Physicians are still the cornerstone of the medical system, with the power over most of the dollars spent and as the group patients trust the most to act in their best interest. The job satisfaction of doctors is important, as it may even affect the quality of their work. The American Medical Association asked the Rand Corporation to survey physicians to get a picture of their job perceptions. (Rand Report) The research covered thirty practices in six states, with a survey of 447 physicians and interviews with a subset of the doctors and with practice managers. Doctors’ perceptions of the quality of care they deliver was a primary factor in their professional satisfaction. Doctors who described barriers to delivery of quality services had lower satisfaction. Another very important factor is the use of electronic medical records and other health information technology. While doctors support EHRs in concept and understand their potential to improve care; the practical reality at this point is a high level of frustration. EHRs have been more expensive than most physicians anticipated but the greatest source of dissatisfaction is with data entry issues, little useful functionality, interference with patient time and normal work processes and actual degradation of the clinical content of medical records.
As might be anticipated, autonomy was a significant factor in professional satisfaction. Doctors in physician-owned practices were likely to be more satisfied than those in hospital or other ownership settings. Relationships with colleagues, within and without the practice, patients and payers also affected job satisfaction. While many doctors report stress from their workload and pace, some, particularly surgeons, had concerns about the adequacy of demand for their services. Most physicians said they were currently happy with their income, but many were concerned about the stability of their earnings. Professional liability was not a major concern for most, perhaps because of reforms in many of the states where the survey was conducted. Other legal and regulatory issues were a concern, in particular meaningful use requirements which were perceived as having little value. The study gives a fairly in-depth analysis of current physician perceptions, which should be closely monitored by public policy makers.