from August 1, 2022, through September 31, 2022. We identified all patients who received a blood transfusion intra-op or postoperatively. We excluded all patients who had a medium-risk hemorrhage score or greater. We then calculated timing of blood transfusion from wheels into the OR. RESULTS: We identified a total of 85 patients scheduled for CD. Of these, 7 patients required a blood transfusion, and 4/7 patients received a blood transfusion within 60 minutes of wheels into the OR. There were no patients with a low-risk hemorrhage score on admission who received a blood transfusion within 60 minutes of wheels into the OR. CONCLUSION: There were no patients with a low-risk hemorrhage score scheduled for CD required a blood transfusion within 60 minutes of wheels into the OR. This supports elimination of mandatory type and screen result prior to wheels in for patient scheduled for CD with a low-risk hemorrhage score.

Analysis of Remuneration System Satisfaction and Its Affecting Factors (Case Study on Specialist-Physician at Government Hospital in Jakarta)

Background:Remuneration is an important strategy to improve the competence of hospital services. Remuneration aims to motivate employees which can be achieved if the remuneration system is implemented fairly, but the gap between the ratio of the number of doctors and the average points to rates causes’ physician dissatisfaction toward the remuneration system. Objective:Analyze satisfaction level and measure remuneration satisfaction factors on Pediatricians and Obstetrics and Gynecologists at ABC Hospital Jakarta. Method:This study used quantitative methods with multiple linear regression analysis measured by the Equity Scale and Remuneration Satisfaction Scale. Interviews were used to obtain comprehensive analysis results from respondents who were in the lower and upper limits of the questionnaire results. The interview also involved the management of ABC Hospital Jakarta.Result and discussion:Total 44 respondents consisting of 30 Pediatricians and 14 Obstetricians and Gynecologists, showed dissatisfaction with the remuneration system (45,46%), neutral (31,53%), and satisfied (23%). There was a relationship between perceptions of external fairness (P= 0,003) and procedural fairness (P= 0,002) with remuneration satisfaction. There was no relationship between perceptions of internal justice (P= 0,929) and perceptions of individual justice (P= 0,130) with remuneration satisfaction. These results were explored using interviews and the causes of doctor dissatisfaction due to the gap in the achievement of the Individual Performance Index, lots of doctor examinations that were not listed in the rates, and remuneration points did not consider the complexity of each job. Meanwhile, the dissatisfaction felt by the management was due to the lack of measurement of quality indicators in the remuneration system.Conclusion and recommendation:External and procedural justices are factors that affect the satisfaction of remuneration felt by specialist-physician. The remuneration obtained at ABC Hospital Jakarta is lower than other Government Hospitals of the same type. In addition, there are binding rules, doctors' lack of understanding of the remuneration system, and lack of socialization. The management needs to formulate a more detailed remuneration system based on applicable regulations by adjusting the hospital situation.

The improvement of medical education within the framework of scientific educational cluster

The article presents analysis of problems of training of physicians. The defects of professional orientation of applicants were noted, resulting in the fact that 19% of students already during their studies choose not to work in health care after graduation. Besides, deficiency of practical experience among students, as well imbalance of training of specialists in various specialties, shortage of budget places in residency, dissatisfaction of young physicians with working conditions and its schedule was registered. The authors propose complex of measures developing professional orientation of applicants, improving quality of education in medical universities and assisting their employment and successful adaptation in medical organizations.

