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How Strategies for Managing Patient Visit Time Affect Physician Job Satisfaction: A Qualitative Analysis

Journal of General Internal Medicine volume 23, pages 775–780 (2008)Cite this article

Abstract

BACKGROUND

There is much physician discontent regarding policies that limit time for patient visits and contribute to physician dissatisfaction with the medical profession as a whole. Yet little is known about how physician strategies for managing time limits correspond to job satisfaction.

OBJECTIVE

The goal of this study was to identify strategies physicians use for managing time with patients and the effects these strategies have on job satisfaction.

DESIGN

In-depth interviews with primary care providers in various clinical settings (academic medical centers, community-based centers, solo practices, nonacademic group practices) were audiorecorded.

PARTICIPANTS

Primary care physicians (n = 25).

APPROACH

Transcribed audiorecordings of physician interviews were coded using a modified grounded theory approach. An open coding process was used to identify major themes, subthemes, and the interrelationships among them.

RESULTS

Three main themes emerged. (1) Study physicians disregarded time limits despite the known financial consequences of doing so and justified their actions according to various ethical- and values-based frameworks. (2) Disregarding time limits had a positive impact on job satisfaction in the realm of direct patient care. (3) The existence of time limits had a negative impact on overall job satisfaction.

CONCLUSION

For the study physicians, disregarding time limits on patient visits is an adaptive short-term strategy that enhances satisfaction with direct patient care. It is unlikely that such a strategy alone will help physicians cope with their broader—and growing—dissatisfaction with the profession.

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Acknowledgments

The research upon which this study is based was supported by a grant from the Jeffrey Epstein Fund. The views expressed in this article are those of the author and do not necessarily represent the views of the Department of Veterans Affairs. I would like to thank Barbara Bokhour and Paul Haidet for their comments on earlier drafts of this paper. I also would like to thank Howard Gardner, principal investigator of the Good Work Project, for his permission to use data from the study for the analysis in this paper. I would like to acknowledge the other researchers who conducted interviews for the study: Carrie James, Seth Wax, and Laura Horn. And finally, many thanks to Carrie James for her help in compiling the demographic information relevant to the study.

Conflicts of Interest

None disclosed.

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Authors and Affiliations

  1. Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA

    Jeffrey Solomon PhD

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  1. Jeffrey Solomon PhD
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Correspondence to Jeffrey Solomon PhD.

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Solomon, J. How Strategies for Managing Patient Visit Time Affect Physician Job Satisfaction: A Qualitative Analysis. J GEN INTERN MED 23, 775–780 (2008). https://doi.org/10.1007/s11606-008-0596-y

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  • DOI: https://doi.org/10.1007/s11606-008-0596-y

Key words

  • physicians
  • job satisfaction
  • time constraints
  • professionalism
  • physician–patient relationships