The role of the psychiatrist: job satisfaction of medical directors and staff psychiatrists.

In a previous survey of Columbia University Public Psychiatry Fellowship alumni, medical directors reported experiencing higher job satisfaction compared to staff psychiatrists. To further this inquiry, the authors conducted an expanded survey among the membership of the American Association of Community Psychiatrists (AACP). We mailed a questionnaire to all AACP members. Respondents categorized their positions as staff psychiatrist, program medical director or agency medical director, and rated their overall job satisfaction. The form also included a number of demographic and job characteristic items. Of 479 questionnaires mailed, a total of 286 individuals returned questionnaires (61%-12 forms were undeliverable). As in our previous survey, medical directors experience significantly higher job satisfaction compared to staff psychiatrists. Program and agency medical directors do not differ significantly. In addition, job satisfaction is strongly and negatively correlated with age for staff psychiatrists but not for medical directors. This survey strengthens the previously reported advantage medical directors have over staff psychiatrists regarding job satisfaction. The finding that job satisfaction decreases with increasing age of staff psychiatrists but not medical directors is particularly interesting, suggesting that staff psychiatrist positions may come to be regarded as "dead-end" over time. Psychiatrists are advised to seek promotions to program medical director positions early in their careers, since these positions are far more available, and provide equal job satisfaction, compared to agency medical director positions.