Article Figures & Data
Tables
AU
747CA
2,284FR
502DE
559NL
618NZ
503NO
864SE
2,905CH
1,065UK
1,001US
1,001Sex, female, % 37.0 43.8 35.0 44.3 45.3 45.0 40.0 51.5 32.9 49.1 39.9 Age, y, % <35 11.3 9.5 7.8 1.0 4.5 9.0 13.1 9.1 0.8 13.8 5.5 35-44 28.8 22.1 15.8 35.7 28.1 29.0 31.7 26.6 18.1 30.9 20.3 45-54 32.1 27.5 28.1 27.6 31.3 40.0 22.0 24.3 31.3 30.0 30.1 55-64 17.3 26.3 39.0 28.6 33.3 18.0 27.0 28.1 36.4 19.2 28.8 ≥65 10.5 14.5 9.3 7.1 2.7 4.0 6.2 11.8 13.5 6.2 16.1 Urban area, % 71.8 66.7 70.4 52.9 46.6 69.7 37.7 52.4 51.5 68.0 72.1 GPs FTE in the practice (median) 5 4 1 1 2 4 4 4 2 5 3 GP Satisfaction at work, % Very satisfied 35.1 29.3 9.2 11.5 16.6 33.0 39.5 26.9 27.6 13.6 19.0 Satisfied 53.0 55.0 57.1 52.1 67.8 53.5 52.4 48.5 58.7 53.2 46.5 Somewhat dissatisfied 10.8 14.5 24.0 30.5 14.6 12.1 7.5 20.5 11.7 29.0 28.6 Very dissatisfied 1.1 1.1 9.8 6.9 1.0 1.4 0.6 4.1 2.0 5.9 5.9 AU = Australia; CA = Canada; CH = Switzerland; DE = Germany; FR = France; FTE = full-time equivalent; GP = general practitioner; NL = Netherlands; NO = Norway; NZ = New Zealand; SE = Sweden; UK = United Kingdom; US = United States.
Note: Urbanity was self-reported.
Practice organizational & functioning features AU
747CA
2,284FR
502DE
559NL
618NZ
503NO
864SE
2,905CH
1,065UK
1,001US
1,001Consultation duration (median, min) 15 15 20 10 10 15 20 20 20 10 15 Weekly workload (median, hours) 40 40 50 50 45 36 40 40 48 44 45 Part dedicated to admin task (% total, median) 10 15 15 20 20 20 20 22 20 20 10 Offering home visits, % Frequently 25.1 19.5 56.1 57.1 88.3 20.6 20.3 24.7 42.8 84.0 6.0 Occasionally 59.6 49.4 34.2 30.0 11.7 74.8 77.8 70.1 45.4 15.1 28.6 No 25.1 31.1 9.7 13.0 0.0 4.6 2.0 5.2 11.8 0.8 65.4 Working with case manager, % In practice 75.4 42.9 12.9 20.6 83.0 83.0 31.8 75.8 8.4 87.4 43.9 External 6.2 21.5 83.3 6.8 14.9 7.4 33.9 9.8 52.2 8.3 22.8 No 18.4 35.6 3.8 72.2 2.1 9.6 34.3 14.4 39.3 4.3 33.3 Use of EHR, % 92.4 72.9 75.6 85.5 99.3 99.8 99.5 99.3 54.3 98.4 84.5 AU = Australia; CA = Canada; CH = Switzerland; DE = Germany; EHR = electronic health record; FR = France; NL = Netherlands; NO = Norway; NZ = New Zealand; SE = Sweden; UK = United Kingdom; US = United States.
