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Sng GGR, Tung JYM, Chua JL. Measuring the job satisfaction of junior doctors in Singapore: validating the Satisfaction of Employees in Health Care tool. Singapore Med J 2023:387628. [PMID: 37929562 DOI: 10.4103/singaporemedj.smj-2022-094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
| | | | - Jia Long Chua
- Preventative Medicine Residency, National University Health System, Singapore
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Hoff T, Lee DR. Physician Satisfaction With Telehealth: A Systematic Review and Agenda for Future Research. Qual Manag Health Care 2022; 31:160-169. [PMID: 35132008 DOI: 10.1097/qmh.0000000000000359] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of telehealth has risen dramatically due to the Covid-19 pandemic and is expected to be a regular part of patient care moving forward. We know little currently about how satisfied physicians are with this type of patient care. The present systematic review examines physician satisfaction with telehealth, as physician acceptance remains vital to telehealth gaining wider and more permanent adoption. METHODS A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-guided systematic review of empirical articles published between 2010 and 2020 that contain a finding examining physician satisfaction with using telehealth, using 4 article databases (PubMed, Web of Science, COCHRANE, and CINAHL), to identify relevant studies. A standardized data abstraction Excel sheet was used to extract relevant information from each of the included studies. Relevant study findings related to physician satisfaction with telehealth were reviewed for each of the 37 studies by the coauthors. RESULTS A total of 37 published studies were included in the review. Thirty-three of the 37 (89%) studies reviewed were classified as having findings showing moderate to high levels of physician satisfaction with telehealth. Just under 60% of the studies focused on physician satisfaction with providing telemedicine to patients (21/37). Twelve other studies focused on physician satisfaction with teleconsultations with other providers. Four studies examined physician satisfaction with both. The type of patient telemedicine or provider teleconsultation performed varied greatly across the 37 studies, with several different diagnoses or care situations included. Research designs used in the studies were less robust, with all studies using primary data for assessing physician satisfaction but only one study providing any type of multivariate analysis of physician satisfaction with telehealth. CONCLUSION The results of this review support the observation that physicians across different specialties, geographic locations, practice locations, and care situations appear satisfied with engaging in telehealth for both patient care and consultations with other physicians. The research on telehealth should be enhanced, given how ubiquitous telehealth has become due to the Covid-19 pandemic. This enhancement should include larger physician sample sizes in studies of telehealth satisfaction; more research focused on telehealth in the primary care setting; and the types of virtual modalities that have become more commonplace for physicians to use due to the Covid-19 pandemic.
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Affiliation(s)
- Timothy Hoff
- Management, Healthcare Systems, and Health Policy (Dr Hoff), and School of Pharmacy (Dr Lee), Northeastern University, Boston, Massachusetts
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Khullar D, Prasad K, Neprash H, Poplau S, Brown RL, Williams ES, Audi C, Linzer M. Factors associated with patient trust in their clinicians: Results from the Healthy Work Place Study. Health Care Manage Rev 2022; 47:289-296. [PMID: 35170482 DOI: 10.1097/hmr.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient trust in their clinicians is an important aspect of health care quality, but little evidence exists on what contributes to patient trust. PURPOSE The aim of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. METHODOLOGY/APPROACH The sample used baseline data from the Healthy Work Place trial, a randomized trial of 34 Midwest and East Coast primary care practices to explore factors associated with patient trust in their clinicians. A multivariate "best subset" regression modeling approach was used, starting with an item pool of 45 potential variables. Over 7 million models were tested, with a best subset of correlates determined using standard methods for scale optimization. Skewed variables were transformed to the fifth power using a Box-Cox algorithm. RESULTS The final model of nine variables explained 38% of variance in patient trust at the patient level and 49% at the clinician level. Trust was related mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, and learning about their medical conditions and their clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. CONCLUSION Trust appears to be primarily related to what happens between clinicians and patients in the examination room. PRACTICE IMPLICATIONS System changes such as patient-centered medical homes may have difficulty succeeding if the primacy of physician-patient interactions in inspiring patient trust and satisfaction is not recognized.
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Affiliation(s)
- Dhruv Khullar
- Dhruv Khullar, MD, MPP, Assistant Professor, Division of Health Policy and Economics, Department of Population Health Sciences and Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York. Kriti Prasad, BA, Medical Student, University of Minnesota, and Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota. Hannah Neprash, PhD, Assistant Professor, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis. Sara Poplau, BA, Director of Operations, Office of Professional Worklife, Hennepin Healthcare Research Institute, Minneapolis, Minnesota. Roger L. Brown, PhD, Professor of Research Methodology and Medical Statistics, Schools of Nursing, Medicine and Public Health, University of Wisconsin-Madison. Eric S. Williams, PhD, Professor of Health Care Management, Culverhouse College of Business, University of Alabama, Tuscaloosa. E-mail: . Crystal Audi, BA, Research Assistant, Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota. Mark Linzer MD, MACP, Vice Chair, Department of Medicine, Hennepin Healthcare and Professor of Medicine, University of Minnesota, Minneapolis
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Abdulrhim S, Awaisu A, Ibrahim MIM, Diab MI, Hussain MAM, Al Raey H, Ismail MT, Sankaralingam S. Impact of pharmacist-involved collaborative care on diabetes management in a primary healthcare setting using real-world data. Int J Clin Pharm 2021; 44:153-162. [PMID: 34637104 DOI: 10.1007/s11096-021-01327-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Background Diabetes mellitus is a complex multi-system disorder, requiring multi-disciplinary care. The conventional care model, where physicians are the sole caregivers may not be optimal. Addition of other healthcare team members improves healthcare outcomes for patients with diabetes. Aim To evaluate the impact of pharmacist-involved collaborative care on diabetes-related outcomes among patients with diabetes attending a primary healthcare setting in Qatar using real-world data. Method A retrospective cohort study was conducted among patients with diabetes attending Qatar Petroleum Diabetes Clinic. Patients were categorized as either receiving pharmacist-involved collaborative care (intervention group) or usual care (control group). Data were analyzed using SPSS®. Glycemic control (glycated hemoglobin A1c, HbA1c), blood pressure, lipid profile, and body mass index were evaluated at baseline and up to 17 months of follow-up. Results After 17 months of follow-up, pharmacist-involved collaborative care compared to usual care resulted in a significant decrease in HbA1c (6.8 ± 1.2% vs. 7.1 ± 1.3%, p < 0.01). Moreover, compared to baseline, pharmacist-involved collaborative care significantly improved (p < 0.05) the levels of HbA1c (7.5% vs. 6.8%), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), and body mass index (30.42 kg/m2 vs. 30.17 kg/m2) after 17 months within the intervention group. However, no significant changes for these parameters occurred within the control group. Conclusion The implementation of pharmacist-involved collaborative care in a primary healthcare setting improved several diabetes-related outcomes over 17 months. Future studies should determine the long-term impact of this care model.
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Affiliation(s)
- Sara Abdulrhim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Mohammad Issam Diab
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Hend Al Raey
- Qatar Petroleum Diabetes Clinic, Qatar Petroleum Healthcare Center, Dukhan, Qatar
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Negri L, Cilia S, Falautano M, Grobberio M, Niccolai C, Pattini M, Pietrolongo E, Quartuccio ME, Viterbo RG, Allegri B, Amato MP, Benin M, De Luca G, Gasperini C, Minacapelli E, Patti F, Trojano M, Bassi M. Job satisfaction among physicians and nurses involved in the management of multiple sclerosis: the role of happiness and meaning at work. Neurol Sci 2021; 43:1903-1910. [PMID: 34363548 PMCID: PMC8346783 DOI: 10.1007/s10072-021-05520-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/25/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Health professionals caring for persons with multiple sclerosis (MS) are faced with increasingly complex working conditions that can undermine their job satisfaction and the quality of their healthcare services. The aim of this study was to delve into health professionals' job satisfaction by assessing the predictive role of happiness and meaning at work. Specifically, it was hypothesized that job meaning would moderate the relationship between job happiness and satisfaction. METHODS The study hypothesis was tested among 108 healthcare professionals (53 physicians and 55 nurses) working in eight MS centers in Italy. Participants were administered the Eudaimonic and Hedonic Happiness Investigation and the Job Satisfaction Questionnaire. Hierarchical regression analysis was performed to test the moderating role of job meaning between job happiness and satisfaction. RESULTS A significant interaction effect of job happiness and meaning on job satisfaction was identified for both physicians and nurses. When work was attributed low meaning, participants experiencing high job happiness were more satisfied with their work than those reporting low happiness; by contrast, when work was perceived as highly meaningful, participants' levels of job happiness did not significantly contribute to job satisfaction. CONCLUSIONS Focusing on the interplay between job happiness and meaning, findings bring forward practical suggestions for the preservation and promotion of job satisfaction among health professionals working with MS patients. Particularly, they suggest the need to strengthen those job-related aspects that may enhance job meaning, thus providing health professionals with significant reasons to persevere in their work in the face of daily challenges.
