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Clinician satisfaction tied to healthy workplace, report says

Challenges of contemporary medicine, such as regulation, electronic medical records, a hectic pace and long hours, are dragging down doctors.

Jeff Lagasse, Associate Editor

About 26 percent aren't satisfied with their jobs, according to a new study published in Health Affairs, and a lot of their dissatisfaction has to do with work conditions that can ultimately be fixed.

What's more, these clinicians' employers may have a financial incentive for making their work conditions better. The research shows that clinicians who are unsatisfied are statistically more likely to leave their jobs, and turnover is costly -- a departing primary care clinician can cost between $250,000 and $500,000 to replace, between recruitment and ramping up costs for subspecialty clinicians.

[Also: Study: Healthcare demands taking toll on physician health, patient care]

As for what qualifies as an unsatisfying workplace, chaos, incohesiveness and lack of communication play a big part. Some of it is simply due to the challenges of contemporary medicine, such as regulation, electronic medical records, a hectic pace and long hours. Some medical leaders, the researchers said, have even started wondering about the long-term viability of certain front-line specialities, as many clinicians have been gravitating toward careers with a tradition of better work-life balance.

Chaos and a hectic pace were strong predictors of clinician dissatisfaction. In fact, the odds of satisfaction were 79 percent less if the workplace was chaotic. Such conditions contributed to stress, burnout and the intent to leave. In a follow-up, it was shown that clinicians were 2.9 times more likely to reduce their burnout if they were more satisfied, and 8.7 times more likely to stay in their current role.

[Also: Physician satisfaction is widespread, but raises and student loan help are hard to come by, survey says]

The prevalence of chaos in the workplace was striking. It existed in 40 percent of primary care practices involved in the study, and was associated with less teamwork and professionalism, and more bottlenecks -- such as during patient registration and check-out, over the phone and at the pharmacy. Chaotic clinics have also been found to have more medical errors, leading the researchers to promote more careful attention to work pace, as well as smooth and quiet clinical spaces that can facilitate better communication.

Naturally, the inverse of these trends held true: slower-paced, less chaotic environments were far more satisfying, as were practices with cohesion, good communication and high levels of trust.

And while the study didn't hone in on it specifically, it cited other research showing that higher rates of burnout are associated with increased medical errors, lower-quality outcomes in diabetic patients and lower patient satisfaction with care, as well as lower adherence to treatment recommendations.

To address the issue, the authors suggest a workflow redesign that emphasises quality over productivity, thereby leading to a more clinician-pleasing organizational structure.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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