Impact of day of admission on in-hospital outcomes of cardiogenic shock

BackgroundThe management of cardiogenic shock (CS) requires attentiveness to details and in some cases, invasive interventions. In the past, studies have shown relationships between the day of admission and cardiovascular outcomes. We aim to analyze the trends and in-hospital outcomes of patients admitted with CS over the weekends compared to weekdays. MethodWe identified all patients with CS from the National Inpatient Sample (NIS) database between 2016 and 2020. Using multivariate logistic regression analysis, baseline demographics and in-hospital outcomes were obtained and compared by weekend or weekday admission. ResultsOut of 854,684 CS admissions, 199,255 (23.6%) occurred on weekends. Patients admitted over the weekend had worse outcomes, including higher rates of mortality (aOR 1.09 CI 1.05 – 1.11, p<0.001), cardiac arrest (aOR 1.09 CI 1.04 -1.14, p<0.001), and respiratory failure. We also noted higher percutaneous coronary intervention (PCI) rates (aOR 1.2 CI 1.16 – 1.25, p<0.001) but lower rates of pulmonary artery catheterization (PAC) and post-procedure pneumothorax. Weekend admissions had shorter hospital lengths of stay, and they incurred lower charges ($223,222 vs. $247,908).Between 2016 and 2020, we observed a consistent downward trend in the mortality rates of the weekend and weekday CS admissions, with consistently higher weekend than weekday admissions. ConclusionWeekend admissions for CS are associated with worse outcomes, which have persisted for years. This now begs the question of whether physician dissatisfaction, understaffing, or burn-out are responsible for this finding.

Female Endocrinologists May Be Disproportionately Burdened by Electronic Health Record Messaging

Since the institution of the electronic health record (EHR), there has been a significant change in healthcare delivery and the workflow of a physician; however, until recently, there was not recognition of this significant increase in workload that the EHR places on physicians. The EHR shifts many tasks to physicians and gives patients direct access to their physician through patient initiated messaging resulting in increased time spent facing the computer and a larger amount of EHR work that is completed outside of working hours 1 Muhiyaddin R. Elfadl A. Mohamed E. et al. Electronic Health Records and Physician Burnout: A Scoping Review. Stud Health Technol Inform. 2022; 289: 481-484 PubMed Google Scholar . Additional hours spent on the computer has increasingly caused physician dissatisfaction. 1 Muhiyaddin R. Elfadl A. Mohamed E. et al. Electronic Health Records and Physician Burnout: A Scoping Review. Stud Health Technol Inform. 2022; 289: 481-484 PubMed Google Scholar This combined with other increased administrative burdens such as prior authorizations have negatively impacted physician work satisfaction. 2 Sundarum P. Bhatt V. Feustel P. Mian B. Burden of Prior Authorization Requirements on Urology Practice and Patients. Urology. 2022; 169: 76-83 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar

Satisfaction of Primary Health Care Physicians Towards Electronic Health Information System (WAHED) in Al-Ahsa, Saudi Arabia 2022

Background: The implementation and adoption of the health information systems (HIS) in hospitals has increased globally in the recent years. A physician’s perception of such systems is a crucial determinant of their successful use. In this study, we aim to explore physician satisfaction levels with the electronic health information system and to identify the main factors affecting the satisfaction level of physicians. Methods: A cross-sectional study was performed among the primary health care (PHC) physicians in Al-Ahsa region of Saudi Arabia. Data was collected via a survey which was distributed using Google Forms. Physicians' satisfaction levels towards HIS were explored using a validated 19-item questionnaire and analysed in different categories. Results: A total of 215 primary health care physicians were included in the study. Reliability showed good internal consistency (α = 0.809). The aggregated satisfaction ratings for HIS based on the responses showed some variations. A total of 4 (2%) of the respondents gave an overall rating of ‘poor’ to the system, and 26 (12%) of them rated it as ‘fair’, 97 (45%) of them rated it as ‘good’, 80 (37%) of them rated it as ‘very good’ and 8 (11%) of them found the system ‘excellent’. Nationality (p=0.017), HIS training (p=0.001), and stress or burnout (p=0.001) were significant factors associated with physicians' satisfaction levels with the HIS. Conclusion: Overall, physicians were moderately satisfied with the HIS, and that various aspects of the system require improvement. Continued evaluation of installed systems and feedback from users must guide future improvements in the technology. Further research is required to investigate the causes of the physician’s stress/burnout, and non-trainee physician dissatisfaction, and improve the overall satisfaction among primary health care physicians.

A Narrative Review of Slow Medicine Outcomes.

