Nurses only #3 in affecting Physicians' Employment Satisfaction

  1. a national study of physicians' employment satisfaction

    by sabina b. gesell, for healthleaders, aug. 14, 2002

    in the wake of a decade of hospital cost and staffing cuts, healthcare executives are concerned about the effect of staff morale on service delivery.

    validating these concerns is recent research that shows declines in staff employment satisfaction are indeed accompanied by declines in patient satisfaction with the facility's service quality, according to a 2001 study conducted by press ganey associates for the advisory board company.

    because physicians control the clinical decision-making process, and thereby play a unique role in the patient's care experience and the hospital's reputation, their perceptions of hospital structure and processes, personnel and equipment matter to the success of healthcare delivery systems.

    to assess the current state of physician satisfaction with their current employment situation, press ganey associates conducted a study of 2,638 physicians working at 32 hospitals across the u.s. in 2001. physicians received a comprehensive, anonymous survey asking them to rate various aspects of the hospital administration, medical administration, inpatient admitting, discharge, nursing, surgery, ambulatory surgery, emergency department, administrative ancillary support services, pharmacy, and general facility issues.

    this report answers two specific research questions:

    how satisfied are physicians in their current employment situation?, and
    what can executives within the industry do to increase physician satisfaction?

    how satisfied are physicians in their current employment situation? the level of physician satisfaction is a score of 71 on a 100-point scale (figure 1), indicating that there is much room for improvement.

    see for figure 1 (free registration required)

    between 49% and 56% of the physicians surveyed gave the highest possible rating (very good) when asked to evaluate the likelihood that they would recommend their patients or other physicians to their hospital, and whether they would continue to practice there. these results suggest that approximately half of the physicians surveyed are loyal to their hospital, and conversely, that half of them are not.

    the results of the study are clear: physicians are most satisfied with the technical and interpersonal skills of their colleagues in surgery. they also expressed satisfaction with hospital volunteers. specifically, the highest ratings were given to:

    1. anesthesiologists' technical skills
    2. volunteers
    3. recovery nurses' technical skills
    4. nurse anesthetists' technical skills
    5. recovery nurses' interpersonal skills.

    physicians are least satisfied with the hospital administration. the specific issues with which they expressed the greatest dissatisfaction are:

    1. how well their hospital represents physicians' interests to hmos, ppos, etc.
    2. hospital administration's concern to limit recruitment of unneeded specialists
    3. hospital administration's openness to physician involvement in hospital policy/expansion decisions
    4. amenities for physician comfort
    5. operating room scheduling.

    although the issue of hospitals representing physicians' interests to hmos and ppos was the single lowest scoring issue in this survey, as it was in a similar study conducted in 1999, there has been a significant increase in physician satisfaction on this issue over the past two years.

    what can executives within the industry do to increase physician satisfaction? the most efficient change programs will first allocate improvement resources to the issues physicians are least satisfied with and deem most important in their overall evaluations of their employment situation (table 1).

    results suggest that the highest priorities for increasing physician satisfaction involve improving hospital administration's communication with the medical staff, increasing hospital administration's willingness to involve physicians in policy decisions, and improving administrative processes in surgery.

    table 1. national priority index for physician satisfaction

    1. communication to the medical staff
    2. administrative support in surgery
    3. operating room scheduling
    4.t imely notification of hospital policy or procedural changes
    5. openness to physician involvement in hospital policy/expansion decisions

    this national priority index provides a first glance of the current state of physician satisfaction and can be used to direct improvement efforts until internal data are available.

    averaging across hospitals, these are the specific issues that should be addressed first because they will be accompanied by the most dramatic increases in physician satisfaction.

    hospital executives who are fully committed to improving physician satisfaction at their facility will, however, direct improvement efforts not with national averages but with data specific to their own institution.

    asking physicians to systematically and constructively evaluate the hospital will convey that their input is important and it will highlight the hospital's strengths and weaknesses from the physicians' perspective.

    so as not to frustrate efforts it will be important to avoid the common pitfalls that will arise if the measurement process is poorly planned (by using tested surveys, surveying only once a year, giving ample notification, using tested techniques to maximize response rates, including physicians in the data collection and analysis processes, etc.). equally essential to the success of the initiative is having a plan of action in place to deal with survey results and using the data to guide improvement efforts and monitor successes.

    sabina b. gesell, phd, is senior research associate for press ganey associates. she may be reached at 615-292-5625 or

    still haven't worked out how to embed a graph .gif into a post here. edited link. also note this is one of press ganey's research pieces. have yet so see them do a nursing satisfaction piece.

    because physicians control the clinical decision-making process, and thereby play a unique role in the patient's care experience and the hospital's reputation...
    how about the 24/7 presence of nurses who, imho, make much more of an impact on a patient's satisfaction with a facility. that's why in homecare world i hear patient's choose one facility over another....another reason is patient's perception of how many family members /friends died in that facility (even if it was their time to die due to advanced illness).
    Last edit by NRSKarenRN on Aug 27, '02
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    About NRSKarenRN, BSN, RN Moderator

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  3. by   NurseGirlKaren
    Volunteers? How could volunteers rate above nurses?!?!?!?
  4. by   oramar
    This article comes off making doctors(at least surgeons) sound
    as if they think they are the sun and the rest of us are planets revolving around them.
  5. by   BBnurse34
    Wow lets not forget how important the amenities for physician's comfort is to the well being of our patients.

    Looks like if we want the docs to be happy with us we need to turn in our paychecks and volunteer........just like they would (yeah right)
  6. by   hapeewendy
    the poor doctors probably just got confused..
    give them a break , I mean nurses are a lot like volunteers and work for almost the same pay......
    just kidding
    thats pathetic.....
  7. by   spineCNOR
    Oramar--you've got it!!!!

    YES, the surgeons are the sun, and everyone else in the world are merely satellites revolving aroung them. You are wrong about one thing, though-- we nurses don't qualify as planets, maybe just large fragments of space dust.

    Honestly, not all surgeons are egocentric !*#*!s, but many of them are-- it is ALL ABOUT THEM, and nurses are useful to the degree that we can help the surgeons achieve their goals and make their lives easier.
  8. by   JailRN
    No, no, no, you've got it all wrong

    Volunteers can always stop-

    Slaves (nurses) have to be sold:roll :roll :roll