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Worklife and Satisfaction of Hospitalists: Toward Flourishing Careers

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ABSTRACT

BACKGROUND

The number of hospitalists in the US is growing rapidly, yet little is known about their worklife to inform whether hospital medicine is a viable long-term career for physicians.

OBJECTIVE

Determine current satisfaction levels among hospitalists.

DESIGN

Survey study.

METHODS

A national random stratified sample of 3,105 potential hospitalists plus 662 hospitalist employees of three multi-state hospitalist companies were administered the Hospital Medicine Physician Worklife Survey. Using 5-point Likert scales, the survey assessed demographic information, global job and specialty satisfaction, and 11 satisfaction domains: workload, compensation, care quality, organizational fairness, autonomy, personal time, organizational climate, and relationships with colleagues, staff, patients, and leader. Relationships between global satisfaction and satisfaction domains, and burnout symptoms and career longevity were explored.

RESULTS

There were 816 hospitalist responses (adjusted response rate, 25.6%). Correcting for oversampling of pediatricians, 33.5% of respondents were women, and 7.4% were pediatricians. Overall, 62.6% of respondents reported high satisfaction (≥4 on a 5-point scale) with their job, and 69.0% with their specialty. Hospitalists were most satisfied with the quality of care they provided and relationships with staff and colleagues. They were least satisfied with organizational climate, autonomy, compensation, and availability of personal time. In adjusted analysis, satisfaction with organizational climate, quality of care provided, organizational fairness, personal time, relationship with leader, compensation, and relationship with patients predicted job satisfaction. Satisfaction with personal time, care quality, patient relationships, staff relationships, and compensation predicted specialty satisfaction. Job burnout symptoms were reported by 29.9% of respondents who were more likely to leave and reduce work effort.

CONCLUSIONS

Hospitalists rate their job and specialty satisfaction highly, but burnout symptoms are common. Hospitalist programs should focus on organizational climate, organizational fairness, personal time, and compensation to improve satisfaction and minimize attrition.

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REFERENCES

  1. Pham HH, Devers KJ, Kuo S, Berenson R. Health care market trends and the evolution of hospitalist use and roles. J Gen Intern Med. 2005;20(2):101–7.

    Article  PubMed  Google Scholar 

  2. 2010 Media Kit. Society of Hospital Medicine; 2010 [updated 2010; cited 2011 April 12]; Available from: http://www.hospitalmedicine.org/AM/Template.cfm?Section=Home&CONTENTID=23077&TEMPLATE=/CM/ContentDisplay.cfm.

  3. U.S. Census Bureau: Physicians by Sex and Specialty: 1980 to 2007. [cited 2011 April 12]; Available from: http://www.census.gov/compendia/statab/2010/tables/10s0158.pdf.

  4. Hospital Medicine, Focused Practice. American Board of Internal Medicine; [cited 2011 April 12]; Available from: http://www.abim.org/specialty/hospital-medicine.aspx.

  5. Wachter RM, Goldman L. The hospitalist movement 5 years later. Jama. 2002;287(4):487–94.

    Article  PubMed  Google Scholar 

  6. Wachter RM. The state of hospital medicine in 2008. Med Clin North Am. 2008;92(2):265–73.

    Article  PubMed  Google Scholar 

  7. Schneller ES, Epstein KR. The hospitalist movement in the United States: agency and common agency issues. Health Care Manage Rev. 2006;31(4):308–16.

    PubMed  Google Scholar 

  8. Goldberg R, Boss RW, Chan L, Goldberg J, Mallon WK, Moradzadeh D, et al. Burnout and its correlates in emergency physicians: four years’ experience with a wellness booth. Acad Emerg Med. 1996;3(12):1156–64.

    Article  PubMed  CAS  Google Scholar 

  9. Guntupalli KK, Fromm RE Jr. Burnout in the internist-intensivist. Intensive Care Med. 1996;22(7):625–30.

    Article  PubMed  CAS  Google Scholar 

  10. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851–8.

