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1.
To determine physician characteristics associated with the use of bone densitometry (BD), we conducted a cross-sectional survey of primary care practitioners in an urban community hospital. Participants were internists, geriatricians, and family practitioners. Seventy-two percent of the physicians never used BD. There was no association between physician or practice characteristics and BD use. Bone densitometry users were more likely than nonusers to treat their patients with osteoporosis or at risk of developing it. Self-reported barriers to use included cost, unfamiliarity with guidelines, uncertainty with clinical applicability, minimal impact on treatment decisions, and availability. In conclusion, although it has been shown that osteoporotic women who are aware of their BD results are more likely to accept treatment, further attention should be paid to primary care practitioners' attitudes, knowledge, and behavior regarding the use of BD in the management of osteoporosis.
KEY WORDS: bone densitometry; osteoporosis; physician knowledge; attitudes; behaviors. 相似文献
KEY WORDS: bone densitometry; osteoporosis; physician knowledge; attitudes; behaviors. 相似文献
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Does physician gender affect satisfaction of men and women visiting the emergency department? 下载免费PDF全文
OBJECTIVE: To assess the association of physician gender with patient ratings of physician care. DESIGN: Interviewer-administered survey and follow-up interviews 1 week after emergency department (ED) visit. SETTING: Public hospital ED. PATIENTS/PARTICIPANTS: English- and Spanish-speaking adults presenting for care of nonemergent problems; of 852 patients interviewed in the ED who were eligible for follow-up, 727 (85%) completed a second interview. MEASUREMENTS AND MAIN RESULTS: We conducted separate ordered logistic regressions for women and men to determine the unique association of physician gender with patient ratings of 5 interpersonal aspects of care, their trust of the physician, and their overall ratings of the physician, controlling for patient age, health status, language and interpreter status, literacy level, and expected satisfaction. Female patients trusted female physicians more (P =.003) than male physicians and rated female physicians more positively on the amount of time spent (P =.01), on concern shown (P =.04), and overall (P =.03). Differences in ratings by female patients of male and female physicians in terms of friendliness (P =.13), respect shown (P =.74), and the extent to which the physician made them feel comfortable (P =.10) did not differ significantly. Male patients rated male and female physicians similarly on all dimensions of care (overall, P =.74; friendliness, P =.75; time spent, P =.30; concern shown, P =.62; making them feel comfortable, P =.75; respect shown, P =.13; trust, P =.92). CONCLUSIONS: Having a female physician was positively associated with women's satisfaction, but physician gender was not associated with men's satisfaction. Further studies are needed to identify reasons for physician gender differences in interpersonal care delivered to women. KEY WORDS: patient satisfaction; gender; physician-patient relations; delivery of care; health care quality. 相似文献
4.
Waterman AD Banet G Milligan PE Frazier A Verzino E Walton B Gage BF 《Journal of general internal medicine》2001,16(7):460-463
OBJECTIVES: To compare the satisfaction and knowledge of patients who have their warfarin managed by their physician or by a multidisciplinary, telephone-based anticoagulation service (ACS) and to assess referring physicians' satisfaction with the ACS. DESIGN AND PARTICIPANTS: We surveyed 300 patients taking warfarin (mean age 73 years): 150 at health centers randomized to have access to an ACS, and 150 at control health centers without ACS access. We also surveyed 17 physicians who refer patients to the ACS. SETTING: Eight outpatient health centers in Missouri and Southern Illinois. MEASUREMENTS: We asked patients about the timeliness of international normalized ratio (INR) monitoring, perceived safety of warfarin, overall satisfaction with their warfarin management, and knowledge of what a high INR meant. We asked physicians at ACS-available health centers how many minutes they saved per INR by referring patients to the ACS, their satisfaction with the ACS, and their willingness to recommend the ACS to a colleague. MAIN RESULTS: As compared with patients at control health centers, patients at ACS-available health centers were more satisfied with the timeliness of getting blood test results (mean 4.31 vs 4.03, P =.02), were more likely to know what a safe INR value was (45% vs 15%, P =.001), and felt safer taking warfarin (mean 5.7 vs 5.2, P =.04). Physicians reported that using the ACS saved, on average, four minutes of their time and 13 minutes of their staff's time, per INR. All physicians recommended use of the ACS to a colleague and were highly satisfied with the ACS. CONCLUSIONS: A telephone-based ACS can be endorsed by primary-care physicians and improve patients' satisfaction with and knowledge about their antithrombotic therapy. 相似文献
5.
