Right mix of responsibilities can elevate doctors' job satisfaction, say researchers

Researchers have identified a simple way for teaching hospitals to elevate doctors' job satisfaction and improve retention: make sure the doctors have the right mix of responsibilities.

The researchers set out to see if doctors were leaving academic medicine because they spent too much time seeing patients. But that wasn't the case: The researchers found no link between the time doctors spent on patient care and intent to leave their institution. Instead, the researchers found, doctors became dissatisfied when they felt their work was out of balance. "We looked at how much time clinicians spent in each mission area  - teaching, research, patient care and administration - as well as how they felt about how much time they spent in each area," explained Susan M. Pollart, MD, of the University of Virginia School of Medicine. "For every mission area, if you thought you were spending too much time doing work in that area, you were more likely to leave."

The researchers reviewed data from more than 8,000 doctors nationwide surveyed as part of the 2011-12 Faculty Forward Engagement Survey. Their goal was to determine what prompts some doctors to leave their institution and the field of academic medicine. "It's been hypothesized that if an academic clinician spends 90 percent of his or her time seeing patients, they are more likely to leave academic medicine to do that in private practice," Pollart said. "We wanted to ask, is how much time you actually spend seeing patients driving your decision to leave? Or is it something else?"

Perception, it turned out, was key. By recognizing that different physicians have different interests and priorities, academic hospitals can work with individual faculty members to find the right mix of clinical, teaching and administrative responsibilities, Pollart said.

"The message to us, then, is when faculty have an annual review, there needs to be a conversation: How are you spending your time, and are you spending it the right way? Are you spending the right amount of time teaching, the right amount of time seeing patients, the right amount of time in the various aspects of your job?" she said. "We don't know if adjusting those will reduce the number of people who leave. It's possible it will. It's possible that just asking the question will reduce the number of people who leave.  … And it at least suggests people should be asked, how do you feel about the way you are spending your time?"

In a separate study, Pollart and other researchers looked at the engagement and satisfaction of 674 part-time faculty members at U.S. medical schools. Men, they found, worked part-time most often to accommodate other jobs and professional obligations, while women worked part-time most often because of family responsibilities. Pollart herself worked part-time at the School of Medicine while raising her children and has gone on to become senior associate dean for faculty affairs and faculty development. It's critically important, she said, for medical schools to appreciate the potential of their part-time employees, to present them with opportunities and to keep them engaged. Doing so, she said, can build lasting bonds that pay major dividends in the years to come.

Both studies have been published online by Academic Medicine, a journal of the Association of American Medical Colleges.