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Affiliation(s)
- Luca Negri
- Department of Pathophysiology, and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Sabina Cilia
- Multiple Sclerosis Centre, University Polyclinic Hospital G. Rodolico, Catania, Italy.,Department of Territorial Activities, Health District, Azienda Sanitaria Pronvinciale, Catania, Italy
| | - Monica Falautano
- Psychology Service, Neurology and Neurorehabilitation Unit, San Raffaele Hospital, Milan, Italy
| | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, Psychology Unit, ASST Lariana, Como, Italy
| | | | - Marianna Pattini
- Multiple Sclerosis Centre, Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Erika Pietrolongo
- Multiple Sclerosis Centre, Neurology Unit, University Hospital SS Annunziata, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | | | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Beatrice Allegri
- Multiple Sclerosis Centre, Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Maria Pia Amato
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of NEUROFARBA, University of Florence, Florence, Italy
| | - Miriam Benin
- Laboratory of Clinical Neuropsychology, Psychology Unit, ASST Lariana, Como, Italy
| | - Giovanna De Luca
- Multiple Sclerosis Centre, Neurology Unit, University Hospital SS Annunziata, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Claudio Gasperini
- Department of Neuroscience, San Camillo-Forlanini Hospital, Rome, Italy
| | - Eleonora Minacapelli
- Psychology Service, Neurology and Neurorehabilitation Unit, San Raffaele Hospital, Milan, Italy
| | - Francesco Patti
- Multiple Sclerosis Centre, University Polyclinic Hospital G. Rodolico, Catania, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy.
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Xiao Y, Dong M, Shi C, Zeng W, Shao Z, Xie H, Li G. Person-environment fit and medical professionals' job satisfaction, turnover intention, and professional efficacy: A cross-sectional study in Shanghai. PLoS One 2021; 16:e0250693. [PMID: 33905430 PMCID: PMC8078800 DOI: 10.1371/journal.pone.0250693] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Using the person-environment (PE) fit theory, this study aims to explore factors affecting medical professionals’ job satisfaction, turnover intention, and professional efficacy, and to examine individual characters associated with PE fit. Design and methods This study used data from the sixth National Health Service Survey conducted in 2018, with a focus on job outcomes among medical professionals in Shanghai. The reliability and validity of the tools for measuring PE and job outcomes were calculated. A structural equation model was used to examine the relationship among person-job (PJ) fit and person-group (PG) fit, job satisfaction, turnover intention, and professional efficacy. Finally, a hierarchical regression model was used to analyze the association between demographic variables and the PJ and PG fit. Results PG fit was directly and positively associated with job satisfaction and professional efficacy. PJ fit had a direct and positive association with job satisfaction but had a direct and negative association with turnover intention. The indirect association of PJ fit with turnover intention was statistically significant. The results from the hierarchical regression analysis showed that younger physicians generally had a lower level of PJ fit and older physicians with higher education tended to have a lower level of PG fit. Conclusions Medical professionals with higher PJ or PG fit have higher job satisfaction, and those with higher PG fit have higher professional efficacy. The impact of PJ fit on turnover intention was mediated by job satisfaction. Healthcare managers should take actions to effectively promote medical professionals’ PJ and PG fit to improve their retention and efficiency.
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Affiliation(s)
- Yuyin Xiao
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Minye Dong
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Chenshu Shi
- Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Wu Zeng
- Department of International Health, School of Nursing & Health Studies, Georgetown University, Washington, DC, United States of America
| | - Zhenyi Shao
- Centre for Health Statistics and Information, Shanghai Health Commission, Shanghai, China
| | - Hua Xie
- Centre for Health Statistics and Information, Shanghai Health Commission, Shanghai, China
- * E-mail: (GL); (HX)
| | - Guohong Li
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
- * E-mail: (GL); (HX)
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Venugopal D, Lal B, Shirodker S, Kanojiya R, Kaushal R. Optometry students' perspective on optometry in suburban Western India: A qualitative study. JOURNAL OF OPTOMETRY 2021; 14:215-223. [PMID: 32201069 PMCID: PMC8093523 DOI: 10.1016/j.optom.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/17/2019] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE Optometry has been an established profession in India for 60 years. Despite this, students who choose this course may have misconceptions and unrealistic expectations about the profession. The goal of this study is to understand the perceptions about optometry among optometry students, prior to and during their studies. METHODS A snap-shot narrative qualitative study using a semi-structured open-ended questionnaire was designed to understand the perception of optometry. Optometry students and educators from three suburban colleges were invited to participate. Forty-one participants took part in 24 in-depth interviews and 5 focus groups; of those 32 were undergraduate optometry students and 9 were optometry educators. Interviews and focus groups were audio-recorded, transcribed, coded, and analyzed. RESULTS Three major themes emerged: retrospective perception of optometry, current perception and strategies to improve awareness level. All the participants mentioned that there was a considerable lack of awareness about optometry in society. None of the students stated that they chose optometry as their first choice of professional education. Most students expressed that they were provided with ample exposure during the curriculum to understand the scope of optometry. Various strategies were recommended to improve the level of awareness of optometry. CONCLUSIONS The current study highlights the lack of awareness and knowledge of optometry among the students while enrolling in the course. Knowledge about the scope of optometry practice among optometry students improved after extensive education and clinical exposure. Improving the awareness level of the profession will improve the quality of students entering the profession.
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Affiliation(s)
- Dinesh Venugopal
- Optometry Division, Allied Health Science Course, Goa Medical College and Hospital, Bambolim 403202, Goa, India.
| | - Barsha Lal
- Optometry Division, Allied Health Science Course, Goa Medical College and Hospital, Bambolim 403202, Goa, India; School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia
| | - Suchana Shirodker
- Optometry Division, Allied Health Science Course, Goa Medical College and Hospital, Bambolim 403202, Goa, India
| | - Rashmi Kanojiya
- Laxmi College of Optometry, Panvel 410206, Navi Mumbai, Maharastra, India; ITM Institute of Health Sciences, New Panvel 410206, Navi Mumbai, Maharastra, India
| | - Rakesh Kaushal
- Laxmi College of Optometry, Panvel 410206, Navi Mumbai, Maharastra, India; ITM Institute of Health Sciences, New Panvel 410206, Navi Mumbai, Maharastra, India
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Zhang W, Miao R, Tang J, Su Q, Aung LHH, Pi H, Sai X. Burnout in nurses working in China: A national questionnaire survey. Int J Nurs Pract 2020; 27:e12908. [PMID: 33336456 DOI: 10.1111/ijn.12908] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/18/2020] [Accepted: 11/08/2020] [Indexed: 12/21/2022]
Abstract
AIM This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. METHODS This was a national cross-sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self-administered questionnaire. RESULTS A total of 51 406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. CONCLUSION We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented.
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Affiliation(s)
- Wenyu Zhang
- Department of Nursing, Medical School of Chinese PLA, Beijing, China.,Department of Senior Citizens Welfare, Beijing College of Social Administration, Beijing, China
| | - Ran Miao
- Department of Nursing, Medical School of Chinese PLA, Beijing, China.,Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jingping Tang
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Qingqing Su
- Department of Nursing, Medical School of Chinese PLA, Beijing, China
| | - Lynn Htet Htet Aung
- Center for Molecular Genetics, Institute for Translational Medicine, College of Medicine, Qingdao University, Qingdao, China
| | - Hongying Pi
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyong Sai
- Department of Epidemiology and Statistics, Graduate School, Chinese PLA General Hospital, Beijing, China
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Kameyama N, Nagai H, Ikoma N. Job Characteristics Affecting Japanese Surgeons' Satisfaction Levels. J Surg Res 2020; 260:475-480. [PMID: 33279220 DOI: 10.1016/j.jss.2020.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The number of medical graduates choosing surgical careers has been declining rapidly in Japan, likely because of surgeons' notoriously stressful working environments and inadequate compensation. We hypothesized that surgeons, in comparison to those in other specialties, have distinct perceptions of their job. To better understand the reasons for the decline in the number of surgeons, we conducted an email-based survey to characterize surgeons' and physicians' job perceptions. MATERIALS AND METHODS The study population, recruited via emailed invitations, completed a questionnaire primarily modeled after the Hackman and Oldham multidimensional tool. The survey contained seven dimensions: task significance, dealing with others, feedback from the job, autonomy, skill variety, task identity, and ethics. The response rate was 29.4%. Results were compared across specialty groups (surgery, internal medicine, and others) and-among surgeons-by hospital setting (university hospitals versus community hospitals). RESULTS Responses from 415 Japanese physicians were included in this study. The mean scores for ethics, task significance, and dealing with others, and feedback from the job were significantly higher in the surgery group than in the internal medicine and other specialty groups (P < 0.05). In contrast, the mean score for autonomy was lower in the surgery group than in the other groups, and the autonomy score was significantly lower in the university hospital surgery group than in the community hospital surgery group (P < 0.05). CONCLUSIONS There are clear differences in job perception between surgeons and other physicians, particularly in regard to ethics, task significance, dealing with others, and feedback from the job. Improvement of surgeons' working environments is an imminent need to avoid surgeons' burnout and mitigate the decline in the number of new surgical trainees in Japan.