Primary care practice in the United States suffers from short consultation duration and distracting electronic health record tasks. This leads to patient and physician dissatisfaction and physician burnout, as well as potentially unnecessary referrals and interventions. Slow medicine - providing longer and higher-quality consultations - has been proposed to improve medical care quality and patient outcomes. However, definitive outcome data for US settings are lacking. Following a structured narrative approach, we identified, reviewed, and synthesized existing reports (peer-reviewed and grey) to determine if there is sufficient evidence to support systematic evaluation of slow medicine in the US. We assessed whether longer versus shorter face-to-face primary care consultations were associated with quantitative patient outcomes including utilization; prevention; visit elements; medication adherence and prescription volume; mortality; and costs. We found suggestive evidence of substantial savings in hospital use and costs in varied geographic and clinical settings. However, this evidence lacks investigative rigor such as convincing prospective or natural randomization. With potentially significant health and financial benefits from slow medicine and little risk to subjects, randomized trials, natural experiments, and mixed methods evaluations are strongly indicated. We discuss the need for modified payment practices to facilitate a slow medicine approach.

An Empirical Study on the Autonomy and Satisfaction for the Physician Behavior under the National Health Insurance Plan in Taiwan

The current research will focus on the issue of physician autonomy and satisfaction under the NHIP to explore the dimensions of physician behavior and establish a reliable measurement in Taiwan. The research conducted a cross-sectional, mailed survey study on hospital-based physicians in Taiwan. The questionnaires were mailed to physicians during the first two months of 2020. Random selection and stratified sampling procedure was used to select homogeneous samples of subset of physicians. SPSS 23.0 and Smart PLS 3.0 for windows were used for data analysis. The study hypothesized that the physician satisfaction covers: resources, autonomy, professional relationship and hypothesized dimension that included autonomy, management, workload, incomes and physician-patient relationship and so no. A total of 772 mailed out, a total of 641 mails were used for analysis purpose that constituted an adjusted response rate of 83.79 percent. About less than one half of the respondents reported that they were satisfied with their jobs. Physicians in Taiwan are generally more dissatisfied and the situation is getting worse than before. The estimated average annual income of physicians in Taiwan is about five times more than that of the general population. Moreover, they tend to come from overall better family background and enjoy higher than average social status. All of them have passed the toughest and most competitive national examinations to enter medical schools. The implementation of the national health insurance policy in Taiwan changes the landscape of market practice to a certain extent. In current study we found that the general levels of satisfaction among physicians in hospitals under the NHIP and the aspects they were satisfied and dissatisfied. Secondly, physician demographics and hospital characteristics were significantly associated with physician satisfaction. Thirdly, some of the attitudinal and behavioral analysis correlated with physician satisfaction and dissatisfaction

Impact of Scribe Intervention on Documentation in an Outpatient Pediatric Primary Care Practice

The use of the electronic health record (EHR) has led to physician dissatisfaction, physician burnout, and delays in documentation and billing. Medical scribes can mitigate these unintended consequences by reducing documentation workload and increasing efficiency. To study the effects of medical scribes on time to completion of notes and clinician experience, with a focus on time spent charting during clinic and after-hours. We hypothesized that medical scribes in an outpatient pediatric setting would decrease clinician time spent charting, time to finalize encounter notes, and clinician's perceived documentation time. This 15-month single-center observational study was carried out with 3 study periods: pre-scribe, with-scribe, and scribe-withheld. Time spent in EHR was extracted by our EHR vendor. Participants completed surveys regarding time spent documenting. Six clinicians (5 physicians, 1 nurse practitioner) participated in this study to trial the implementation of medical scribes. EHR time data were collected for 4329 patient visits (2232 pre-scribe, 1888 with-scribe, 209 scribe-withheld periods). Comparing pre-scribe versus with-scribe periods, documentation time per patient decreased by 3-minutes 28-seconds per patient (pre-scribe IQR: 6, with-scribe IQR: 3, P=.028); note timeliness decreased from 0.96 days to 0.26 days (pre-scribe IQR: 0.22, with-scribe IQR: 0.11, P=.028); and clinicians' estimates of time spent in the EHR decreased by 1.2 hours per clinic session (pre-scribe IQR: 0.5, with-scribe IQR: 0.5, P=.031). Medical scribes in an outpatient pediatric setting result in: 1) decreased time spent charting, 2) reduced time to final sign clinic notes, and 3) decrease in clinician's perceived time spent documenting.

