Article Figures & Data
Tables
Characteristic Physicians, No., Unweighted Physicians, %, Unweighted Physicians, %, Weighted Age, y <35 45 5.1 5.7 35-44 192 21.6 20.1 45-54 244 27.4 29.4 55-64 296 33.3 29.3 ≥65 110 12.4 15.5 Missing/Imputed 3 0.3 − Sex Female 345 38.8 39.1 Male 545 61.2 60.9 Practice environment City 345 38.8 41.0 Suburb 269 30.2 29.6 Small town 167 18.8 18.6 Rural 103 11.6 10.7 Missing/Imputed 6 0.7 − Year of graduation from residency Before 1986 222 24.9 26.5 1986-1995 229 25.7 25.0 1996-2003 221 24.8 25.9 2004 or later 206 23.1 22.6 Missing/Imputed 12 1.3 − Part of larger integrated provider system No 614 69.0 69.4 Yes 273 30.7 30.6 Missing/Imputed 3 0.3 − US region Northeast 206 23.1 21.9 Midwest 199 22.4 23.5 South 290 32.6 33.0 West 195 21.9 21.6 Missing/Imputed 0 0.0 − Medical specialty Family medicine/Medicine-pediatrics/General practice 448 50.3 42.8 Internal medicine 263 29.6 38.4 Pediatrics 179 20.1 18.8 Missing/Imputed 0 0.0 − Size (full-time equivalent clinicians) ≤1 238 26.7 28.2 >1 to 3 242 27.2 26.7 >3 to 7 191 21.5 20.8 >7 208 23.4 24.3 Missing/Imputed 11 1.2 − Frequency of caring for patients needing social services Often 325 36.5 36.6 Sometimes 399 44.8 45.4 Rarely 140 15.7 15.2 Never 23 2.6 2.7 Missing/Imputed 3 0.3 − Job satisfaction Very satisfied 156 17.5 18.1 Satisfied 411 46.2 46.8 Somewhat dissatisfied 264 29.7 29.0 Very dissatisfied 55 6.2 6.0 Missing/Imputed 4 0.4 − Job stress No stress 94 10.6 10.9 Moderately stressed 393 44.2 45.1 Very stressed 282 31.7 31.2 Extremely stressed 115 12.9 12.8 Missing/Imputed 6 0.7 − Satisfaction with income Very satisfied 137 15.4 15.5 Satisfied 449 50.4 51.0 Somewhat dissatisfied 209 23.5 23.2 Very dissatisfied 90 10.1 10.3 Missing/Imputed 5 0.6 − Satisfaction with income relative to specialists Very satisfied 59 6.6 7.1 Satisfied 187 21.0 22.0 Somewhat dissatisfied 358 40.2 41.1 Very dissatisfied 274 30.8 29.8 Missing/Imputed 12 1.3 − Satisfaction with amount of time spent with patients Very satisfied 69 7.8 8.5 Satisfied 392 44.0 45.0 Somewhat dissatisfied 330 37.1 36.7 Very dissatisfied 92 10.3 9.8 Missing/Imputed 7 0.8 − Believes patient medical care quality is improving No 663 74.5 74.8 Yes 225 25.3 25.2 Missing/Imputed 2 0.2 − Preparedness to manage patients in need of social services Well prepared/some- what prepared 293 32.9 33.7 Not prepared 597 67.1 66.3 Ease of care coordination Very easy/easy 326 36.6 37.5 Somewhat difficult/very difficult 564 63.4 62.5 Note: Characteristics are as reported by physicians.