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Affiliation(s)
- Noriaki Kameyama
- Department of Digestive Surgery, KKR Tachikawa Hospital, Tokyo, Japan.
| | - Hirohisa Nagai
- Graduate School of Business Sciences, University of Tsukuba, Tokyo, Japan
| | - Naruhiko Ikoma
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Sano Y, Yoshikawa T, Nakashima Y, Kido M, Ogawa M, Makimoto H, Matsumoto K, Aizawa Y. [Analysis of occupational health activities through classifying reports from medical facilities in Japan]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2020; 62:115-126. [PMID: 31656235 DOI: 10.1539/sangyoeisei.2019-010-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The objectives of this study were to analyze current trends in occupational health activities by classifying reports from medical facilities in Japan. METHODS Reports of current workplace-level occupational health activities from medical activities that were collected by the Japan Medical Association Occupational Health Committee were used for the study. Of 5,000 questionnaire forms sent to medical facilities, 1,920 responses were returned. The freely described reports on ongoing occupational health activities contained in these responses were classified according to each of the following aspects of reported activities: 1) details of occupational health activities including main actors in workplace-level actions; and 2) approaches taken for occupational safety and health. The classification of the reports was implemented by a working group comprising selected occupational health practitioners and researchers. RESULTS Among 1,920 survey responses, 581 valid texts were analyzed. Altogether, 1,044 occupational health activities currently undertaken by the facilities were extracted. The reported activities that were classified according to details of occupational health activities mainly comprised "Measures for preventing overwork, labor management, and work-style reform" (35.7%), "Measures for improving mental health" (21.0%), and "Review of occupational safety and health management systems" (19.3%). Medical facilities implementing "Measures for mental health" alongside "Measures for preventing overwork, labor management, and work-style reform" were reported in 13.2% of the responding medical facilities. "Occupational health professionals or safety and health management staff" (71.7%) were the most frequent main actors of these activities, followed by "Members of the workplace" (18.4%) and "Outsourced experts" (2.4%). "Comprehensive safety and health management" (42.0%) was the most common approach taken for occupational safety and health, followed by "Management focusing on topics" (23.8%) and "Case management" (16.5%). Most of these activities focused on primary prevention aimed at labor management including prevention of overwork, work-style reform, and mental health promotion. Another key trend could be "Teamwork among occupational safety and health staff, workers, and employers at respective workplaces as well as outsourced experts." DISCUSSION Several key trends were extracted from current occupational health activities at medical facilities. In most cases, these measures were implemented simultaneously. This suggests the importance of combining primary prevention measures for mental health with measures for labor management including prevention of overwork. These activities reflect emerging trends that incorporate teamwork between experts, workers, and employers, and provide new perspectives on workplace-level occupational safety and health activities.
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Affiliation(s)
- Yumi Sano
- The Ohara Memorial Institute for Science of Labour
| | - Toru Yoshikawa
- Committee for Occupational Health, Japan Medical Association
- National Institute of Occupational Safety and Health
| | - Yoshifumi Nakashima
- Committee for Occupational Health, Japan Medical Association
- Mitsui Memorial Hospital
| | - Michiko Kido
- Committee for Occupational Health, Japan Medical Association
- Japanese Red Cross Medical Center
| | | | | | - Kichiro Matsumoto
- Committee for Occupational Health, Japan Medical Association
- The Japan Medical Association
| | - Yoshiharu Aizawa
- Committee for Occupational Health, Japan Medical Association
- Kitasato University
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Stan VA, Correa R, Deslauriers JR, Faynboym S, Shah T, Widge AS. Support, technology and mental health: correlates of trainee workplace satisfaction. PERSPECTIVES ON MEDICAL EDUCATION 2020; 9:31-40. [PMID: 31953654 PMCID: PMC7012793 DOI: 10.1007/s40037-019-00555-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Low physician workplace satisfaction may negatively impact patient care. Dissatisfaction may begin during residency training, where trainees face lower autonomy and less control over work conditions. The theoretical and empirical literature on trainees is couched mainly in terms of burnout. Theories of satisfaction, a different construct, are derived from studies of independent physicians. Identifying specific correlates of trainee satisfaction may be a clearer path to preparing a sustainable physician workforce. METHODS We surveyed 3300 residents and fellows (response rate of 7.2% to 46,574 surveys sent) across multiple specialties and institutions in the US. The instrument was adapted from a previous large-scale survey of physician satisfaction, with changes reflecting factors theorized to specifically affect trainee satisfaction. We applied generalized linear regression to identify correlates of higher satisfaction. RESULTS A total of 1444 (44%) residents/fellows reported they were very satisfied and 1311 (40%) reported being somewhat satisfied. Factors associated with satisfaction included positive perceptions of supporting clinical staff, the electronic health record, and stability of personal mental health. Surprisingly, a strong negative perception of completing insurance and/or disability forms was also associated with higher satisfaction. Factors often presumed to correlate with satisfaction, such as duty hours, debt load, and specialty, did not show significant associations. DISCUSSION Multiple workplace factors are correlated with trainee satisfaction, but they are not the factors (such as financial debt) that we initially hypothesized. The factors we identified, including clinical staff support and personal mental health, may be targets for further study and/or pilot interventions aimed at improving satisfaction.
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Affiliation(s)
| | - Ricardo Correa
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Semyon Faynboym
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Tina Shah
- TNT Health Enterprises, Atlanta, GA, USA
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The association between psychological strains and life satisfaction: Evidence from medical staff in China. J Affect Disord 2020; 260:105-110. [PMID: 31494361 DOI: 10.1016/j.jad.2019.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/09/2019] [Accepted: 09/01/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Previous research on the relationship between life satisfaction and its influencing factors has mainly focused on the work domain. Psychological strains, which result from these stress-related outcomes, have not been paid enough attention to explain how it correlates negatively with life satisfaction. METHOD A cross-sectional study was conducted, using questionnaires sent to selected medical staff in a public hospital in Shandong, China (N = 1012). Multiple regression analysis was used to investigate how psychological strains influencing life satisfactions among medical staff. RESULTS The findings indicate that aspiration strain and deprivation strain have significantly negative impact on medical staff's life satisfaction even with other variables controlled for. Weekly working hour was a significant predictor for life satisfaction. Family factors, such as marital status and kids in the family as well as social support were important factors in influencing individuals' life satisfaction. CONCLUSION The current study highlights the negative associations between aspiration strain, deprivation strain and life satisfaction. The result underlines the importance of actions taken to prevent and combat psychological strains. It also provides some evidence for policy makers to improve the work environment for medical staff, such as reduce weekly working hours and enhance social support in order to increase medical staff's life satisfaction.
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Nørøxe KB, Vedsted P, Bro F, Carlsen AH, Pedersen AF. Mental well-being and job satisfaction in general practitioners in Denmark and their patients' change of general practitioner: a cohort study combining survey data and register data. BMJ Open 2019; 9:e030142. [PMID: 31694846 PMCID: PMC6858117 DOI: 10.1136/bmjopen-2019-030142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Low job satisfaction and poor well-being (eg, stress and burnout) among physicians may have negative consequences for patient experienced healthcare quality. In primary care, this could manifest in patients choosing another general practitioner (GP). The objective of this study was to examine change of GP (COGP) (unrelated to change of address) among patients in relation to their GPs' job satisfaction, well-being and self-assessed work-ability. DESIGN AND SETTING Data from a nationwide questionnaire survey among Danish GPs in May 2016 was combined with register data on their listed patients. Associations between patients' COGP in the 6-month study period (from May 2016) and the job satisfaction/well-being of their GP were estimated as risk ratios (RRs) at the individual patient level using binomial regression analysis. Potential confounders were included for adjustment. PARTICIPANTS The study cohort included 569 776 patients aged ≥18 years listed with 409 GPs in single-handed practices. RESULTS COGP was significantly associated with occupational distress (burnout and low job satisfaction) in the GP. This association was seen in a dose-response like pattern. For burnout, associations were found for depersonalisation and reduced sense of personal accomplishment (but not for emotional exhaustion). The adjusted RR was 1.40 (1.10-1.72) for patients listed with a GP with the lowest level of job satisfaction and 1.24 (1.01-1.52) and 1.40 (1.14-1.72) for patients listed with a GP in the most unfavourable categories of depersonalisation and sense of personal accomplishment (the most favourable categories used as reference). COGP was not associated with self-assessed work-ability or domains of well-being related to life in general. CONCLUSIONS Patients' likelihood of changing GP increased with GP burnout and decreasing job satisfaction. These findings indicate that patients' evaluation of care as measured by COGP may be influenced by their GPs' work conditions and occupational well-being.
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Affiliation(s)
- Karen Busk Nørøxe
- Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Flemming Bro
- Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Anette Fischer Pedersen
- Research Unit for General Practice, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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14
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Nørøxe KB, Pedersen AF, Carlsen AH, Bro F, Vedsted P. Mental well-being, job satisfaction and self-rated workability in general practitioners and hospitalisations for ambulatory care sensitive conditions among listed patients: a cohort study combining survey data on GPs and register data on patients. BMJ Qual Saf 2019; 28:997-1006. [PMID: 31427467 DOI: 10.1136/bmjqs-2018-009039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/19/2019] [Accepted: 08/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Physicians' work conditions and mental well-being may affect healthcare quality and efficacy. Yet the effects on objective measures of healthcare performance remain understudied. This study examined mental well-being, job satisfaction and self-rated workability in general practitioners (GPs) in relation to hospitalisations for ambulatory care sensitive conditions (ACSC-Hs), a register-based quality indicator affected by referral threshold and prevention efforts in primary care. METHODS This is an observational study combining data from national registers and a nationwide questionnaire survey among Danish GPs. To ensure precise linkage of each patient with a specific GP, partnership practices were not included. Study cases were 461 376 adult patients listed with 392 GPs. Associations between hospitalisations in the 6-month study period and selected well-being indicators were estimated at the individual patient level and adjusted for GP gender and seniority, list size, and patient factors (comorbidity, sociodemographic characteristics). RESULTS The median number of ACSC-Hs per 1000 listed patients was 10.2 (interquartile interval: 7.0-13.7). All well-being indicators were inversely associated with ACSC-Hs, except for perceived stress (not associated). The adjusted incidence rate ratio was 1.26 (95% CI 1.13 to 1.42) for patients listed with GPs in the least favourable category of self-rated workability, and 1.19 (95% CI 1.05 to 1.35), 1.15 (95% CI 1.04 to 1.27) and 1.14 (95% CI 1.03 to 1.27) for patients listed with GPs in the least favourable categories of burn-out, job satisfaction and general well-being (the most favourable categories used as reference). Hospitalisations for conditions not classified as ambulatory care sensitive were not equally associated. CONCLUSIONS ACSC-H frequency increased with decreasing levels of GP mental well-being, job satisfaction and self-rated workability. These findings imply that GPs' work conditions and mental well-being may have important implications for individual patients and for healthcare expenditures.
