TUESDAY, Jan. 21, 2003 (HealthDayNews) -- Despite all the reports of harried doctors buried under mounds of paperwork and an ever-increasing patient load, the majority of physicians say they're still happy with their career choice.
Slightly more than 80 percent of doctors, both primary-care physicians and specialists, reported being "very" or "somewhat" satisfied with their profession, says a Harvard Medical School survey published in the Jan. 22 issue of the Journal of the American Medical Association.
The researchers questioned more than 12,000 doctors across the United States to assess their level of job satisfaction. The survey took part in three phases -- the first in 1997, the second in 1999, and the third in 2001.
"Contrary to what we were expecting to find, physician satisfaction stayed pretty stable," says study author Dr. Bruce Landon, an assistant professor of healthcare policy and management at Harvard Medical School in Boston.
Landon says that with the increase in managed care, the researchers had expected to find a corresponding decrease in physician satisfaction, but that wasn't the case nationally.
Also, there wasn't a significant difference in levels of satisfaction between primary-care physicians and specialists.
About 18 percent of physicians across the country reported being at least somewhat dissatisfied with their job. No one area really stood out above all others as the cause of dissatisfaction, Landon says. He adds the largest factor in dissatisfaction definitely wasn't a decline in income, but a loss of clinical autonomy. Physicians want more control over their patients' care and want to be able to provide high-quality care, he says.
The researchers also looked at 12 local markets more closely: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Phoenix.; Orange County, Calif.; Seattle; and Syracuse, N.Y. They found a wide variation in levels of satisfaction between local markets.
For example, nearly one in four physicians in Phoenix reported dissatisfaction, while only one in 10 doctors in Lansing, Mich., felt the same way.
The areas that saw the biggest changes during the survey period were northern New Jersey and Syracuse, N.Y.
In northern New Jersey, physician dissatisfaction declined considerably -- starting at 24 percent in 1997 and dropping to 17 percent in 2001. According to the study, this change may have occurred because New Jersey adopted more stringent regulations for managed care, including faster payment for doctors.
The reverse was true in Syracuse, where dissatisfied physicians made up only 14 percent of the total in 1997 but jumped to 20 percent in 2001. During that time, two large health plans in the Syracuse area merged, which the authors theorize may have played a role in the rise of unhappy doctors.
Dr. John Sattenspiel, a family physician from Salem, Ore., and a member of the American Academy of Family Physicians' board of directors, says no one cause stood out as the source of dissatisfaction because the researchers weren't asking the right questions. He says the focus of the survey questions was on managed care issues, but that "physician dissatisfaction with managed care has leveled off."
Sattenspiel believes one of the most important issues contributing to physician dissatisfaction is medical liability and malpractice. "That has definitely diminished satisfaction," says Sattenspiel. Rising expenses and diminished reimbursements are another big problem, he says.
He does agree with the survey findings that the issue of clinical autonomy is a big problem for doctors. "Physicians are frustrated by the impact of managed care and other regulations that impact our ability to function autonomously as we try to provide the best quality care."
More information
To learn about the results of another physician satisfaction survey, read this press release from the University of California, Davis. For patients, having a doctor who is content with his or her career choice is important. Here are some other qualities to look for when choosing a doctor.
