Modeling factors explaining physicians’ satisfaction with competence

Abstract

Objective:Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians’ self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity.Methods:Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions.Results:The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = −.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians’ perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians.Conclusion:Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians.

The effects of distress and the dimensions of coping strategies on physicians’ satisfaction with competence

“…Coping, complementary to Distress, was measured using 15 items scored on the same 7-point scales. 5 Control variables were Years in Practice, Self-Reported Health, and Duties of Physicians. Self-Reported Health used a 5-point scale ranging from very poor to very good, and was included because it was significantly correlated with Distress and Coping, yet sufficiently independent from both.…”

“…3 Daily Distress was used in the companion study and in this analysis. 5 In Canada, 13% of physicians reported very high levels of Distress, with 14.3% of female physicians and 17% of general practitioners reporting very high levels of Distress. 3 About 15% of physicians in the United States 23 and the United Kingdom 24 suffer from mental illness, alcoholism, and/or substance abuse which at some point prevents fulfillment of professional obligations.…”

“…34 In a study of physicians in Western Canada, Lemaire and Wallace 26 found that collegial advice, planning tasks, setting priorities, and being optimistic were associated with lower levels of emotional exhaustion. This national study hypothesized for the first time the existence of four factors of Coping strategies: Collegiality, Managing Work, Self-Care, and Positive Attitude within the 15-item Coping measure reported in the companion study 5 and used in this analysis.…”

“…2 Effectively meeting the diverse demands of professional practice is important to physicians 3,4 and the companion article "Modeling factors explaining physicians' satisfaction with competence (SwC)" established SwC as an integral part of career satisfaction. 5 In striving to meet the demands of practice, however, physicians also experience considerable stress. 3,4 Physicians have used many ways to cope with the pressures of practicing medicine, most prominently collegial support; 6 however, there is little evidence on whether Coping methods alleviate Distress or positively influence SwC.…”

“…2 Effectively meeting the diverse demands of professional practice is important to physicians 3,4 and the companion article “Modeling factors explaining physicians’ satisfaction with competence (SwC)” established SwC as an integral part of career satisfaction. 5…”