Swenson SL Buell S Zettler P White M Ruston DC Lo B 《Journal of general internal medicine》2004,19(11):1069-1079
OBJECTIVE: To investigate patient preferences for a patient-centered or a biomedical communication style. DESIGN: Randomized study. SETTING: Urgent care and ambulatory medicine clinics in an academic medical center. PARTICIPANTS: We recruited 250 English-speaking adult patients, excluding patients whose medical illnesses prevented evaluation of the study intervention. INTERVENTION: Participants watched one of three videotaped scenarios of simulated patient-physician discussions of complementary and alternative medicine (CAM). Each participant watched two versions of the scenario (biomedical vs. patient-centered communication style) and completed written and oral questionnaires to assess outcome measurements. MEASUREMENTS AND MAIN RESULTS: Main outcome measures were 1) preferences for a patient-centered versus a biomedical communication style; and 2) predictors of communication style preference. Participants who preferred the patient-centered style (69%; 95% confidence interval [CI], 63 to 75) tended to be younger (82% [51/62] for age < 30; 68% [100/148] for ages 30-59; 55% [21/38] for age > 59; P < .03), more educated (76% [54/71] for postcollege education; 73% [94/128] for some college; 49% [23/47] for high school only; P= .003), use CAM (75% [140/188] vs. 55% [33/60] for nonusers; P= .006), and have a patient-centered physician (88% [74/84] vs. 30% [16/54] for those with a biomedical physician; P < .0001). On multivariate analysis, factors independently associated with preferring the patient-centered style included younger age, use of herbal CAM, having a patient-centered physician, and rating a "doctor's interest in you as a person" as "very important."CONCLUSIONS: Given that a significant proportion of patients prefer a biomedical communication style, practicing physicians and medical educators should strive for flexible approaches to physician-patient communication. 相似文献
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Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection 总被引:3,自引:0,他引:3 下载免费PDF全文
Schneider J Kaplan SH Greenfield S Li W Wilson IB 《Journal of general internal medicine》2004,19(11):1096-1103
BACKGROUND: There is little evidence to support the widely accepted assertion that better physician-patient relationships result in higher rates of adherence with recommended therapies. OBJECTIVE: To determine whether and which aspects of a better physician-patient relationship are associated with higher rates of adherence with antiretroviral therapies for persons with HIV infection. DESIGN: Cross-sectional analysis. SETTING: Twenty-two outpatient HIV practices in a metropolitan area. PARTICIPANTS: Five hundred fifty-four patients with HIV infection taking antiretroviral medications. MEASUREMENTS: We measured adherence using a 4-item self-report scale (alpha= 0.75). We measured core aspects of physician-patient relationships using 6 previously tested scales (general communication, HIV-specific information, participatory decision making, overall satisfaction, willingness to recommend physician, and physician trust; alpha > 0.70 for all) and 1 new scale, adherence dialogue (alpha= 0.92). For adherence dialogue, patients rated their physician at understanding and solving problems with antiretroviral therapy regimens. RESULTS: Mean patient age was 42 years, 15% were female, 73% were white, and 57% reported gay or bisexual sexual contact as their primary HIV risk factor. In multivariable models that accounted for the clustering of patients within physicians' practices, 6 of the 7 physician-patient relationship quality variables were significantly (P < .05) associated with adherence. In all 7 models worse adherence was independently associated (P < .05) with lower age, not believing in the importance of antiretroviral therapy, and worse mental health. CONCLUSIONS: This study showed that multiple, mutable dimensions of the physician-patient relationship were associated with medication adherence in persons with HIV infection, suggesting that physician-patient relationship quality is a potentially important point of intervention to improve patients' medication adherence. In addition, our data suggest that it is critical to investigate and incorporate patients' belief systems about antiretroviral therapy into adherence discussions, and to identify and treat mental disorders. 相似文献
7.
Dr. Gregory W. Froehlich MD MS H. Gilbert Welch MD MPH 《Journal of general internal medicine》1996,11(8):470-474
OBJECTIVE: To examine the relation between meeting expectations for tests and visit satisfaction in walk-in patients.