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Affiliation(s)
- Karen Busk Nørøxe
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anette Fischer Pedersen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anders Helles Carlsen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Flemming Bro
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Peter Vedsted
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
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15
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Job satisfaction and guideline adherence among physicians: Moderating effects of perceived autonomy support and job control. Soc Sci Med 2019; 233:208-217. [DOI: 10.1016/j.socscimed.2019.04.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022]
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16
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Hossain MS, Kiumarsi S, Yahya S, Hashemi S. The effect of healthcare management and physicians’ loyalty. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1620479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Md Shamim Hossain
- Graduate School of Business, Universiti Sains Malaysia, USM Penang, Malaysia
- Management Studies Department, Faculty of Business Studies, University of Rajshahi, Rajshahi, Bangladesh
| | - Shaian Kiumarsi
- Graduate School of Business, Universiti Sains Malaysia, USM Penang, Malaysia
| | - Sofri Yahya
- Graduate School of Business, Universiti Sains Malaysia, USM Penang, Malaysia
| | - Shiva Hashemi
- School of Housing, Building and Planning (HBP), (USM), Penang, Malaysia
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17
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Al-Wotayan R, Annaka M, Nazar M. Job Satisfaction and Mental Health among Physicians in Primary Health Care Centers in Kuwait. Health (London) 2019. [DOI: 10.4236/health.2019.116058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Luther L, Fukui S, Garabrant JM, Rollins AL, Morse G, Henry N, Shimp D, Gearhart T, Salyers MP. Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales. J Behav Health Serv Res 2019; 46:64-79. [PMID: 29651600 PMCID: PMC6185830 DOI: 10.1007/s11414-018-9601-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Measuring quality of care can transform care, but few tools exist to measure quality from the client's perspective. The aim of this study was to create concordant clinician and client self-report quality-of-care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 124, Indianapolis, Indiana, 46220, USA.
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA.
| | - Sadaaki Fukui
- Center for Mental Health Research and Innovation, University of Kansas School of Social Welfare, 1545 Lilac Lane, Twente Hall, Lawrence, KS, 66045, USA
| | - Jennifer M Garabrant
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 124, Indianapolis, Indiana, 46220, USA
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA
| | - Angela L Rollins
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA
- Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, 1481 W. 10th Street, 11-H Indianapolis, Indianapolis, Indiana, 46202, USA
| | - Gary Morse
- Places for People, Inc., 4130 Lindell Boulevard, St. Louis, MO, 63108, USA
- Department of Psychological Sciences, University of Missouri-St. Louis, One University Boulevard, 325 Stadler Hall, St. Louis, MO, 63121, USA
| | - Nancy Henry
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 124, Indianapolis, Indiana, 46220, USA
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA
| | - Dawn Shimp
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 124, Indianapolis, Indiana, 46220, USA
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA
| | - Timothy Gearhart
- Four County Counseling Center, 1015 Michigan Avenue, Logansport, IN, 46947, USA
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 124, Indianapolis, Indiana, 46220, USA
- ACT Center of Indiana, 402 North Blackford Street, LD 124, Indianapolis, IN, 46220, USA
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19
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Friedman SE, Levy EI, Owen M, Vossler AH, Friedman EP, Shallwani H. Commentary: Flow State (Trading the Sweat Spot for the Sweet Spot): A Roadmap to Measure and Enhance Workplace Growth and Well-Being. Neurosurgery 2018; 83:E262-E265. [PMID: 30239927 DOI: 10.1093/neuros/nyy447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/18/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Scott E Friedman
- Lippes Mathias Wexler Friedman LLP, Buffalo, New York.,D21 Partners, LLC, Buffalo, New York
| | - Elad I Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Mary Owen
- D21 Partners, LLC, Buffalo, New York
| | - Andrea H Vossler
- Lippes Mathias Wexler Friedman LLP, Buffalo, New York.,D21 Partners, LLC, Buffalo, New York
| | - Eliza P Friedman
- Lippes Mathias Wexler Friedman LLP, Buffalo, New York.,D21 Partners, LLC, Buffalo, New York
| | - Hussain Shallwani
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
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20
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Murali K, Banerjee S. Burnout in oncologists is a serious issue: What can we do about it? Cancer Treat Rev 2018; 68:55-61. [DOI: 10.1016/j.ctrv.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
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21
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Malhotra J, Wong E, Thind A. Canadian family physician job satisfaction - is it changing in an evolving practice environment? An analysis of the 2013 National Physician Survey database. BMC FAMILY PRACTICE 2018; 19:100. [PMID: 29935531 PMCID: PMC6015660 DOI: 10.1186/s12875-018-0786-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 05/31/2018] [Indexed: 11/12/2022]
Abstract
Background To explore the determinants of job satisfaction and work-life balance satisfaction of family physicians in Canada. Methods This is a secondary analysis of the Canadian 2013 National Physician’s Survey using descriptive statistics and binomial logistic regression. An estimated 34,753 family physicians practicing in Canada at the time of survey administration in 2013 were eligible for the survey. The main outcome measures were respondent satisfaction with professional life and satisfaction with work-life balance. Results The survey had a response rate of 17%. Seventy-two percent of respondents were satisfied with their professional lives, and 49% were satisfied with their work-life balance. Male family physicians had lower odds of satisfaction with their work-life balance than their female counterparts (OR = 0.86, 95% CI 0.82–0.92). Family physicians using an electronic medical record had higher odds of dissatisfaction with their professional lives (OR = 1.13, 95% CI 1.05–1.22) and work-life balance (OR = 1.22, 95% CI 1.15–1.30) than those not using an EMR. Family physicians not in a focused practice had greater odds of dissatisfaction (OR = 1.61, 95% CI 1.50–1.72) with both their professional lives and work-life balance (OR = 1.29, 95% CI 1.22–1.37) compared to their colleagues who have one or more areas of clinical focus. Conclusions Canadian family physicians are more satisfied with their professional lives than with their work-life balance. Novel findings that family physicians with one or more clinical areas of focus are more satisfied with their work and work-life balance satisfaction, and that family physicians using electronic health records are less satisfied with their work and their work-life balance merit further inquiry. Electronic supplementary material The online version of this article (10.1186/s12875-018-0786-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jana Malhotra
- Department of Family Medicine, University of Ottawa, 309-1580 Merivale Road, Ottawa, ON, K2G 4B5, Canada.
| | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, PO Box 5777, Stn B, London, ON, N6A 4V2, Canada
| | - Amardeep Thind
- Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University, WCPHFM 4131, 1465 Richmond Street, London, ON, N6G 2M1, Canada.,Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, WCPHFM 4131, 1465 Richmond Street, London, ON, N6G 2M1, Canada
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22
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Murali K, Makker V, Lynch J, Banerjee S. From Burnout to Resilience: An Update for Oncologists. Am Soc Clin Oncol Educ Book 2018; 38:862-872. [PMID: 30231394 DOI: 10.1200/edbk_201023] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Physician burnout remains a highly complex and topical issue. The negative impact of burnout on physicians, patients, and institutions has become increasingly apparent. Globally, a multitude of professional bodies and organizational leaders are giving this important subject much-deserved attention. In this review, we provide a summary of the latest evidence, with a focus on solutions and future strategies, while incorporating our own perspectives as practicing oncologists.
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Affiliation(s)
- Krithika Murali
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Vicky Makker
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - James Lynch
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
| | - Susana Banerjee
- From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom
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23
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Johnson JM, Carragher R. Interprofessional collaboration and the care and management of type 2 diabetic patients in the Middle East: A systematic review. J Interprof Care 2018; 32:621-628. [PMID: 29764248 DOI: 10.1080/13561820.2018.1471052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The World Health Organization has ranked the Middle East (ME) as the second most prevalent region globally for type 2 diabetes. Currently, treatment options initiated by physicians focus mainly on pharmaceuticals; however, lifestyle factors also have a tremendous impact on a patient's wellness or illness. A potential solution to this issue is to use an interprofessional team approach when caring for this patient population. The purpose of this systematic review is to look at the present literature involving the use of an interprofessional team approach to the care and maintenance of people with type 2 diabetes in the ME. A PRISMA flow diagram demonstrates the authors' literature search and screening process. The systematic review includes nine studies with mixed-methodologies performed in the Middle Eastern region in an outpatient or primary care setting, and demonstrates the use of interprofessional collaboration when providing care for type 2 diabetic patients. A meta-analysis was not included due to the heterogeneity of the studies; however, data analysis is discussed and results are demonstrated through an extraction tool developed by the authors based on The Cochrane Collaboration's data collection form. The aim of this review is to construct meaning surrounding the use and effectiveness of this collaborative approach with the adult and geriatric Middle Eastern diabetic patient population. Recommendations include continued support from multiple healthcare professions, involving nurses, pharmacists, dietitians, and physicians to promote holistic and patient-centred-care leading to fewer type 2 diabetes complications and hospital admissions.
