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Managed care and primary physician satisfaction.

David Grembowski1, Cornelia M Ulrich, David Paschane

  • 1Center for Cost and Outcomes Research, University of Washington, Seattle 98195, USA. grem@u.washington.edu

The Journal of the American Board of Family Practice
|December 4, 2003
PubMed
Summary
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Physician compensation, particularly salary, and larger group practices are linked to job dissatisfaction. These factors may reduce physician autonomy in managed care settings.

Area of Science:

  • Health Services Research
  • Medical Economics
  • Physician Workforce Studies

Background:

  • Investigated associations between physician compensation, financial incentives, care management tools, and primary physician satisfaction.
  • Utilized a conceptual model of physician satisfaction grounded in existing literature.

Purpose of the Study:

  • To determine if physician compensation, financial incentives, and care management tools impact primary physician job and referral satisfaction.
  • To identify key drivers of physician dissatisfaction within primary care settings.

Main Methods:

  • Cross-sectional survey administered to 495 primary care physicians in the Seattle metropolitan area in 1997.
  • Included family practitioners, general practitioners, and general internists.

Related Experiment Videos

Main Results:

  • Bivariate analyses indicated salary compensation, productivity bonuses, and referral withholds correlated with dissatisfaction.
  • Multivariate analysis revealed only salary payment remained significantly associated with job dissatisfaction.
  • Practicing in larger, multi-physician offices showed the strongest link to job dissatisfaction.

Conclusions:

  • Managed care features correlate with physician job and referral dissatisfaction.
  • Dissatisfaction may stem from employment in large medical groups, potentially limiting physician autonomy due to bureaucratic controls.