Physicians are satisfied with most aspects of their work. Those who trained in the specialism of their choice are more satisfied than those who did not. Job satisfaction among physicians varies according to career stage, sex and specialism. They are least satisfied with aspects relating to the organization of their work. These are the conclusions of a thesis by UMCG PhD candidate Lodewijk Schmit Jongbloed on job satisfaction among physicians in the Netherlands. He will be awarded a PhD by the University of Groningen on 6 November.
Schmit Jongbloed studied physicians' satisfaction with various aspects of their work and how their satisfaction developed in the period 2000–2009. The aim of his research was to gain a better understanding of job satisfaction among physicians, factors that influence this and how to improve job satisfaction. From the medical-sociological literature, he defined 13 aspects that determine job satisfaction; these are representative and comprehensive enough to determine job satisfaction among physicians.
Physicians who were able to train in their preferred specialism proved to be more satisfied with professional accomplishments, appreciation from support personnel and appreciation from patients than their peers who did not. One in four medical school graduates does not manage to secure a place on a training programme in their preferred specialism. A major cause of this is the disproportionate level of interest in a limited number of clinical specialities. More variation in the preferred specialism training of medical school graduates would therefore be desirable. Schmit Jongbloed calls for a study into whether decentralized selection can be used to attract students with the skills required for less popular specialities. This has been done in the past with veterinary medicine.
The career stage of physicians causes differences in job satisfaction. Physicians at the end of their careers are more satisfied with appreciation from patients but less satisfied with appreciation from support personnel and income compared with physicians at the beginning and in the middle of their careers. Schmit Jongbloed believes that older physicians may be more satisfied with appreciation from patients because they have built up long-term relationships with their patients. What is more, less satisfied patients will probably have found another physician. The older physicians may be less satisfied with appreciation from support personnel because of generational differences in working styles. Younger physicians are more used to working on an equal footing with nurses, physician assistants, assistant practitioners and other care professionals.
Schmit Jongbloed also showed that 'sex' and 'specialism' influence physicians' level of satisfaction with various aspects of their work. Clinical specialists proved less satisfied with balance work-private hours than general practitioners and physicians in other roles. This probably relates to the higher number of night and weekend shifts that they have to work. The physicians said that part-time work had a positive effect on their satisfaction with the aspects control over work planning and balance work-private hours. This better balance seems to be a good reason to aim for a working week of four days on average. However, a working week that is any shorter has a negative effect on satisfaction with professional accomplishments. As female physicians work fewer hours than male physicians, this might explain why they are less satisfied with professional accomplishments than their male counterparts. This could also be the reason why part-time female physicians in particular try to increase their working hours. Schmit Jongbloed notes that allowing people to increase or reduce their working hours increases their job satisfaction and does not result in too few or too many physicians. It can thus have a positive effect on the quality of care.
Less satisfied with administrative work
Three aspects – control over work planning, administrative work and cooperation with management – scored lowest among the physicians. It is precisely these aspects that are taking up more of their working hours. Schmit Jongbloed calls for further research into the possibility of transferring administrative and organizational work to specially trained support staff (medical scribes). This has been positively received in the US. He also believes that physicians should acquire organizational skills – they are an aspect of their work and will help them deal with the increased complexity in health care. He advises devoting more time to this during training.
Schmit Jongbloed believes that his research shows that a tailored approach is required to increase the job satisfaction among physicians. He therefore concludes that there is no point in taking a 'one size fits all' approach, but that one should instead take career phase, sex and specialism into account.
Lodewijk Schmit Jongbloed (1956) studied medicine and business administration at Erasmus University Rotterdam. He conducted his research at the SHARE research institute of the University Medical Center Groningen. His thesis is entitled 'Physician job satisfaction in the Netherlands'. He is director/owner of two companies: Schmit Jongbloed Advies and Baromed. To share his research findings with the wider public Schmit Jongbloed has made a podcast and a video in which he summarizes the findings in layperson's terms.