Extent and Impact of Inadequate Disease Control in US Adults with a History of Moderate to Severe Atopic Dermatitis Following Introduction of New Treatments.

IntroductionAtopic dermatitis (AD) is a chronic inflammatory disorder which, despite recent therapeutic developments, leads to significant burden and morbidity, impacting on daily functioning, physical and mental health, and health-related quality of life. The objective of this study was to investigate the impact of new therapeutic approaches in the treatment of moderate to severe AD and quantify subsequent differences in disease and symptom control.MethodsData were drawn from the 2018 Adelphi US AD Disease Specific Programme™ (DSP™), a cross-sectional survey of physicians (n = 150) and their patients with a history of moderate to severe AD (n = 749, 52.7% female, 72.1% white, mean age 40.1 ± 16.3 years). Inadequately controlled AD as rated by the physician was defined as currently flaring, and/or deteriorating/changeable AD and/or physician dissatisfaction with disease control on current treatment.ResultsThe overall inadequate control rate was 42.3%, an improvement from 58.7% as identified in the 2014 DSP survey. The proportion of inadequately controlled patients increased as physician subjective severity (ranked from mild through to severe) increased; 15.4% of patients classified as having mild disease were inadequately controlled, compared to 94.5% of patients classified with severe disease. Relative to patients with controlled disease, patients with inadequately controlled disease were more likely to be unemployed, reported more frequent flares, and had a greater burden of symptoms and worse quality of life measures including itch, stress, anxiety, depression, and sleep disturbance (all p < 0.0001).ConclusionDespite the introduction of new therapies, the burden and impact of AD and lack of symptom control, although reduced compared with previous studies, still remains high.

Job satisfaction among family medicine physicians in Saudi Arabia.

Objective:Physicians are subject to chronic stressors, depression, and burnout due to long working hours, high requirements, and critical decision-making.[12345] All those reasons contribute to the dissatisfaction of physicians. The dissatisfaction of physicians might lead to lower health-care quality.[6] Moreover, patient satisfaction is strongly affected by physician satisfaction.[78] This study aims to measure job satisfaction among family medicine (FM) physicians in Saudi Arabia.Study Design:In this cross-sectional study, we recruited 265 FM physicians working in Saudi Arabia to participate in an online survey between October 2019 and January 2019.Results:Results showed that more than 50% of the respondents were very satisfied with their career choice (55.5%, n = 147). Non-Saudis who were satisfied or strongly satisfied were higher than those of Saudis (P = 0.035) and 2.45 times more likely to be dissatisfied compared to non-Saudi respondents. Respondents from the southern region were 81% less likely to be dissatisfied than respondents from the central region (OR = 0.19, P < 0.05).Conclusion:Family medicine physicians showed a high level of satisfaction with their career choice regardless of gender, age, sector public or private, marital status. This is promising for family medicine as a medical specialty. The future of health care in Saudi Arabia is driven toward general practice and primary care centers, which aligns with the future vision of Saudi Arabia 2030.

Impact of pre-analytical errors on costs of clinical analysis laboratory

ABSTRACT Introduction: Currently, it is well known that quality assurance systems in healthcare organizations are constantly evolving. Quality improvements can reduce costs by avoiding repetition of exams, which results in a waste of time and money for the company, as well as customer and physician dissatisfaction. Objective: To quantify the cost that errors in the pre-analytical phase generate for the laboratory using the collection indicators, direct material cost, and operating cost. Materials and methods: The database of a large laboratory in the city of Porto Alegre, Rio Grande do Sul, was analyzed between January 2013 and July 2014. Results: A total cost of R$ 23,330.71 spent on recollections was obtained. Discussion: Management cost is committed to efficiency in reducing expenses, through studies and analyzes aimed at changing management and conduct processes. Conclusion: Cost management is necessary in any company because in the case where it fails to be carried out, besides the being able to bring the institution down to bankrupt, it brings negative costs, as well as impacts customers and physician’s satisfaction.

