High levels of physician professional satisfaction were found across multiple specialties and primary care in the closed, integrated practice setting of Southern California Permanente Medical Group.

Cover: Physician Professional Satisfaction and Area of Clinical Practice

Physician Professional Satisfaction and Area of Clinical Practice

Evidence from an Integrated Health Care Delivery System

Published in: The Permanente Journal, v. 20, no. 2, Spring 2016, p. 35-41

Posted on RAND.org on May 09, 2016

by John P. Caloyeras, Michael Kanter, Nicole Ives, Chong Woo Kim, Hemal Kanzaria, Sandra H. Berry, Robert H. Brook

Research Question

  1. Can primary care physicians be as satisfied professionally as their specialist peers?

CONTEXT: For health care reform to succeed, health care systems need a professionally satisfied primary care workforce. Evidence suggests that primary care physicians are less satisfied than those in other medical specialties. OBJECTIVE: To assess three domains of physician satisfaction by area of clinical practice among physicians practicing in an established integrated health system. DESIGN: Cross-sectional online survey of all Southern California Permanente Medical Group (SCPMG) partner and associate physicians (N = 1034) who were primarily providing clinic-based care in 1 of 4 geographically and operationally distinct Kaiser Permanente Southern California Medical Centers. MAIN OUTCOME MEASURES: Primary measure was satisfaction with one's day-to-day professional life as a physician. Secondary measures were satisfaction with quality of care and income. RESULTS: Of the 636 physicians responding to the survey (61.5% response rate), on average, 8 in 10 SCPMG physicians reported satisfaction with their day-to-day professional life as a physician. Primary care physicians were only minimally less likely to report being satisfied (difference of 8.2-9.5 percentage points; p < 0.05) than were other physicians. Nearly all physicians (98.2%) were satisfied with the quality of care they are able to provide. Roughly 8 in 10 physicians reported satisfaction with their income. No differences were found between primary care physicians and those in other clinical practice areas regarding satisfaction with quality of care or income. CONCLUSION: It is possible to create practice settings, such as SCPMG, in which most physicians, including those in primary care, experience high levels of professional satisfaction.

Key Findings

  • Almost all the doctors surveyed reported satisfaction with the quality of care they can provide to patients, and over 80 percent reported satisfaction with their professional day-to-day life.
  • On average medical specialists and general surgeons reported satisfaction levels about 9 percentage points higher than primary care physicians.
  • Younger physicians reported greater satisfaction with their professional life than older physicians, and physicians who graduated from medical schools based outside the United States reported greater satisfaction than graduates of U.S.-based schools.
  • Both income and the perceived quality of care provided were associated with professional life satisfaction. No correlation was found between measures of income satisfaction and quality.

Recommendation

Professional satisfaction among primary care doctors should be actively monitored as new models of care are implemented.

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