Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy

Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy

Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy

Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy

Synopsis

One of the American Medical Association's core strategic objectives is to advance health care delivery and payment models that enable high-quality, affordable care and restore and preserve physician satisfaction. Such changes could yield a more sustainable and effective health care system with highly motivated physicians. To that end, the AMA asked RAND Health to characterize the factors that lead to physician satisfaction. RAND sought to identify high-priority determinants of professional satisfaction that can be targeted within a variety of practice types, especially as smaller and independent practices are purchased by or become affiliated with hospitals and larger delivery systems. Researchers gathered data from 30 physician practices in six states, using a combination of surveys and semistructured interviews. This report presents the results of the subsequent analysis, addressing such areas as physicians' perceptions of the quality of care, use of electronic health records, autonomy, practice leadership, and work quantity and pace. Among other things, the researchers found that physicians who perceived themselves or their practices as providing high-quality care reported better professional satisfaction. Physicians, especially those in primary care, were frustrated when demands for greater quantity of care limited the time they could spend with each patient, detracting from the quality of care in some cases. Electronic health records were a source of both promise and frustration, with major concerns about interoperability between systems and with the amount of physician time involved in data entry.

Excerpt

The American Medical Association (AMA) has adopted, as a core strategic objective, the advancement of health care delivery and payment models that enable high-quality, affordable care and restore and preserve physician satisfaction. The AMA has undertaken this commitment in the belief that such change can and should result in a more sustainable and effective health care system with a highly motivated physician workforce. At the same time, the AMA has noted challenges for physicians interested in payment and delivery reform, including existing variability in the degree of care integration, the need for new skills and resources, and the uncertainty created by the emergence of as yet untested new payment models. Therefore, the AMA’s objective includes facilitating transition, for physicians who are seeking a path to more integrated practice models, in a manner that supports professional satisfaction and practice sustainability. This objective is consistent with the mission of the AMA: To promote the art and science of medicine and the betterment of public health.

This project, sponsored by the AMA, aimed to characterize factors that influence physician professional satisfaction. By using a mixed-methods (primarily qualitative) design, the project sought to identify a broad array of potential targets for interventions to improve physician professional satisfaction. In accordance with the AMA’s strategic objective and in the context of recent health reform legislation (including but not limited to the Affordable Care Act), changing fee-for-service payment rates, and perceived consolidation of independent physician practices by larger delivery systems, the influences of physician practice model (e.g., physician ownership versus hospital or other corporate ownership) and practice sustainability on professional satisfaction were of particularly high interest.

The project began on October 22, 2012, and was completed on September 30, 2013. An advisory committee convened by the AMA provided input on key study activities, including data collection methods and interpretation of results. Committee membership is listed in Appendix A.

Using project findings and input from other sources, including its membership and experts in physician practice design, the AMA plans to develop resources to assist physicians seeking to improve practice effectiveness, efficiency, sustainability, and professional satisfaction.

This work was sponsored by the American Medical Association. The research was conducted by RAND Health, a division of the RAND Corporation. A profile of RAND Health, abstracts of publications, and ordering information can be found at www.rand.org/health.

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