    Article  PubMed  CAS  Google Scholar 

  11. McCook A. Tackling burnout before it’s too late. Today’s Hospitalist. 2004;11:2010.

    Google Scholar 

  12. Holton L. Put more than money on the table when recruiting hospitalists. American College of Physicians; 2007 [updated 2007; cited 2011 April 12]; Available from: http://www.acphospitalist.org/archives/2007/02/recruiting.htm.

  13. Konrad TR, Williams ES, Linzer M, McMurray J, Pathman DE, Gerrity M, et al. Measuring physician job satisfaction in a changing workplace and a challenging environment SGIM Career Satisfaction Study Group. Society of General Internal Medicine. Med Care. 1999;37(11):1174–82.

    Article  PubMed  CAS  Google Scholar 

  14. Williams ES, Konrad TR, Linzer M, McMurray J, Pathman DE, Gerrity M, et al. Refining the measurement of physician job satisfaction results from the physician worklife survey. Med Care. 1999;37(11):1140–54.

    Article  PubMed  CAS  Google Scholar 

  15. Scheurer D, McKean S, Miller J, Wetterneck T. US physician satisfaction: a systematic review. Journal of hospital medicine. 2009;4(9):560–8. An official publication of the Society of Hospital Medicine.

    Article  PubMed  Google Scholar 

  16. Linzer M, Manwell LB, Williams ES, Bobula JA, Brown RL, Varkey AB, et al. Working conditions in primary care: physician reactions and care quality. Ann Intern Med. 2009;151(1):28–U48.

    PubMed  Google Scholar 

  17. Colquitt JA. On the dimensionality of organizational justice: A construct validation of a measure. J Appl Psychol. 2001;86(3):386–400.

    Article  PubMed  CAS  Google Scholar 

  18. Yang CL, Carayon P. Effect of job demands and social support on worker stress—a study of VDT users. Behav Inform Technol. 1995;14(1):32–40.

    Article  Google Scholar 

  19. Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract. 1994;8(2):58–63.

    PubMed  CAS  Google Scholar 

  20. Rohland BM, Kruse GR, Rohrer JE. Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians. Stress Health. 2004;20(2):75–9.

    Article  Google Scholar 

  21. Wetterneck T, Linzer M, Gangnon RE, Auerbach AD, Kaboli P, Schnipper JL, et al. Burnout and intent to leave in academic hospitalist and non-hospitalist general medical ward attendings. J Gen Intern Med. 2005;20:141.

    Google Scholar 

  22. Xie JL. Karasek’s model in the People’s Republic of China: Effects of job demands, control, and individual differences. Acad Manage J. 1996;39(6):1594–618.

    Article  Google Scholar 

  23. Wetterneck TB, Linzer M, McMurray JE, Douglas J, Schwartz MD, Bigby J, et al. Worklife and satisfaction of general internists. Arch Intern Med. 2002;162(6):649–56.

    Article  PubMed  Google Scholar 

  24. Linzer M, Manwell LB, Mundt M, Williams ES, Maguire A, McMurray JE, et al. Organizational Climate, Stress, and Error in Primary Care: The MEMO Study. Advances in Patient Safety. 2005;1:65–77.

    Google Scholar 

  25. Lindenauer PK, Pantilat SZ, Katz PP, Wachter RM. Hospitalists and the practice of inpatient medicine: results of a survey of the National Association of Inpatient Physicians. Ann Intern Med. 1999;130(4 Pt 2):343–9.

    PubMed  CAS  Google Scholar 

  26. Auerbach AD, Nelson EA, Lindenauer PK, Pantilat SZ, Katz PP, Wachter RM. Physician attitudes toward and prevalence of the hospitalist model of care: results of a national survey. Am J Med. 2000;109(8):648–53.

    Article  PubMed  CAS  Google Scholar 

  27. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358–67.

