Factors associated with internal medicine physician job attitudes in the Veterans Health Administration.

Autor: Mohr DC; Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA. David.Mohr2@va.gov.; Boston University School of Public Health, Boston, MA, USA. David.Mohr2@va.gov., Eaton JL; Department of Veterans Affairs, Office of Patient Care Services, Occupational Health Services, Washington, DC, USA., Meterko M; VA Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID -10EA), Field-based at the Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.; Boston University School of Public Health, Boston, MA, USA., Stolzmann KL; Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA., Restuccia JD; Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA.; Boston University Questrom School of Business, Boston, MA, USA.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2018 Apr 05; Vol. 18 (1), pp. 244. Date of Electronic Publication: 2018 Apr 05.
DOI: 10.1186/s12913-018-3015-z
Abstrakt: Background: US healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator. Further, many health care organizations also have an academically oriented mission. Physician involvement in research and teaching may lead to more positive workplace attitudes, with subsequent decreases in turnover and beneficial impact on patient care. This article aimed to understand the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among internal medicine physicians in the Veterans Health Administration (VHA).
Methods: A cross-sectional survey was conducted with inpatient attending physicians from 36 Veterans Affairs Medical Centers. Participants were surveyed regarding demographics, practice settings, workplace staffing, perceived quality of care, and job attitudes. Job attitudes consisted of three measures: overall job satisfaction, intent to leave the organization, and burnout. Analysis used a two-level hierarchical model to account for the nesting of physicians within medical centers. The regression models included organizational-level characteristics: inpatient bed size, urban or rural location, hospital teaching affiliation, and performance-based compensation.
Results: A total of 373 physicians provided useable survey responses. The majority (72%) of respondents reported some level of teaching involvement. Almost half (46%) of the sample reported some level of research involvement. Degree of research involvement was a significant predictor of favorable ratings on physician job satisfaction and intent to leave. Teaching involvement did not have a significant impact on outcomes. Perceived quality of care was the strongest predictor of physician job satisfaction and intent to leave. Perceived levels of adequate physician staffing was a significant contributor to all three job attitude measures.
Conclusions: Expanding opportunities for physician involvement with research may lead to more positive work experiences, which could potentially reduce turnover and improve system performance.
Databáze: MEDLINE
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