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Primary care physician job satisfaction and turnover
S B Buchbinder1, M Wilson, C F Melick
1Healthcare Management Program, Department of Health Science, Towson University, 8000 York Rd, Towson, MD 21252-0001, USA. sbuchbinder@towson.edu
The American Journal of Managed Care
|July 24, 2001
Summary
Job dissatisfaction and beliefs about third-party payers significantly predict primary care physician (PCP) turnover. Understanding these factors is crucial for retaining PCPs in practice.
Area of Science:
- Medical Economics
- Health Services Research
- Physician Workforce Studies
Background:
- Physician turnover presents a significant challenge to healthcare systems, impacting patient care continuity and practice stability.
- Understanding the drivers of primary care physician (PCP) turnover is essential for developing effective retention strategies.
Purpose of the Study:
- To investigate the association between personal characteristics, organizational factors, and job satisfaction with PCP turnover.
- To identify key predictors of PCP attrition to inform policy and practice.
Main Methods:
- A longitudinal cohort study of 507 early-career, non-federal PCPs surveyed in 1987 and 1991.
- Analysis of job satisfaction, perceived payer influence, and practice characteristics as predictors of subsequent turnover.
- Bivariate and multivariate statistical analyses were employed.
Main Results:
- Over half (55%) of PCPs changed practices between 1987 and 1991, with 20% changing employers twice.
- Job dissatisfaction in 1987 was a strong predictor of turnover (OR=2.38, P < .001).
- Beliefs about decreasing third-party payer influence (OR=1.29, P < .03), non-board certification (OR=1.3, P < .003), and overuse of standardized protocols (OR=1.18, P < .05) were also associated with higher turnover.
Conclusions:
- PCP turnover is a substantial issue, particularly among early-career physicians.
- Job satisfaction emerges as a critical factor influencing PCP retention.
- Findings offer insights for policymakers and healthcare organizations to mitigate PCP turnover.
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