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Physician, Practice, and Patient Characteristics Related to Primary Care Physician Physical and Mental Health: Results from the Physician Worklife Study

工作满意度 心理健康 结构方程建模 初级保健医师 家庭医学 医学 健康维护 医疗保健 质量(理念) 概念模型 护理部 心理学 初级保健 精神科 社会心理学 认识论 哲学 统计 经济 经济增长 数学
作者
Eric S. Williams,Thomas R. Konrad,Mark Linzer,Julia E. McMurray,Donald E. Pathman,Martha Gerrity,Mark D. Schwartz,William E. Scheckler,J. A. Douglas
出处
期刊:Health Services Research [Wiley]
卷期号:37 (1): 119-141 被引量:152
标识
DOI:10.1111/1475-6773.00007
摘要

Objective. To study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, and physical health. Data Sources. Based on a survey of over 5,000 physicians nationwide. Four waves of surveys resulted in 2,325 complete responses. Elimination of ineligibles yielded a 52 percent response rate; 1,411 responses from primary care physicians were used. Study Design. A conceptual model was tested by structural equation modeling. Physician job satisfaction and stress mediated the relationship between physician, practice, and patient characteristics as independent variables and physician physical and mental health as dependent variables. Principle Findings. The conceptual model was generally supported. Practice and, to a lesser extent, physician characteristics influenced job satisfaction, whereas only practice characteristics influenced job stress. Patient characteristics exerted little influence. Job stress powerfully influenced job satisfaction and physical and mental health among physicians. Conclusions. These findings support the notion that workplace conditions are a major determinant of physician well‐being. Poor practice conditions can result in poor outcomes, which can erode quality of care and prove costly to the physician and health care organization. Fortunately, these conditions are manageable. Organizational settings that are both “physician friendly” and “family friendly” seem to result in greater well‐being. These findings are particularly important as physicians are more tightly integrated into the health care system that may be less clearly under their exclusive control.

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