- Table 3
Associations Between Work Dissatisfaction and Physician and Practice Characteristics
Physician Characteristics No. Single Independent Variables OR (CI 95%) Multiple Analysis Final Model OR (CI 95%) (N = 10’191) GP sex Male 6,693 Female 5,324 1.06 (0.94-1.22) 1.05 (0.90-1.22) GP age, y <35 1,162 35-44 2,921 1.01 (0.90-1.13) 1.02 (0.94-1.11) 45-54 3,155 1.35 (1.19-1.53) 1.32 (1.17-1.49) 55-64 3,561 1.27 (1.13-1.43) 1.25 (1.10-1.42) ≥65 1,230 0.69 (0.54-0.89) 0.67 (0.52-0.88) Rural/Urban area Rural 5,065 Urban 6,898 1.08 (0.98-1.18) 1.12 (1.03-1.22) Practice organizational & functional features Weekly workload (hours/week) ≤40 6,150 41-50 3,444 1.11 (0.97-1.26) 1.14 (1.01-1.27) >50 2,315 1.26 (1.09-1.47) 1.26 (1.12-1.42) Administrative task (% total workload) ≤10 4,044 11-20 3,957 1.10 (0.97-1.25) 1.14 (1.01-1.29) >20 3,839 1.55 (1.39-1.74) 1.55 (1.37-1.73) GP FTE in the practice 1 2,351 2 2,150 0.90 (0.78-1.05) 0.97 (0.80-1.17) 3-5 4,009 0.74 (0.64-0.86) 0.83 (0.69-0.99) 6-10 2,321 0.68 (0.52-0.88) 0.76 (0.60-0.96) >10 804 0.77 (0.55-1.06) 0.82 (0.62-1.08) Same-day appointment, % >50 7,704 About 50 1,607 1.20 (0.98-1.47) 1.15 (0.96-1.37) 20-40 1,275 1.51 (1.31-1.74) 1.49 (1.29-1.71) <20 1,047 2.01 (1.48-2.93) 1.83 (1.34-2.50) Home visits No 4,080 Yes 7,824 1.23 (1.11-1.36) 0.89 (0.83-0.96) Inter-visit contacts with patients No 1,493 Yes 10,427 0.72 (0.60-0.87) 0.83 (0.70-0.98) Information on clinical targets No 5,771 Yes 6,118 0.73 (0.59-0.91) 0.80 (0.66-0.98) Involved in coordinated care with hospital No 1,744 Yes 10,139 0.71 (0.63-0.80) 0.84 (0.76-0.93) Working with case manager No 2,914 Yes, external 2,759 0.92 (0.71-1.19) 1.01 (0.81-1.25) Yes, in practice 6,261 0.74 (0.62-0.90) 0.84 (0.75-0.95) Delay discharge ≤2 days 3,757 2 days-2 weeks 6,473 1.30 (1.15-1.47) 1.23 (1.07-1.41) 3-4 weeks 960 1.92 (1.64-2.25) 1.66 (1.39-1.98) >1 month or never 558 2.00 (1.79-2.23) 1.82 (1.52-2.19) Use of EHR No 1,621 Yes 10,364 0.78 (0.71-0.85) 0.82 (0.68-0.98) Electronic drug prescription alerts No 2,486 Yes, routinely 8,049 0.89 (0.73-1.07) 1.11 (0.89-1.38) Yes, occasionally 1,343 1.19 (0.99-1.44) 1.43 (1.17-1.75) Consultation duration 11,934 0.99 (0.97-1.01) ... Information about hospital admissions ... No 7,441 Yes 4,375 0.80 (0.70-0.91) Patient satisfaction surveys ... No 6,046 Yes 5,848 0.76 (0.63-0.92) Preventive targets to reach ... No 8,056 Yes 3,732 0.78 (0.66-0.93) Performance comparisons ... No 5,742 Yes 6,098 0.87 (0.76-1.00) Coordinated care with social workers ... No 709 Occasionally 5,218 0.77 (0.67-0.90) Routinely 6,016 0.62 (0.48-0.80) Contacts with home care provider ... Never 352 Occasionally 5,710 0.79 (0.62-1.00) Routinely 5,243 0.65 (0.49-0.87) Information on changes in patient health ... Never 316 Occasionally 4,903 0.79 (0.62-0.99) Routinely 6,117 0.59 (0.44-0.79) Country variance 0.35 EHR = electronic health record; FTE = full time equivalent; GP = general practitioner; OR = odds ratio.
Note: The final multivariate model was built in 2 steps: first, we retained from the univariate analyses, the variables associated at a P value of .2 or less. Next, we performed a manual, backward, stepwise selection (removal of the least significant variable at each step) to obtain a final model (variables associated at a P value ≤05).
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The Article in Brief
Practice Organization Characteristics Related to Job Satisfaction Among General Practitioners in 11 Countries
Christine Cohidon , and colleagues
Background Organizational and functional features of general practitioner practices in 11 countries were studied in search of underlying reasons for job dissatisfaction.
What This Study Found This was done by conducting a secondary analysis of 12,049 subjects in the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians. Job dissatisfaction was measured on a four-point Likert scale using the question: "How satisfied are you regarding your practicing of medicine?" The findings revealed dissatisfaction at work ranged from 8.1% in Norway to 37.4% in Germany. Greater dissatisfaction was noted among middle-aged (45 to 54 years old) GPs, those practicing in urban areas and those working alone. Also, high weekly workloads (greater than 50 hours), heavy administrative burdens, long delays in hospital discharge notices (greater than one month), and limited possibilities of offering same-day appointments added to the dissatisfaction.
Implications
- Using electronic health records and having an in-practice case manager were linked to higher satisfaction. Creating changes such as forming group practices, employing case managers, using electronic health records, and reducing workloads could reduce dissatisfaction levels.