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Affiliation(s)
- J M Johnson
- a Faculty of Nursing , University of Calgary , Qatar
| | - R Carragher
- a Faculty of Nursing , University of Calgary , Qatar
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24
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Abstract
BACKGROUND Physician financial conflict of interest is a concern in the delivery of medicine because of its possible influence on the cost and the quality of patient care. There has been an extensive discussion of the ethical, economic, and legal aspects of this issue but little direct empirical evidence of its magnitude or effects. METHODOLOGY A nationally representative survey (n = 4,720) was used to empirically examine physician self-report of receipt of financial gifts from the pharmaceutical and medical devices industry and its association with their ability to provide quality care. FINDINGS Results indicate that the vast majority of physicians receive industry gifts in various forms, and the receipt of gifts is associated with lower perceived quality of patient care. There is also an inverse relationship between the frequency of received gifts and the perceived quality of care. PRACTICE IMPLICATIONS Physicians need to be aware of the widespread receipt of industry gifts in medical practice and the potential adverse impact of such receipts on the delivery of care.
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Shanafelt TD, Lightner DJ, Conley CR, Petrou SP, Richardson JW, Schroeder PJ, Brown WA. An Organization Model to Assist Individual Physicians, Scientists, and Senior Health Care Administrators With Personal and Professional Needs. Mayo Clin Proc 2017; 92:1688-1696. [PMID: 29101937 DOI: 10.1016/j.mayocp.2017.08.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/01/2017] [Accepted: 08/22/2017] [Indexed: 11/22/2022]
Abstract
Working as a physician, scientist, or senior health care administrator is a demanding career. Studies have demonstrated that burnout and other forms of distress are common among individuals in these professions, with potentially substantive personal and professional consequences. In addition to system-level interventions to promote well-being globally, health care organizations must provide robust support systems to assist individuals in distress. Here, we describe the 15-year experience of the Mayo Clinic Office of Staff Services (OSS) providing peer support to physicians, scientists, and senior administrators at one center. Resources for financial planning (retirement, tax services, college savings for children) and peer support to assist those experiencing distress are intentionally combined in the OSS to normalize the use of the Office and reduce the stigma associated with accessing peer support. The Office is heavily used, with approximately 75% of physicians, scientists, and senior administrators accessing the financial counseling and 5% to 7% accessing the peer support resources annually. Several critical structural characteristics of the OSS are specifically designed to minimize potential stigma and reduce barriers to seeking help. These aspects are described here with the hope that they may be informative to other medical practices considering how to create low-barrier access to help individuals deal with personal and professional challenges. We also detail the results of a recent pilot study designed to extend the activity of the OSS beyond the reactive provision of peer support to those seeking help by including regular, proactive check-ups for staff covering a range of topics intended to promote personal and professional well-being.
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Woloschuk W, Myhre D, Dickinson J, Ross S. Implications of not matching to a first-choice discipline: a family medicine perspective. CANADIAN MEDICAL EDUCATION JOURNAL 2017; 8:e30-e36. [PMID: 29098046 PMCID: PMC5661736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Family medicine is often selected as an alternate career choice by medical students who do not match to their first choice discipline. Consequently, family medicine residency programs accept and train some residents who prepared for and intended a career in another specialty. The implications of this warrant investigation. METHODS Graduates (2006-2011) of Albertan family medicine residency programs were surveyed to examine differences between physicians who indicated family medicine was their first choice discipline and those who indicated that it was not their first choice. Survey questions targeted practice location, preparedness for practice, perceptions of family medicine, lifestyle satisfaction, and well-being. Principal components analysis was used to examine the factor structure of our survey items and ANOVA and Chi square were used to compare mean scores and proportions, respectively. RESULTS The overall response rate was 47.2% (307/651). Most (263) respondents reported that family medicine was their first choice discipline (yes-group); 42 respondents indicated that it was not (no-group) and two did not answer. The two groups were similar demographically. The no-group reported significantly lower mean scores on perceptions of family medicine. There were no significant differences between the two groups in their preparedness for practice and measures of lifestyle satisfaction and well-being. CONCLUSION Irrespective of their perceptions of the discipline, the respondents who did not match to their first choice discipline found family medicine to be a viable career option.
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27
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Schmit Jongbloed LJ, Cohen-Schotanus J, Borleffs JCC, Stewart RE, Schönrock-Adema J. Physician job satisfaction related to actual and preferred job size. BMC MEDICAL EDUCATION 2017; 17:86. [PMID: 28494758 PMCID: PMC5425993 DOI: 10.1186/s12909-017-0911-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Job satisfaction is essential for physicians' well-being and patient care. The work ethic of long days and hard work that has been advocated for decades is acknowledged as a threat for physicians' job satisfaction, well-being, and patient safety. Our aim was to determine the actual and preferred job size of physicians and to investigate how these and the differences between them influence physicians' job satisfaction. METHOD Data were retrieved from a larger, longitudinal study among physicians starting medical training at Groningen University in 1982/83/92/93 (N = 597). Data from 506 participants (85%) were available for this study. We used regression analysis to investigate the influence of job size on physicians' job satisfaction (13 aspects) and ANOVA to examine differences in job satisfaction between physicians wishing to retain, reduce or increase job size. RESULTS The majority of the respondents (57%) had an actual job size less than 1.0 FTE. More than 80% of all respondents preferred not to work full-time in the future. Respondents' average actual and preferred job sizes were .85 FTE and .81 FTE, respectively. On average, respondents who wished to work less (35% of respondents) preferred a job size reduction of 0.18 FTE and those who wished to work more (12%) preferred an increase in job size of 0.16 FTE. Job size influenced satisfaction with balance work-private hours most (β = -.351). Physicians who preferred larger job sizes were - compared to the other groups of physicians - least satisfied with professional accomplishments. CONCLUSIONS A considerable group of physicians reported a gap between actual and preferred job size. Realizing physicians' preferences as to job size will hardly affect total workforce, but may greatly benefit individual physicians as well as their patients and society. Therefore, it seems time for a shift in work ethic.
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Affiliation(s)
- Lodewijk J. Schmit Jongbloed
- Schmit Jongbloed Advies, Hofbrouckerlaan 30, 2341 LP Oegstgeest, The Netherlands
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Janke Cohen-Schotanus
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Jan C. C. Borleffs
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Roy E. Stewart
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Johanna Schönrock-Adema
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
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28
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Zhou X, Pu J, Zhong X, Zhu D, Yin D, Yang L, Zhang Y, Fu Y, Wang H, Xie P. Burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists. Neurology 2017; 88:1727-1735. [DOI: 10.1212/wnl.0000000000003883] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 02/09/2017] [Indexed: 11/15/2022] Open
Abstract
Objective:To investigate the prevalence of and personal and professional characteristics associated with burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists.Methods:The China Neurologist Association conducted a national cross-sectional study from September 2014 to March 2015. A questionnaire including the Maslach Burnout Inventory, the 12-item General Health Questionnaire, the Consultants' Mental Health Questionnaire, and questions assessing personal and professional characteristics, career satisfaction, and current doctor-patient relationships was administered.Results:A total of 693 directors of neurology departments and 6,111 neurologists in 30 Chinese provinces returned surveys. Overall, 53.2% of responding neurologists experienced burnout, 37.8% had psychological morbidity, 50.7% had high levels of job stress, 25.7% had low levels of job satisfaction, 76.9% had poor doctor-patient relationships, and 58.1% regretted becoming a doctor. Factors independently associated with burnout were lower income, more hours worked per week, more nights on call per month, working in public hospitals, psychological morbidity, high levels of job stress, low levels of job satisfaction, and poor doctor-patient relationships. Factors independently associated with psychological morbidity included lower income, more nights on call per month, working in enterprise-owned hospitals, burnout, high levels of job stress, and low levels of job satisfaction.Conclusions:Burnout and psychological morbidity are common in Chinese neurologists. Burnout is the single greatest predictor of neurologists' psychological morbidity, high job stress, and low job satisfaction.
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Bergman D, Liljefors I, Palm K. The effects of dialogue groups on physicians' work environment: A matter of gender? Work 2016; 52:407-17. [PMID: 26409351 DOI: 10.3233/wor-152105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Over the past decades, the work environment of physicians has been deteriorating, particularly for female physicians. OBJECTIVES In this study, we evaluated the effects of dialogue groups on the work environment of physicians in relation to gender. METHODS Sixty physicians (38 women) at Sachs' Children's Hospital in Stockholm, Sweden, participated in dialogue groups once a month during a period of one year. Assessments of their psychosocial work environment were performed before and after the intervention. RESULTS At baseline, female physicians experienced their work environment as less satisfactory compared to male physicians. After the intervention, the female physicians perceived improvements in more areas than their male colleagues. CONCLUSIONS Our study shows that female physicians at this clinic were disadvantaged in relation to the work environment, but, more importantly, the findings suggest that several of the disadvantages can be reduced. Dialogue groups appear to improve the physicians' work environment and promote gender equality.