    PubMed  Google Scholar 

  28. Carayon P, Hundt AS, Alvarado CJ, Springman SR, Ayoub P. Patient safety in outpatient surgery: The viewpoint of the healthcare providers. Ergonomics. 2006;49(5–6):470–85.

    Article  PubMed  CAS  Google Scholar 

  29. Fields DL. Taking the measure of work: a guide to validated scales for organizational research and diagnosis. Thousand Oaks: Sage Publications; 2002.

    Google Scholar 

  30. Caplan RD, Cobb S, French JRP, Van Harrison R, Penneau SR. Job demands and worker health. Ann Arbor: University of Michigan, Institute for Social Research; 1980.

    Google Scholar 

  31. AHA Hospital Statistics. American Hospital Association; 2009 [updated 2009; cited 2011 April 12]; Available from: http://www.ahadata.com/ahadata/html/AHAStatistics.html.

  32. Thorpe C, Ryan B, McLean SL, Burt A, Stewart M, Brown JB, et al. How to obtain excellent response rates when surveying physicians. Fam Pract. 2009;26(1):65–8.

    Article  PubMed  CAS  Google Scholar 

  33. Armstrong JS, Overton TS. Estimating nonresponse bias in mail surveys. J Marketing Res. 1977;14(3):396–402.

    Article  Google Scholar 

  34. McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K, et al. The work lives of women physicians—results from the physician work life study. J Gen Intern Med. 2000;15(6):372–80.

    PubMed  CAS  Google Scholar 

  35. Principles for a sustainable and successful hospitalist program. American Medical Association; [cited 2011 April 12]; Available from: http://www.ama-assn.org/ama1/pub/upload/mm/21/sustainable-hospitalist-program.pdf.

  36. Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L, Satele D, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250(3):463–71.

    PubMed  Google Scholar 

  37. Halpern SD, Hussen SA, Metkus TS, Ward NS, Luce JM, Curtis JR. Development of an e-mail database of US intensive care physicians. J Crit Care. 2007;22(1):28–31.

    Article  PubMed  Google Scholar 

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Acknowledgement

Supported in part by funding from Emcare, HCA Inc., In Compass Health, and SHM. Dr. Wetterneck was supported by K08-HS17014 from the Agency for Healthcare Research and Quality. Press-Ganey Associates assisted with survey layout and administration. The authors thank Kenneth A. Rasisnski and members of the SHM Career Satisfaction Task Force for their assistance in survey development. RJW is employed by Press Ganey Associates. JAM is employed by the Society of Hospital Medicine.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, 211 E. Ontario St, 7–727, Chicago, IL, 60611, USA

    Keiki Hinami MD, MS

  2. Loyola University Stritch School of Medicine, Forest Park, IL, USA

    Chad T. Whelan MD

  3. Press Ganey Associates, South Bend, IN, USA

    Robert J. Wolosin PhD

  4. Society of Hospital Medicine, Philadelphia, PA, USA

    Joseph A. Miller MS

  5. University of Wisconsin School of Medicine and Public Health and the Center for Quality and Productivity Improvement, University of Wisconsin, Madison, WI, USA

    Tosha B. Wetterneck MD, MS

Authors
  1. Keiki Hinami MD, MS
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  2. Chad T. Whelan MD
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  3. Robert J. Wolosin PhD
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  5. Tosha B. Wetterneck MD, MS
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Correspondence to Keiki Hinami MD, MS.

Additional information

(Supported by K08-HS17014 from the Agency for Healthcare Research and Quality) for the Society of Hospital Medicine Career Satisfaction Task Force

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Hinami, K., Whelan, C.T., Wolosin, R.J. et al. Worklife and Satisfaction of Hospitalists: Toward Flourishing Careers. J GEN INTERN MED 27, 28–36 (2012). https://doi.org/10.1007/s11606-011-1780-z

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  • DOI: https://doi.org/10.1007/s11606-011-1780-z

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