Corneal nerves anatomy, function, injury and regeneration

The cornea is a highly innervated tissue, exhibiting a complex nerve architecture, distribution, and structural organization. Significant contributions over the years have allowed us to come to the current understanding about the corneal nerves. Mechanical or chemical trauma, infections, surgical wounds, ocular or systemic comorbidities, can induce corneal neuroplastic changes. Consequently, a cascade of events involving the corneal wound healing, trophic functions, neural circuits, and the lacrimal products may interfere in the corneal homeostasis. Nerve physiology drew the attention of investigators due to the popularization of modern laser refractive surgery and the perception of the destructive potential of the excimer laser to the corneal nerve population. Nerve fiber loss can lead to symptoms that may impact the patient's quality of life, and impair the best-corrected vision, leading to patient and physician dissatisfaction. Therefore, there is a need to better understand preoperative signs of corneal nerve dysfunction, the postoperative mechanisms of nerve degeneration and recovery, aiming to achieve the most efficient way of treating nerve disorders related to diseases and refractive surgery.

Work-life balance and burnout: the practicing doctor's dilemma

Burnout rates and physician dissatisfaction are at an all-time high. Work-life balance is the panacea to worker's burn-out. The dictionary defines work-life balance as "the amount of time you spend doing your job compared with the amount of time you spend with yournfamily and doing things you enjoy". Workers in public sector work officially for 8hrs per day and depending on the profession this may be further prolonged as in the health sector for 24hrs in some days of the week.

153-LB: Physician Well-being Related to Diabetes Technology and Clinic Workflow

Background: Endocrinology physicians and clinic staff are burdened by workload created during the download of diabetes devices (insulin pumps, glucometers, and sensors). Inefficiencies caused by data interoperability can impact physician well-being and clinic workflow. The aim of this study is to identify physician wellbeing related to Diabetes Technology (DT) and determine whether the use of a single software platform to upload and view diabetes data improves efficiency. Methods: Physician satisfaction survey related to DT was sent to providers at a single academic endocrinology office. Tidepool®, a free software, was implemented to enable data upload from multiple devices onto a single platform. The time required to have this data available to the provider was recorded pre and post-implementation. The provider was then able to view this data in the patients’ electronic chart. Results: All providers (n=14) completed the survey. Only 7% felt that pumps were always downloaded on time. Related to DT, 21% felt a sense of dread at work, 36% experienced a lack of enthusiasm, and 43% experienced emotional exhaustion. Almost 80% felt that clinic workflow due to DT contributed to spending less time with patients. Data from a total of 90 devices pre and 144 devices post-Tidepool® were included in the study. There was a significant improvement in the average time of sensor and glucometer data availability; 4.95 vs. 3.2 minutes (CI -2.48 to -1.01, p-value &amp;lt;0.0001). There was no significant change in average time for insulin pump data availability; 8.8 vs. 8.46 minutes (CI -2.6 to 2.1, p-value 0.7) post Tidepool®. Time and resources related to printing the data were saved as well. 100% of staff at the download station felt that Tidepool® was an easier software to use. Conclusion: Our study shows a high prevalence of physician dissatisfaction and symptoms of burnout related to DT among the providers even at a university academic office with access to the best resources. The use of Tidepool® could potentially improve clinic workflow. Disclosure V. Shah: None. D. Pinkhasova: None. E. Karslioglu French: None. Funding University of Pittsburgh Medical Center

Wellness, burnout, and the dermatologist: Fundamentals for practice longevity

Physician wellness is a critical component of any effective health care system, as physicians serve essential roles as diagnosticians, surgeons, and leaders in medical care. Physician burnout, defined as a combination of the presence of emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, is an increasingly recognized problem in the US health care system, as rates of burnout among physicians are on the rise, now exceeding 50%. To date, few studies have examined the impact of burnout on dermatologists specifically, but existing studies evaluating physicians collectively have shed light on the problem that exists in our specialty. This review focuses on the causes of physician dissatisfaction and burnout and provides an overview on interventions to mitigate them while emphasizing wellness; where applicable, special emphasis is placed on dermatologists.

