Physician satisfaction with capitation patients in an academic family medicine clinic

Physician work satisfaction may play an important role in the management and quality of health care, yet cost-containment measures may compromise levels of physician satisfaction. This article reports an evaluation of physician attitudes toward aspects of capitation plans that may place the physician in conflict with the physician's traditional role. The literature was reviewed in an effort to generate a list of constructs that would be relevant to physician work satisfaction. By using constructs that focus on both physician work satisfaction and capitation, a survey instrument was developed and serially administered to physicians involved directly in a capitation program. Among the five dimensions studied, providers rated capitation patients more favorably in only one area: interpersonal relationships. Providers indicated a preference for noncapitation patients in the dimensions of autonomy, intellectual stimulation, time restraints, and structural variables. Furthermore, physicians' satisfaction levels with capitation patients tended to decrease the longer they cared for them. These findings are consistent with expectations, and lend support to the hypothesis that organizational constraints may have an adverse effect on physician attitudes toward selected aspects of caring for capitation patients.