News Release
Quality of Patient Care Drives Physician Satisfaction; Doctors Have Concerns About Electronic Health Records
Oct 9, 2013
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Appendix B-E (available on-line only)
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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.
Chapter One
Introduction
Chapter Two
Background: Scan of the Literature on Physician Professional Satisfaction
Chapter Three
Methods
Chapter Four
Conceptual Model
Chapter Five
Characteristics of the Survey Sample
Chapter Six
Quality of Care
Chapter Seven
Electronic Health Records
Chapter Eight
Autonomy and Work Control
Chapter Nine
Practice Leadership
Chapter Ten
Collegiality, Fairness, and Respect
Chapter Eleven
Work Quantity and Pace
Chapter Twelve
Work Content, Allied Health Professionals, and Support Staff
Chapter Thirteen
Payment, Income, and Practice Finances
Chapter Fourteen
Regulatory and Professional Liability Concerns
Chapter Fifteen
Health Reform
Chapter Sixteen
Conclusions
Appendix A
Advisory Committee Members
Appendix B
Interview Guides
Appendix C
Practice Structural Questionnaire
Appendix D
Physician Experience Survey
Appendix E
Physician Experience Survey Scale Calculation
The research described in this report was sponsored by the American Medical Association, and was produced within RAND Health, a division of the RAND Corporation.
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