Erin P O'Donnell1, Katherine M Humeniuk2, Colin P West3, Jon C Tilburt4. 1. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2. Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN. 3. Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 4. Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN; Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN. Electronic address: Tilburt.jon@mayo.edu.
Abstract
OBJECTIVE: To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians' perceptions of their professional responsibilities in a time of upheaval in health care. METHODS: From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment. RESULTS: A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9). CONCLUSION: Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians' perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment.
OBJECTIVE: To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians' perceptions of their professional responsibilities in a time of upheaval in health care. METHODS: From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment. RESULTS: A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9). CONCLUSION: Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians' perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment.
Authors: Elizabeth A Krupinski; Kevin S Berbaum; Kevin M Schartz; Robert T Caldwell; Mark T Madsen Journal: Acad Radiol Date: 2017-05-23 Impact factor: 3.173
Authors: Daniel S Tawfik; Jochen Profit; Timothy I Morgenthaler; Daniel V Satele; Christine A Sinsky; Liselotte N Dyrbye; Michael A Tutty; Colin P West; Tait D Shanafelt Journal: Mayo Clin Proc Date: 2018-07-09 Impact factor: 7.616
Authors: Teppo J Heikkilä; Harri Hyppölä; Jukka Vänskä; Tiina Aine; Hannu Halila; Santero Kujala; Irma Virjo; Markku Sumanen; Kari Mattila Journal: BMC Med Educ Date: 2015-10-05 Impact factor: 2.463