Management Practices, Physician Autonomy, and Satisfaction

Schulz, Rockwell; Schulz, Carol

doi:10.1097/00005650-198808000-00002

Cited by 40 publications

(20 citation statements)

References 16 publications

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“…The survey contained information on physicians' workplace relationships, including separate measures of satisfaction with relationships with colleagues, staff, and patients . The domains were drawn from earlier measures of physicians' professional satisfaction (Schulz & Schulz, 1988;Reames & Dunstone, 1989;McMurray et al, 1997) and validated via expert review.…”

Section: Methodsmentioning

confidence: 99%

Workplace relational factors and physicians' intention to withdraw from practice

Masselink

Lee

Konrad

2008

Health Care Management Review

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This study suggests that workplace relationships may influence physicians' intention to withdraw from practice, but the mechanisms by which they do so are unclear. Possible interventions to improve physician retention include promotion of informal mentoring and efforts to support community involvement of physicians and their families. Further research examining the role of these and other programs in promoting physician retention can help employers to foster positive workplace relationships and improve retention.

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Section: Methodsmentioning

confidence: 99%

Workplace relational factors and physicians' intention to withdraw from practice

Masselink

Lee

Konrad

2008

Health Care Management Review

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“…Also unclear is, whether an expected relationship between bureaucratic organization and job satisfaction has the same impact for both medical specialists and residents in training to be specialists. It is interesting to note that Schulz and Schulz in a recent study of hospital psychiatrists found significant zero-order correlations between certification (specialist or not) and all satisfaction measures (Schulz and Schulz 1988). This might indicate that formal position or being in a different stage of professional socialization might affect the relationship between bureaucratic structure and job satisfaction.…”

Section: Introductionmentioning

confidence: 95%

“…Recently Schulz and Schulz found that perceived clinical autonomy was an important factor in explaining the job satisfaction of physicians in German psychiatric hospitals. In general, professional autonomy seems to be the main motive when physicians choose a solo practice and it is a key determinant of job satisfaction (Freidson 1970;Mechanic 1976;Wolinsky 1982;Goodman and Swartwout 1984;Schulz and Schulz 1988). Several authors suggest a complementary view.…”

Section: Introductionmentioning

confidence: 99%

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Organizational and Professional Predictors of Physician Satisfaction

Stevens

Philipsen

Diederiks

1992

Organization Studies

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In order to find out whether organizational characteristics and professional attitudes are positive predictors of the job satisfaction of physicians, an analysis is presented, based on a survey of 121 internists in 13 medical departments in Dutch university hospitals. The study indicates that formal structuring of work activities is a positive predictor of work environment satisfaction, whereas size is a negative predictor. Professional attitudes such as service orientation and craftsmanship are strong positive predictors of satisfaction with patient demand. The study also indicates that certification (being a medical specialist or not) positively relates to work load satisfaction.Controlling for certification reveals that the absence of a significant relationship between formal structuring of work activities and work load satisfaction is accounted for by a positive correlation for medical specialists and a negative one for residents in training to become specialists. This indicates the importance of a difference in hierarchical position for the relation between formal structuring of work activities and physician satisfaction. The results for hospital physicians are consistent with satisfaction studies in other settings: dependency on bureaucratic procedures is associated with dissatisfaction, while the advantages of bureaucracy — the possibility of creating routines and procedures to limit role ambiguity — are conducive to satisfaction.

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“…On the other hand, by providing feedback and involving staff in the decision-making process, staff motivation and job performance can be improved [25,30,31].…”

Section: Job Design and Staff Moralementioning

confidence: 99%

Clinic Decentralization: An Israeli Model and Evaluation Strategy

Gross

Elhayany²,

Zmora³

1993

Journal of Management in Medicine

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KHC is Israel's dominant provider and insurer of primary care services. It operates about 1,300 clinics and employs over 2,300 primary care physicians. KHC also owns eight acute-care hospitals, three psychiatric hospitals and three geriatric hospitals. Approximately 75 per cent of Israel's population are insured through KHC, another 20 per cent through three smaller health insurance funds, while 5 per cent of the population is uninsured [6].At present, KHC has a centralized organizational structure: central management defines overall policy, allocates itemized budgets to its 14 districts and 14 hospitals, and supervises their activities. Each district has a district management responsible for the district's budget and for supervising its community clinics, specialty clinics, laboratories and diagnostic centres. District management is responsible for determining the drugs which physicians can prescribe, the hospitals and diagnostic centres to which they can refer patients, and clinic operating policy.The community clinics are staffed by physicians, nurses, administrators, pharmacists and, in some cases, specialists. Some clinics also operate a laboratory. The clinic itself is managed by a team comprising a physician, a nurse and an administrator. The clinics provide services, but have little autonomy. They do not determine staff employment, operating hours or the scope of services offered by the clinic, nor do they have any fiscal responsibility.Over the years, KHC' s deficit has grown and its membership has declined[7]. KHC' s decentralization programme is, in part, a response to mounting difficulties in containing costs, and increasing competition from other health insurance funds.The main objectives of decentralizing KHC clinics in the Negev district are to:(1) improve services, with the aim of increasing client satisfaction and attracting more members; (2) make more efficient use of existing resources by introducing budgetary responsibility at the clinic and physician levels; and (3) upgrade the functioning of clinic staff by increasing individual motivation, responsibility and initiative, and by improving morale.

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Management Practices, Physician Autonomy, and Satisfaction

Cited by 40 publications

References 16 publications

Workplace relational factors and physicians' intention to withdraw from practice

Workplace relational factors and physicians' intention to withdraw from practice

Organizational and Professional Predictors of Physician Satisfaction

Clinic Decentralization: An Israeli Model and Evaluation Strategy

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