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Petrosyan Y, Bai YQ, Koné Pefoyo AJ, Gruneir A, Thavorn K, Maxwell CJ, Bronskill SE, Wodchis WP. The Relationship between Diabetes Care Quality and Diabetes-Related Hospitalizations and the Modifying Role of Comorbidity. Can J Diabetes 2016; 41:17-25. [PMID: 27789111 DOI: 10.1016/j.jcjd.2016.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the impact of comorbidity on diabetes care quality and diabetes-related hospitalizations and to examine whether associations between the likelihood of diabetes-related hospitalizations and compliance with diabetes testing are modified by type of comorbidity. METHODS A population-based cohort study of 861 354 adults with diabetes was conducted in Ontario, Canada. The diabetes cohort was categorized into 4 groups defined by their comorbidity statuses: no comorbidity, diabetes-concordant only, diabetes-discordant only, and both concordant and discordant. Outcome variables were defined as having had at least 1 hospitalization for diabetes-related short- or long-term complications between 2009 and 2011. Diabetes-care quality measures included testing for glycated hemoglobin (A1C) and low-density lipoprotein-cholesterol levels and eye examinations between 2007 and 2009. Multivariable logistic regression models were performed to examine the associations between diabetes testing and diabetes-related hospitalizations and the modifying role of comorbidity type. RESULTS Compliance with all 3 monitoring tests by patients with diabetes had a strong positive impact on reducing hospitalizations for diabetes-related long-term complications, especially in patients with diabetes-concordant conditions. The highest levels of adherence to all 3 diabetes monitoring tests were observed in patients with diabetes-concordant conditions only and in patients with diabetes-discordant conditions. The highest odds of hospitalizations for diabetes-related short-term complications were observed in patients having both discordant and concordant conditions. CONCLUSIONS Meeting diabetes testing goals has the potential to reduce hospitalizations for diabetes-related complications; however, this depends on types of coexisting chronic conditions and diabetes-related complications in patients with diabetes.
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Affiliation(s)
- Yelena Petrosyan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Yu Qing Bai
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Anna J Koné Pefoyo
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Cancer Care Ontario, Toronto, Ontario, Canada
| | - Andrea Gruneir
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kednapa Thavorn
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Colleen J Maxwell
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Ontario, Canada
| | - Susan E Bronskill
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
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Waddimba AC, Scribani M, Hasbrouck MA, Krupa N, Jenkins P, May JJ. Resilience among Employed Physicians and Mid-Level Practitioners in Upstate New York. Health Serv Res 2016; 51:1706-34. [PMID: 27620116 DOI: 10.1111/1475-6773.12499] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the factors associated with resilience among medical professionals. DATA SOURCES/STUDY SETTING Administrative information from a rural health care network (1 academic medical center, 6 hospitals, 31 clinics, and 20 school health centers) was triangulated with self-report data from 308 respondents (response rate = 65.1 percent) to a 9/2013-1/2014 survey among practitioners serving a nine-county 5,600-square-mile area. STUDY DESIGN A cross-sectional questionnaire survey comprising valid measures of resilience, practice meaningfulness, satisfaction, and risk/uncertainty intolerance, nested within a prospective, community-based project. DATA COLLECTION/EXTRACTION METHODS The sampling frame included practitioners on institutional payroll, excluding voluntary/involuntary attritions and advisory board/research team members. In multivariable mixed-effects models, we regressed full-range and high-/low-resilience scores on demographics, professional satisfaction, workplace needs, risk/uncertainty intolerance, and service unit characteristics. PRINCIPAL FINDINGS Relational needs, uncertainty intolerance, satisfaction ≥75 percent of the time, number of practitioners on a unit, and workload were significantly associated with resilience. Higher scores were most strongly associated with uncertainty tolerance, satisfaction, and practitioner numbers. Practitioner/unit demographics were mostly nonsignificant. CONCLUSIONS More resilient practitioners experienced frequent satisfaction, relational needs gratification, better uncertainty tolerance, lighter workloads, and practiced on units with more colleagues. Further studies should investigate well-being interventions based on these mutable factors.
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Affiliation(s)
- Anthony C Waddimba
- Health Services Research Scientist, Bassett Healthcare Network, Research Institute, Cooperstown, NY. .,Assistant Professor of Pediatrics, Columbia University College of Physicians & Surgeons, Cooperstown, NY.
| | - Melissa Scribani
- Biostatistics and Computing Center, Bassett Healthcare Network, Research Institute, Cooperstown, NY
| | - Melinda A Hasbrouck
- Health Services Research Scientist, Bassett Healthcare Network, Research Institute, Cooperstown, NY
| | - Nicole Krupa
- Biostatistics and Computing Center, Bassett Healthcare Network, Research Institute, Cooperstown, NY
| | - Paul Jenkins
- Biostatistics and Computing Center, Bassett Healthcare Network, Research Institute, Cooperstown, NY
| | - John J May
- Health Services Research Scientist, Bassett Healthcare Network, Research Institute, Cooperstown, NY.,Department of Epidemiology, Columbia University Mailman School of Public Health, Cooperstown, New York
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Pedrazza M, Berlanda S, Trifiletti E, Bressan F. Exploring Physicians' Dissatisfaction and Work-Related Stress: Development of the PhyDis Scale. Front Psychol 2016; 7:1238. [PMID: 27588013 PMCID: PMC4988987 DOI: 10.3389/fpsyg.2016.01238] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/03/2016] [Indexed: 11/13/2022] Open
Abstract
Research, all over the world, is starting to recognize the potential impact of physicians' dissatisfaction and burnout on their productivity, that is, on their intent to leave the job, on their work ability, on the amount of sick leave days, on their intent to continue practicing, and last but not least, on the quality of the services provided, which is an essential part of the general medical care system. It was interest of the provincial medical board's ethical committee to acquire information about physician's work-related stress and dissatisfaction. The research group was committed to define the indicators of dissatisfaction and work-related stressors. Focus groups were carried out, 21 stressful experience's indicators were identified; we developed an online questionnaire to assess the amount of perceived stress relating to each indicator at work (3070 physicians were contacted by e-mail); quantitative and qualitative data analysis were carried out. The grounded theory perspective was applied in order to assure the most reliable procedure to investigate the concepts' structure of "work-related stress." We tested the five dimensions' model of the stressful experience with a confirmatory factor analysis: Personal Costs; Decline in Public Image and Role Uncertainty; Physician's Responsibility toward hopelessly ill Patients; Relationship with Staff and Colleagues; Bureaucracy. We split the sample according to attachment style (secure and insecure -anxious and avoidant-). Results show the complex representation of physicians' dissatisfaction at work also with references to the variable of individual difference of attachment security/insecurity. The discriminant validity of the scale was tested. The original contribution of this paper lies on the one hand in the qualitative in depth inductive analysis of physicians' dissatisfaction starting from physicians' perception, on the other hand, it represents the first attempt to analyze the physicians' dissatisfaction with reference to attachment styles, which is recognized as being a central variable of individual difference supporting caregiving practices. This study represents an original and innovative attempt to address physicians' dissatisfaction and job satisfaction. The PhyDis scale has been developed and, in line with international findings, our results indicate that role uncertainty and loss of social esteem are the most dissatisfying factors.
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Affiliation(s)
- Monica Pedrazza
- Department of Human Sciences, University of VeronaVerona, Italy
| | | | | | - Franco Bressan
- Department of Economics, University of VeronaVerona, Italy
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Iglay K, Hannachi H, Joseph Howie P, Xu J, Li X, Engel SS, Moore LM, Rajpathak S. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin 2016; 32:1243-52. [PMID: 26986190 DOI: 10.1185/03007995.2016.1168291] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Patients with type 2 diabetes (T2DM) often have multiple comorbidities which may impact the selection of antihyperglycemic therapies. The purpose of this study was to quantify the prevalence and co-prevalence of common comorbidities. RESEARCH DESIGN AND METHODS A retrospective study was conducted using the Quintiles Electronic Medical Record database. Adult patients with T2DM who had ≥1 encounter from July 2014 to June 2015 (index period) with ≥1 year medical history available were included. The index date was defined as the most recent encounter date during the 1 year index period. MAIN OUTCOME MEASURES Comorbid conditions were assessed using all data available prior to and including the index date. Patient characteristics, laboratory measures, and comorbidities were summarized via descriptive analyses, overall and by subgroups of age (<65, 65-74, 75+ years) and gender. RESULTS Of the 1,389,016 eligible patients, 53% were female and the median age was 65 years. 97.5% of patients had at least one comorbid condition in addition to T2DM and 88.5% had at least two. The comorbidity burden tended to increase in older age groups and was higher in men than women. The most common conditions in patients with T2DM included hypertension (HTN) in 82.1%; overweight/obesity in 78.2%; hyperlipidemia in 77.2%; chronic kidney disease (CKD) in 24.1%; and cardiovascular disease (CVD) in 21.6%. The highest co-prevalence was demonstrated for the combination of HTN and hyperlipidemia (67.5%), followed by overweight/obesity and HTN (66.0%), overweight/obesity and hyperlipidemia (62.5%), HTN and CKD (22.4%), hyperlipidemia and CKD (21.1%), HTN and CVD (20.2%), hyperlipidemia and CVD (20.1%), overweight/obesity and CKD (19.1%) and overweight/obesity and CVD (17.0%). LIMITATIONS Limitations include the potential for misclassification/underreporting due to the use of diagnostic codes, drug codes, or laboratory measures for identification of medical conditions. CONCLUSIONS The vast majority of patients with T2DM have multiple comorbidities. To ensure a comprehensive approach to patient management, the presence of multimorbidity should be considered in the context of clinical decision making.
