Wisconsin internal medicine physician career satisfaction and associated risks to retention.

摘要

The purpose of this study was to assess the career satisfaction of primary care internal medicine (PCIM) physicians in Wisconsin, based on physician satisfaction variables reported to influence retention in the Cejka Search and America Medical Group Association (AMGA) Physician Retention Survey (2005). The satisfaction variables in the Cejka Search and AMGA study addressed issues of practice, compensation, location, and spousal satisfaction. Additional demographic information was included in this descriptive quantitative study to assess survey data for correlations between career satisfaction, risk to retention, and demographics. The research questions were: (1) What career satisfaction variables are assessed below the level of satisfaction by Wisconsin PCIM physicians? (2) What are the demographic correlations to low levels of Wisconsin PCIM physician career satisfaction? (3) What percentage of Wisconsin PCIM physicians anticipate leaving their current position due to career dissatisfaction? (4) What are career satisfaction variables and demographics that correlate with Wisconsin PCIM physicians that anticipate leaving their current position? (5) What percentage of Wisconsin PCIM physicians anticipate leaving the career of medicine due to career dissatisfaction? (6) What are career satisfaction variables and demographics that correlate with Wisconsin PCIM physicians that anticipate leaving the career of medicine?;The findings of this study were consistent with the Cejka Search and AMGA Physician Retention Survey (2005). All four of the general areas of career satisfaction including practice, compensation, location, and spousal satisfaction had an average response of less than satisfied. Compensation satisfaction was reported at the lowest level of satisfaction. Practice satisfaction was reported at the highest level of satisfaction. Particular issues of concern were autonomy, work hours and lifestyle, pressure regarding patient volume, practice leadership, administrative responsibilities, compensation regarding salary, contracted insurance and Medicare/Medicaid reimbursement, and spousal satisfaction with physician worklife.;The general demographic findings of this study were consistent with information presented by the Cejka Search and AMGA study and the American Medical Association (2006). The general profile of the responding physicians was approximately 50 years old, male, white, worked full-time, board certified, and worked in multi-specialty groups. There was no strong demographic differentiation as to physician career satisfaction, although there were multiple small, but significant correlations to career satisfaction variables.;This study revealed that 19.9 percent of Wisconsin primary care internal medicine physicians anticipate leaving their current position due to their career dissatisfaction, and 14.8 percent of these physicians anticipated leaving the career of medicine due to their career dissatisfaction. There were physicians that responded that they anticipated leaving their current position, and anticipated leaving the career of medicine. The cumulative retention risk was 24.9 percent, with a potential financial impact to the healthcare organizations in Wisconsin of greater than 33 million dollars. This would also have a major impact on access for patients to primary care internal medicine physicians. A large number of patients may need to find another healthcare provider, potentially impacting the continuity of care for these patients.;There were moderate correlations between career satisfaction variables and Wisconsin primary care internal medicine physicians that anticipate leaving their current position with practice satisfaction issues including autonomy, work hours and lifestyle, pressure regarding patient volume, practice group, and practice leadership. Compensation satisfaction issues were related to dissatisfaction with salary. Spousal satisfaction issues were related to spousal satisfaction with physician worklife. Location satisfaction was not a major concern. Although practice satisfaction was reported at the highest level of satisfaction practice satisfaction had the highest correlations to physician anticipating leaving their current position. Healthcare leaders will need to continue to work towards improving practice satisfaction, as there may be limited opportunities to improve compensation in the current financial environment of healthcare. There were no major correlations between demographics and physicians anticipating leaving their current position.;There were moderate correlations between practice satisfaction variables and Wisconsin primary care internal medicine physicians that anticipate leaving the career of medicine including the variables of autonomy, and work hours and lifestyle. Again, healthcare leaders must continue to work with physicians to improve satisfaction in these variables, as there are a decreasing number of physicians entering the specialty of internal medicine. There were no demographic correlations with physicians anticipating leaving the career of medicine.