Survey finds employed doctors mostly satisfied with their jobs

Physicians with jobs at hospitals or large health systems appear to be pretty happy with their employers.

On a scale of one to five, employed physicians’ engagement — their level of satisfaction with their employers and co-workers — was 4.12 in 2011, according to a research brief released May 14 by Morehead Associates, a health care consulting firm in Charlotte, N.C., that advises institutions on physician relations. A five indicates strong agreement, and a one means strong disagreement.

Despite a slight drop from 4.17 in 2010, “the 2011 average physician score of 4.12 is still a high engagement score,” Morehead reported in “The State of Staff Physician Engagement: 2011 in Review.”

The report analyzed 1.4 million survey responses from thousands of employed doctors. The company did not reveal how many doctors were queried. Some were asked 10 questions about their employment experience, while others were asked more than 100.

People who advise hospitals and large health systems about physician relations say engagement is important to retain and maintain the productivity of the growing number of directly employed doctors. The count of physicians and dentists with full-time jobs at community hospitals increased from 62,152 in 1998 to 91,282 in 2010, according to the American Hospital Assn.

Alignment also is viewed as crucial to achieving quality measures that come into play as part of the rollout of the Patient Protection and Affordable Care Act.

“Physicians are getting smarter and savvier about where they want to be,” said Barbara Reilly, PhD, senior vice president of science and research for Morehead. “Hospitals, in turn, have to be a little more nimble and quicker to respond to physician needs to keep the physician engaged and attracted to their organization.”

The Morehead survey found that health care institutions were doing better in some areas than others. The majority of physicians strongly agreed that their hospital provided high-quality care and service. The question scored 4.23 in 2010 and 2011. They also would recommend their institution to family and friends. This question hit 4.25 in 2010 and 4.24 in 2011.

Researchers, however, expressed concern about several numbers that were not that high and heading downward. The overall score for agreement with the statement, “If I am practicing medicine three years from now, I am confident that I will be practicing at this hospital” went down from 4.05 in 2010 to 3.94 in 2011. When physicians were asked in 2011 about their satisfaction with the efficiency of ambulatory services, the score was 3.09 in 2011, the lowest scoring item. Data on this question for 2010 are not available.

On the question of whether physicians believe they have input in decisions, the score was 3.36 in 2010 and dipped to 3.30 in 2011. Satisfaction with the scheduling process fell the most, from 3.76 in 2010 to 3.43 in 2011. The rating for senior management responding to physician feedback declined from 3.39 in 2010 to 3.37 in 2011.

“Every doctor I have talked to in the last five years has felt that they have not been communicated with in the way they would like,” said Ken E. Mack, a consultant based in Cleveland who counsels health systems on physician integration.

Consultants suggest that these issues can be addressed if employed physicians and health systems develop relationships based on partnership rather than employment status.

“Physicians are not typical employees,” Reilly said. “If a hospital treats a physician as a typical employee, it’s not going to work out well for either party.”

This may include health systems developing strategies to nurture physician leadership skills and improving one-on-one communication.

Increasing physician engagement, however, is not wholly on the shoulders of hospitals and health systems, said Marc D. Halley, president and CEO of Halley Consulting Group based in Westerville, Ohio, who works with medical practices on hospital alignment. Physicians who want to do well in these types of jobs may need to take some initiative as well as increase their participation in the running of the institution.

“Many physicians say, ‘I don’t want anything to do with the business side of medicine.’ That’s a prescription for failure,” Halley said. “Physicians need to be engaged with everything going on.”