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Affiliation(s)
| | | | | | - Jinfei Xu
- a Merck & Co. Inc. , Kenilworth , NJ , USA
| | - Xueying Li
- a Merck & Co. Inc. , Kenilworth , NJ , USA
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Scheepers RA, Boerebach BCM, Arah OA, Heineman MJ, Lombarts KMJMH. A Systematic Review of the Impact of Physicians' Occupational Well-Being on the Quality of Patient Care. Int J Behav Med 2016; 22:683-98. [PMID: 25733349 PMCID: PMC4642595 DOI: 10.1007/s12529-015-9473-3] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background It is widely held that the occupational well-being of physicians may affect the quality of their patient care. Yet, there is still no comprehensive synthesis of the evidence on this connection. Purpose This systematic review studied the effect of physicians’ occupational well-being on the quality of patient care. Methods We systematically searched PubMed, Embase, and PsychINFO from inception until August 2014. Two authors independently reviewed the studies. Empirical studies that explored the association between physicians’ occupational well-being and patient care quality were considered eligible. Data were systematically extracted on study design, participants, measurements, and findings. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess study quality. Results Ultimately, 18 studies were included. Most studies employed an observational design and were of average quality. Most studies reported positive associations of occupational well-being with patient satisfaction, patient adherence to treatment, and interpersonal aspects of patient care. Studies reported conflicting findings for occupational well-being in relation to technical aspects of patient care. One study found no association between occupational well-being and patient health outcomes. Conclusions The association between physicians’ occupational well-being and health care’s ultimate goal—improved patient health—remains understudied. Nonetheless, research up till date indicated that physicians’ occupational well-being can contribute to better patient satisfaction and interpersonal aspects of care. These insights may help in shaping the policies on physicians’ well-being and quality of care. Electronic supplementary material The online version of this article (doi:10.1007/s12529-015-9473-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Renée A Scheepers
- Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Benjamin C M Boerebach
- Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Onyebuchi A Arah
- Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.,Department of Epidemiology, The Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.,UCLA Center for Health Policy Research, Los Angeles, CA, USA
| | - Maas Jan Heineman
- Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.,Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kiki M J M H Lombarts
- Professional Performance Research Group, Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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Nguyen HV, Duong HT, Vu TT. Factors associated with job satisfaction among district hospital health workers in Northern Vietnam: a cross-sectional study. Int J Health Plann Manage 2016; 32:163-179. [DOI: 10.1002/hpm.2337] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Huy Van Nguyen
- Institute for Preventive Medicine and Public Health; Hanoi Medical University; Hanoi Vietnam
| | - Huong Thao Duong
- Institute for Preventive Medicine and Public Health; Hanoi Medical University; Hanoi Vietnam
| | - Toan Thinh Vu
- Institute for Preventive Medicine and Public Health; Hanoi Medical University; Hanoi Vietnam
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Schmit Jongbloed LJ, Schönrock-Adema J, Borleffs JCC, Stewart RE, Cohen-Schotanus J. The influence of achievement before, during and after medical school on physician job satisfaction. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2014; 19:581-595. [PMID: 24464365 DOI: 10.1007/s10459-013-9489-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 12/02/2013] [Indexed: 06/03/2023]
Abstract
In this longitudinal study, we investigated the relationship between physicians' prior achievements (before, during and after medical school) and job satisfaction, and tested the two lines of reasoning that prior achievements influence job satisfaction positively or negatively, respectively. The participants were graduates who started their medical training in 1982 (n = 147), 1983 (n = 154), 1992 (n = 143) and 1993 (n = 153). We operationalised job satisfaction as satisfaction (on a 10-point scale) with 13 cognitive, affective and instrumental aspects of the participants' jobs. The measures of achievement before, during and after medical school included pre-university grade point average, study progress and a residency position in the specialty of first choice, respectively. We included the effect of curriculum type (problem-based learning versus traditional), gender and years of experience as moderator variables. Higher achievers before and during medical school were more satisfied about their income (β = .152, p < .01 and β = .149, p < .05), but less satisfied with their opportunities for personal development (β = -.159, p < .05). High achievers after medical school were more satisfied with professional accomplishments (β = .095, p < .05), with appreciation from support personnel (β = .154, p < .01) and from patients (β = .120, p < .05). Effect sizes were small. Prior achievements influenced job satisfaction. The direction of the influences depended on the job satisfaction aspect in question, which indicates that it is important to distinguish between aspects of job satisfaction. To optimize job satisfaction of high achievers, it is important for graduates to obtain their preferred specialty. Furthermore, it is vital to provide them with enough opportunities for further development.
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Affiliation(s)
- Lodewijk J Schmit Jongbloed
- Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
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Grace SM, Rich J, Chin W, Rodriguez HP. Implementing Interdisciplinary Teams Does Not Necessarily Improve Primary Care Practice Climate. Am J Med Qual 2014; 31:5-11. [PMID: 25214648 DOI: 10.1177/1062860614550333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The complexity of successfully implementing interdisciplinary care team approaches in primary care has challenged many delivery system stakeholders. One-year changes in clinicians' and staff experiences of practice climate among 5 practices implementing interdisciplinary primary care teams and 28 other practices were compared. In adjusted analyses, practices implementing care teams reported improved team structure (78.0 in 2011 vs 79.3 in 2012), team functioning (75.7 vs 77.7), readiness for change (77.6 vs 77.7), and perceptions of skills and knowledge (48.0 vs 53.6) over time. However, the improvements were not significantly different from changes experienced by other practices. Achieving improvements in practice climate through care team redesign is challenging, even with structured learning opportunities for team members. Practice climate did not deteriorate over time, indicating that implementing a complex team redesign does not harm working relationships of frontline clinicians and staff.
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Affiliation(s)
| | - Jeremy Rich
- HealthCare Partners Institute for Applied Research and Education, Torrance, CA
| | - William Chin
- HealthCare Partners Affiliates Medical Group, Torrance, CA
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Reis D, Hoppe A. Change in affective well-being on change in perceived job characteristics: The mediating role of hope. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2014. [DOI: 10.1111/joop.12076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ashcroft R, Silveira J, Rush B, Mckenzie K. Incentives and disincentives for the treatment of depression and anxiety: a scoping review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:385-92. [PMID: 25007422 PMCID: PMC4086319 DOI: 10.1177/070674371405900706] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 01/01/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There is widespread support for primary care to help address growing mental health care demands. Incentives and disincentives are widely used in the design of health care systems to help steer toward desired goals. The absence of a conceptual model to help understand the range of factors that influence the provision of primary mental health care inspired a scoping review of the literature. Understanding the incentives that promote and the disincentives that deter treatment for depression and anxiety in the primary care context will help to achieve goals of greater access to mental health care. METHOD A review of the literature was conducted to answer the question, how are incentives and disincentives conceptualized in studies investigating the treatment of common mental disorders in primary care? A comprehensive search of MEDLINE, PsycINFO, CINAHL, and Google Scholar was undertaken using Arksey and O'Malley's 5-stage methodological framework for scoping reviews. RESULTS We identified 27 studies. A range of incentives and disincentives influence the success of primary mental health care initiatives to treat depression and anxiety. Six types of incentives and disincentives can encourage or discourage treatment of depression and anxiety in primary care: attitudes and beliefs, training and core competencies, leadership, organizational, financial, and systemic. CONCLUSIONS Understanding that there are 6 different types of incentives that influence treatment for anxiety and depression in primary care may help service planners who are trying to promote improved mental health care.
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Affiliation(s)
- Rachelle Ashcroft
- Postdoctoral Fellow, Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, Toronto, Ontario; Assistant Professor, School of Social Work, Renison University College, University of Waterloo, Waterloo, Ontario
| | - Jose Silveira
- Chief of Psychiatry, Medical Director, Mental Health and Addiction Program, St Joseph's Health Centre, Toronto, Ontario; Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Brian Rush
- Senior Scientist, Health Equity Research Group, Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Associate Professor, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Kwame Mckenzie
- Medical Director of Underserved Populations Program, Centre for Addictions and Mental Health, Toronto, Ontario; Professor of Psychiatry, University of Toronto: Director of Division of Equity, Gender and Populations, Toronto, Ontario; Director of Canadian Institutes of Health Research Social Aetiology of Mental Illness Training Program, Toronto, Ontario; President, Canadian Mental Health Association Toronto, Toronto, Ontario
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Williams SP, Zipp GP. Prevalence and Associated Risk Factors of Burnout Among US Doctors of Chiropractic. J Manipulative Physiol Ther 2014; 37:180-9. [DOI: 10.1016/j.jmpt.2013.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 11/16/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
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Determinants of career satisfaction among pediatric hospitalists: a qualitative exploration. Acad Pediatr 2014; 14:361-8. [PMID: 24976348 PMCID: PMC4158453 DOI: 10.1016/j.acap.2014.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 03/27/2014] [Accepted: 03/30/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To characterize determinants of career satisfaction among pediatric hospitalists working in diverse practice settings; to develop a framework to conceptualize factors influencing career satisfaction. METHODS Semistructured interviews were conducted with community and tertiary care hospitalists, using purposeful sampling to attain maximum response diversity. We used closed- and open-ended questions to assess levels of career satisfaction and its determinants. Interviews were conducted by telephone, recorded, and transcribed verbatim. Emergent themes were identified and analyzed using an inductive approach to qualitative analysis. RESULTS A total of 30 interviews were conducted with community and tertiary care hospitalists, representing 20 hospital medicine programs and 7 Northeastern states. Qualitative analysis yielded 657 excerpts, which were coded and categorized into 4 domains and associated determinants of career satisfaction: 1) professional responsibilities; 2) hospital medicine program administration; 3) hospital and health care systems; and 4) career development. Although community and tertiary care hospitalists reported similar levels of career satisfaction, they expressed variation in perspectives across these 4 domains. Although the role of hospital medicine program administration was consistently emphasized by all hospitalists, community hospitalists prioritized resource availability, work schedule, and clinical responsibilities, while tertiary care hospitalists prioritized diversity in nonclinical responsibilities and career development. CONCLUSIONS We illustrate how hospitalists in different organizational settings prioritize both consistent and unique determinants of career satisfaction. Given associations between physician satisfaction and health care quality, efforts to optimize modifiable factors within this framework, at both community and tertiary care hospitals, may have broad impacts.
