Study: As Patient Care Barriers Rise, Physician Satisfaction Falls

Physicians indicate that professional satisfaction relies heavily on the perception that they are providing quality care to their patients, according to a recently released study by the RAND Corporation.

"Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care, said internist Mark Friedberg, the study's lead author, in a press release for the AMA, the study's sponsor.

Overburdened physicians can feel like they are neglecting their patients, engendering dissatisfaction, fatigue, and early retirement, said AMA president and infectious disease specialist Ardis Dee Hoven, during an Oct. 8 webinar that presented the study results.

The study "Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy" assesses factors affecting physician satisfaction in light of industry changes being driven by health reform. The AMA's objective in commissioning the study was to advance new healthcare delivery and payment models that will restore physician satisfaction.

Researchers interviewed over 200 physicians, administrators, and clinical staff, from 30 medical practices in six states - Colorado, Massachusetts, North Carolina, Texas, Washington, and Wisconsin.

Another key finding was that physicians felt that EHRs were both a positive and negative factor in professional satisfaction. While saying that use of an EHR meant better access to patient data and better communication with other physicians and specialists, physicians overwhelmingly indicated that negative factors such as time spent in data entry, poor user interfaces, and interference with physician-patient interaction significantly altered their professional fulfillment.

One primary-care physician in the study said, "All of the EHRs that I've seen have actually been very time-consuming for physicians. Physicians have to order everything themselves … and do all the data entry themselves, which is time-consuming. EHRs at this point in their development are not time savers for physicians. They're big time sinks."

However, only 20 percent of surveyed physicians said they would prefer to return to paper charts. In light of the sense of frustration with current technology, the study authors recommended that rapidly improving EHR functionality should be made a high priority for all stakeholders.

Other findings mirrored prior studies on physician satisfaction:

• Greater physician control over work flow- both speed and the types of tasks performed - contributed to improved satisfaction.

• Physicians felt greater satisfaction when their values were aligned with practice leadership.

• Collegiality and respect are important drivers of physician satisfaction.

• Physicians are happiest when their work is well-matched to their training.

• Working with a well-trained staff contributed to high physician satisfaction.

• Income stability was an important component of physician satisfaction.

• Regulatory rules were cited as a significant part of physician dissatisfaction; especially "meaningful use" rules for EHRs.

• Physicians expressed uncertainty when asked how health reform affected their professional satisfaction.