Development and validation of a rheumatologist satisfaction with practice scale: The rheumatologist satisfaction scale.

There is a paucity of succinct measures of physician satisfaction. As part of a Performance Improvement Project, we developed and piloted a simple questionnaire to determine rheumatologists satisfaction.Thirty 5 rheumatologists in the academic or private setting were sent opened-ended questions to determine the factors that made them satisfied or dissatisfied with respect to their rheumatology practice. From the responses we formed 14 questions 1 to 10 scale centering on satisfaction and dissatisfaction that was piloted in 30 rheumatologists and subsequently validated in 173 rheumatologists within the US and Latin America.Our combined sample included 173 rheumatologists (55 English and 118 Spanish-speaking respondents). The mean satisfaction for the combined sample was 6.92 (standard deviation=1.1, range 4.08–9.62). The strongest contributors to physician satisfaction were “Seeing interesting and challenging cases” (8.6 ± 1.5) and “The ability to make a difference in patient's life” as well as “Establishing long term relationship with patients” (8.39 ± 1.5). The strongest contributors to physician dissatisfaction were “Getting inappropriate referrals not in the scope of practice” (4.3 ± 2.13) and “Time spent on documentation” (4.5 ± 2.59). The scale had good reliability, relatively normal distribution, and little or no redundancy among items.A simple and practical questionnaire to measure physician satisfaction, in particular rheumatologists satisfaction, was developed, piloted and successfully validated on a predominately academic sample of rheumatologists within the US and Latin America. This scale will serve as a means to identifying potential barriers to the implementation of performance improvement projects in the practice of Rheumatology.

A hybrid SCA–VNS meta-heuristic based on Iterated Hungarian algorithm for physicians and medical staff scheduling problem in outpatient department of large hospitals with multiple branches

This paper investigates the scheduling problem of physicians and medical staff in outpatient department of large hospitals with multi-branch. The large hospital has several branches and each branch has its own medical staff, while the physicians need to serve in all the branches affiliated to the hospital. In order to improve the working efficiency of physicians, each physician would be equipped with a medical staff during his working hours. The working time of physicians and medical staff have several requirements considering the satisfaction of them. The paper takes into account the demand and the available resources of the hospital, the workload of physicians and medical staff, etc. as the constraints, and the purpose is to minimize the dissatisfaction of physicians, the cost of physicians and the deviation of the frequency of physicians at work in different clinics. Then, a hybrid meta-heuristic algorithm SCA–VNS combining a Sine Cosine Algorithm (SCA) and variable neighborhood search (VNS) based on Iterated Hungarian algorithm, which is incorporated to solve the physicians and medical staff assignment, is proposed to solve this problem. Through computational experiments that available physicians and medical staff scheduling have been generated and perform better than other compared algorithms.

Sustaining the HIV care provider workforce: Medical Monitoring Project HIV Provider Survey, 2013-2014.

To describe delivery of recommended HIV care and work satisfaction among infectious disease (ID) physicians, non-ID physicians, nurse practitioners (NPs), and physician assistants (PAs). Medical Monitoring Project 2013-2014 HIV Provider Survey. Population-based complex sample survey. We surveyed 2208 HIV care providers at 505 US HIV care facilities and computed weighted percentages of provider characteristics, stratified by provider type. Rao-Scott chi-square tests and logistic regression used to compare characteristics of ID physicians with each other provider type. The adjusted provider response rate was 64 percent. Among US HIV care providers, 45 percent were ID physicians, 35 percent non-ID physicians, 15 percent NPs, and 5 percent PAs. Satisfaction with administrative burden was lowest among non-ID physicians (27 percent). Compared with ID physicians, satisfaction with remuneration was lower among non-ID physicians and higher among NPs (37, 28, and 51 percent, respectively). NPs were more likely than ID physicians to report performing four of six services that are key to providing comprehensive HIV care, but more NPs planned to leave clinical practice within 5years (19 vs 7 percent). Addressing physician dissatisfaction with remuneration and administrative burden could help prevent a provider shortage. Strengthening the role of NPs may help sustain a high-quality workforce.