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Waddimba AC, Burgess JF, Young GJ, Beckman HB, Meterko M. Motivators and Hygiene Factors Among Physicians Responding to Explicit Incentives to Improve the Value of Care. Qual Manag Health Care 2013; 22:276-92. [DOI: 10.1097/qmh.0000000000000006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hall CB, Brazil K, Wakefield D, Lerer T, Tennen H. Organizational culture, job satisfaction, and clinician turnover in primary care. J Prim Care Community Health 2013; 1:29-36. [PMID: 23804066 DOI: 10.1177/2150131909360990] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study is to examine how organizational culture and job satisfaction affect clinician turnover in primary care pediatric practices. One hundred thirty clinicians from 36 primary care pediatric practices completed the Primary Care Organizational Questionnaire (PCOQ), which evaluates interactions among members of the practice and job-related attributes measuring 8 organizational factors, along with a separate 3-item instrument measuring job satisfaction. Random effects logistic models were used to assess the associations between job satisfaction, the organizational factors from the PCOQ, and clinician turnover over the subsequent year. All 8 measured organizational factors from the PCOQ, particularly perceived effectiveness, were associated with job satisfaction. Five of the 8 organizational factors were also associated with clinician turnover. The effects of the organizational factors on turnover were substantially reduced in a model that included job satisfaction; only 1 organizational factor, communication between clinicians and nonclinicians, remained significant (P = .05). This suggests that organizational culture affects subsequent clinician turnover primarily through its effect on job satisfaction. Organizational culture, in particular perceived effectiveness and communication, affects job satisfaction, which in turn affects clinician turnover in primary care pediatric practices. Strategies to improve job satisfaction through changes in organizational culture could potentially reduce clinician turnover.
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Affiliation(s)
- Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York
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Marsteller JA, Hsu YJ, Wen M, Wolff J, Frick K, Reider L, Scharfstein D, Boyd C, Leff B, Schwartz L, Karm L, Boult C. Effects of Guided Care on providers' satisfaction with care: a three-year matched-pair cluster-randomized trial. Popul Health Manag 2013; 16:317-25. [PMID: 23560515 DOI: 10.1089/pop.2012.0091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It is important to understand the effects of a new care model on health professionals' satisfaction, which may help inform organizations' decisions regarding the adoption of the model. This study evaluates the effect of the Guided Care model of primary care on physicians', Guided Care Nurses' and practice staff satisfaction with processes of care for chronically ill older patients. In Guided Care, a specially educated registered nurse works with 2-5 primary care physicians, performing 8 clinical activities for 50-60 chronically ill older patients. This model was tested in a 3-year matched-pair cluster-randomized controlled trial with 14 pods (teams of physicians and staff) randomly assigned, within pairs, to provide Guided Care or usual care. Physicians and Guided Care Nurses were surveyed at baseline and annually for 3 years. Staff were surveyed at baseline and 2 years later. Physicians' satisfaction with chronic care processes, knowledge of patients, and care coordination were measured, as well as Guided Care Nurses' satisfaction with chronic care processes and staff perceptions of quality of care. Findings suggest that Guided Care improved physician satisfaction with patient/family communication and management of chronic care, and it may bolster staff beliefs that care is patient oriented. Differences in other aspects of care were not statistically significant.
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Affiliation(s)
- Jill A Marsteller
- 1 Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
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McNeil DA, Vekved M, Dolan SM, Siever J, Horn S, Tough SC. A qualitative study of the experience of CenteringPregnancy group prenatal care for physicians. BMC Pregnancy Childbirth 2013; 13 Suppl 1:S6. [PMID: 23445867 PMCID: PMC3561144 DOI: 10.1186/1471-2393-13-s1-s6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background This study sought to understand the central meaning of the experience of group prenatal care for physicians who were involved in providing CenteringPregnancy through a maternity clinic in Calgary, Canada. Method The study followed the phenomenological qualitative tradition. Three physicians involved in group prenatal care participated in a one-on-one interview between November and December 2009. Two physicians participated in verification sessions. Interviews followed an open ended general guide and were audio recorded and transcribed. The purpose of the analysis was to identify meaning themes and the core meaning experienced by the physicians. Results Six themes emerged: (1) having a greater exchange of information, (2) getting to knowing, (3) seeing women get to know and support each other, (4) sharing ownership of care, (5) having more time, and (6) experiencing enjoyment and satisfaction in providing care. These themes contributed to the core meaning for physicians of “providing richer care.” Conclusions Physicians perceived providing better care and a better professional experience through CenteringPregnancy compared to their experience of individual prenatal care. Thus, CenteringPregnancy could improve work place satisfaction, increase retention of providers in maternity care, and improve health care for women.
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Affiliation(s)
- Deborah A McNeil
- Public Health Innovation and Decision Support, Population and Public Health, Alberta Health Services, 10101 Southport Rd SW, Calgary, Alberta T2W 3N2, Canada.
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Williams S, Innes S. Burnout among chiropractic practitioners: real or imagined an exploratory study protocol. Chiropr Man Therap 2012; 20:4. [PMID: 22369737 PMCID: PMC3310809 DOI: 10.1186/2045-709x-20-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 02/27/2012] [Indexed: 11/18/2022] Open
Abstract
Burnout is a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that has been found to exist in a significant number of healthcare and helping professionals. It imposes a significant societal burden by shortened practitioner lifespan, decreased efficiency, negative health outcomes and poorer levels of patient care. Theoretical models suggest that it appears to be the result of a complex interaction between job resources and job demands. It may be reasonable to conclude that Chiropractic professionals experience similar vocational demands and thus experience significant levels of occupational stress and subsequent burnout. However the data on burnout within the chiropractic profession is limited. It is possible that this results in significant negative outcomes on chiropractors and their patients. Therefore, the objective of this paper is to demonstrate the need to explore burnout in chiropractic practice and offer a research protocol for a potential study.
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Job Satisfaction Among Young Board-Certified Surgeons at Academic Centers in Europe and North America. Ann Surg 2012; 256:796-803; discussion 803-5. [DOI: 10.1097/sla.0b013e31827386eb] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lin BYJ, Wan TTH, Hsu CPC, Hung FR, Juan CW, Lin CC. Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses. Health Serv Manage Res 2012; 25:68-77. [PMID: 22673696 DOI: 10.1258/hsmr.2012.012011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Given the limited studies on emergency care management, this study aimed to explore the relationships of emergency department (ED) culture values to certain dimensions of ED physicians' and nurses' work satisfaction and intent to leave. Four hundred and forty-two emergency medical professionals completed the employee satisfaction questionnaire across 119 hospital-based EDs, which had culture value evaluations filed, were used as unit of analysis in this study. Adjusting the personal and employment backgrounds, and the surrounded EDs' unit characteristics and environmental factors, multiple regression analyses revealed that clan and market cultures were related to emergency physicians' work satisfaction and intent to leave. On the other hand, adhocracy, market and hierarchical cultures were related to emergency nurses' work satisfaction. There do exist different patterns among various culture types on various work satisfaction dimensions and intent to leave of emergency physicians and nurses. The findings could offer hospital and ED leaders insights for changes or for building a better atmosphere to enhance the work life of emergency physicians and nurses.
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Affiliation(s)
- Blossom Yen-Ju Lin
- Institute of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan, ROC
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Kim KH, Park EC, Hahm MI. The gap between physicians and the public in satisfaction with the National Health Insurance system in Korea. J Korean Med Sci 2012; 27:579-85. [PMID: 22690087 PMCID: PMC3369442 DOI: 10.3346/jkms.2012.27.6.579] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 03/16/2012] [Indexed: 12/02/2022] Open
Abstract
The Korean National Health Insurance (NHI) system was an unprecedented accomplishment that was achieved in a short period of time. In this study, we sought to identify gaps between physicians and the public with respect to attitudes toward the NHI system in Korea. The study population was derived from the 2008 Korean Medical Association Survey, which was conducted to investigate satisfaction with and perceptions of the NHI system among physicians (n = 961) and the public (n = 935). Only 6.5% of the physicians were satisfied with NHI system, and 71.5% were dissatisfied with it. In contrast, 28.3% of the public were satisfied with the NHI system, and 21.4% were dissatisfied. The level of dissatisfaction expressed by physicians (2.03 ± 0.91 on a five-point scale) was also higher than that expressed by the public (3.06 ± 0.84). Despite rapid growth of NHI system, a large gap in satisfaction exists between physicians and the public.
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Affiliation(s)
- Kye-Hyun Kim
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea
| | - Myung-Il Hahm
- Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea
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Abstract
Although the practice of oncology can be extremely rewarding, it is also one of the most demanding and stressful areas of medicine. Oncologists are faced with life and death decisions on a daily basis, administer incredibly toxic therapies with narrow therapeutic windows, must keep up with the rapid pace of scientific and treatment advances, and continually walk a fine line between providing palliation and administering treatments that lead to excess toxicity. Personal distress precipitated by such work-related stress may manifest in a variety of ways including depression, anxiety, fatigue, and low mental quality of life. Burnout also seems to be one of the most common manifestations of distress among physicians, with studies suggesting a prevalence of 35% among medical oncologists, 38% among radiation oncologists, and 28% to 36% among surgical oncologists. Substantial evidence suggests that burnout can impact quality of care in a variety of ways and has potentially profound personal implications for physicians including suicidal ideation. In this review, we examine the causes, consequences, and personal ramifications of oncologist burnout and explore the steps oncologists can take to promote personal well-being and professional satisfaction.
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Affiliation(s)
- Tait Shanafelt
- All authors: Mayo Clinic College of Medicine, Rochester, MN
| | - Lotte Dyrbye
- All authors: Mayo Clinic College of Medicine, Rochester, MN
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