- Table 2a
Odds of Physician Outcomes Based on Practice Prepared to Address Patients’ Social Needs (N = 890)
Outcome Practice is Well-Prepared to Address Patients With Social Needs Model 1 Model 2 Model 3 OR (95% CI) P Value OR (95% CI) P Value OR (95% CI) P Value Job satisfaction Very satisfied 2.22 (1.10-4.51) .03 2.21 (1.07-4.56) .03 3.23 (1.47-7.09) .004 Satisfied 1.44 (0.74-2.78) .28 1.43 (0.73-2.82) .30 2.05 (0.99-4.25) .053 Somewhat dissatisfied 1.24 (0.63-2.45) .53 1.18 (0.59-2.36) .64 1.61 (0.77-3.37) .21 Very dissatisfied Ref − Ref − Ref − Job stress No stress 1.04 (0.57-1.89) .90 0.99 (0.54-1.83) .98 1.45 (0.76-2.73) .26 Moderately stressed 0.81 (0.52-1.29) .38 0.82 (0.51-1.30) .40 1.02 (0.62-1.70) .93 Very stressed 0.99 (0.62-1.58) .96 1.03 (0.64-1.66) .89 1.10 (0.67-1.81) .71 Extremely stressed Ref − Ref − Ref − Satisfaction with income Very satisfied 1.87 (1.03-3.37) .04 2.02 (1.08-3.80) .03 1.81 (0.92-3.58) .09 Satisfied 1.32 (0.78-2.21) .30 1.38 (0.80-2.39) .25 1.38 (0.78-2.44) .27 Somewhat dissatisfied 1.26 (0.72-2.21) .43 1.30 (0.72-2.35) .39 1.21 (0.65-2.25) .54 Very dissatisfied Ref − Ref − Ref − Satisfied with income relative to specialists Very satisfied 2.22 (1.21-4.07) .01 2.22 (1.18-4.16) .01 1.91 (0.92-3.96) .08 Satisfied 1.13 (0.74-1.72) .57 1.08 (0.70-1.66) .73 1.03 (0.64-1.66) .89 Somewhat dissatisfied 1.17 (0.82-1.66) .39 1.16 (0.80-1.68) .43 1.17 (0.79-1.73) .43 Very dissatisfied Ref − Ref − Ref − Satisfied with amount of time spent with patients Very satisfied 2.65 (1.35-5.20) .005 2.36 (1.17-4.75) .02 2.86 (1.37-6.00) .005 Satisfied 1.06 (0.64-1.76) .82 0.98 (0.58-1.64) .93 1.34 (0.77-2.34) .30 Somewhat dissatisfied 1.09 (0.65-1.83) .74 1.04 (0.61-1.76) .89 1.20 (0.69-2.08) .52 Very dissatisfied Ref − Ref − Ref − Patient medical care received is improving 1.75 (1.26-2.42) .001 1.79 (1.28-2.52) .001 1.72 (1.19-2.49) .004 OR = odds ratio; Ref = reference group.
Notes: Using multiple imputation for all missing variables except sex and outcome variables. Model 1 covariates: none. Model 2 covariates: age, sex, era training completed, specialty, clinic location, region of country, clinic part of integrated provider network, full-time equivalent clinicians in practice. Model 3 covariates: model 2 covariates plus frequency practice sees patients with social needs.
Additional Files
Supplemental Table
Supplemental Table
Files in this Data Supplement:
- Supplemental data: Table - PDF file
The Article in Brief
Practice Capacity to Address Patients' Social Needs and Physician Satisfaction and Perceived Quality of Care
Matthew S. Pantell , and colleagues
Background Recent research suggests that addressing patients' social circumstances can not only benefit patients and reduce health care costs; it might also decrease clinicians' symptoms of burnout. The current study explores that possibility on a larger scale. Using a large health policy survey, researchers explore associations between clinic capacity to address patients' social and economic needs and physician job satisfaction, stress, and perception of medical care quality.
What This Study Found Primary care physicians who practice in a setting prepared to manage patients with social needs have significantly higher job satisfaction than other physicians. Among 890 US physicians responding to the Commonwealth Fund's 2015 International Health Policy Survey of Primary Care Doctors, those who reported working in a practice able to manage patients' social needs had significantly higher job satisfaction, were more satisfied with amount of time spent with patients, and thought that the quality of medical care patients receive had improved. Feeling that it was easy to coordinate patients' care with social services or other community resources was also significantly associated with higher job satisfaction, personal and relative income satisfaction, satisfaction with amount of time spent with patients, and outlook on patients' quality of medical care.
Implications
- The authors call on health systems to include clinician satisfaction, which is closely tied to issues of burnout and retention, in their calculations of the costs and benefits of responding to patients' social needs.
In this issue
Jump to section
Related Articles
Cited By...
- Mise en {oelig}uvre dinterventions sociales en soins de sante primaires
- Sams Story: The Financial and Human Costs of Disjointed Logics of Care
- Implementing social interventions in primary care
- Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review
- Capacity to Address Social Needs Affects Primary Care Clinician Burnout
- In This Issue: Humans of Primary Care Research