DESIGN: Survey of patients before and after the visit.
SETTING: Walk-in medical clinic at a Veterans Affairs Medical Center.
PATIENTS: 143 male veterans were eligible for this study: 128 agreed to participate; 109 completed both questionnaires.
MEASUREMENTS: Before the visit, we measured health status, baseline satisfaction with care, and expectations for common tests. After the
visit, we measured visit-specific satisfaction, patient perception of provider interpersonal behavior (provider humanism),
and patient report of whether specific tests were received. Logistic regression was used to determine the effect of meeting
expectations for tests while controlling for other factors.
RESULTS: Of all patients, 62% expected one or more tests, nearly as many as expected a medication or a diagnosis. In multivariate
analysis restricted to those expecting tests, provider humanism was the sole significant predictor of visit-specific satisfaction
(odds ratio [OR] 6.4; 95% confidence interval [CI] 1.6, 26.1). The proportion of expectations for testing that were met was
not significantly associated with satisfaction (OR 1.05; 95% CI 0.92, 1.21).
CONCLUSIONS: Meeting patient expectations for tests does not have an important effect on satisfaction. Even in the walk-in setting, patient
perception of the providers’ interpersonal behavior was a more important factor in satisfaction with the visit. Physicians
who order tests solely to improve patient satisfaction may be able to reduce unnecessary testing without decreasing patient
satisfaction.
Dr. Froehlich is a Veterans Affairs Ambulatory Care Fellow. Dr. Welch is supported by a Veterans Affairs Career Development
Award in health services research and development. 相似文献
8.
Clifford G. Johnson MD Dr. Jeffrey C. Levenkron PhD Anthony L. Suchman MD Ralph Manchester MD 《Journal of general internal medicine》1988,3(2):144-149
Physicians may choose one of several strategies when initially uncertain about making a specific therapeutic recommendation.
The authors investigated how patients’ satisfaction is affected by disclosure of uncertainty and its attempted resolution
during a clinical encounter. Three hundred and four patients awaiting appointments at a university hospital’s ambulatory medical
clinic were randomized to view one of five videotapes (VTs) of a patient seeking advice about antimicrobial prophylaxis for
a heart murmur. In VT-1 and VT-2, the physician disclosed no uncertainty and prescribed therapy. In VT-3, VT-4, and VT-5,
the physician openly conveyed uncertainty but then: (VT-3) prescribed antibiotics without resolving his uncertainty; (VT-4)
consulted a reference book with the patient present, then prescribed; or (VT-5) checked a computer with the patient present,
then prescribed. Patients rated their satisfaction with the physician on a standardized questionnaire. Differences in satisfaction
between the five VTs were significant (p=0.001), with the highest ratings found for VT-1 and VT-2, where no uncertainty was
disclosed. The lowest ratings in satisfaction were found when the physician expressed but then ignored uncertainty (VT-3)
or examined a textbook (VT-4). Global satisfaction was inversely and significantly correlated (r=−0.47) with the patients’
perception of uncertainty in the physician. The manner in which clinical uncertainty is disclosed to patients and then resolved
by the physician appears to affect patients’ satisfaction.
Received from the General Medicine Unit. Department of Medicine; and the Division of Behavioral and Psychosocial Medicine,
Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York. Dr. Johnson is now
at the North Canton Medical Foundation, North Canton, Ohio.
Supported by a grant from the Charles A. Dana Foundation.
Presented at the tenth annual meeting of the Society for Research and Education in Primary Care Internal Medicine, San Diego,
California, April 30, 1987. 相似文献
9.
Effects of a self-administered previsit questionnaire to enhance awareness of patient’s concerns in primary care 总被引:3,自引:3,他引:3 下载免费PDF全文
John Hornberger MD MS David Thom MD PhD Thomas MaCurdy PhD 《Journal of general internal medicine》1997,12(10):597-606
Objective
To determine if a self-administered previsit questionnaire designed to increase awareness of patients’ concerns alters the visit duration, content of the discussion, and patient and physician satisfaction.Design
A balanced, two-arm trial in which physicians were randomized.Setting
Two primary-care clinics affiliated, with a university hospital.Patients/Participants
Ten physicians and 201 continuitycare patients.Interventions
In intervention visits, patients completed a previsit questionnaire asking about the desire for medical information, psychosocial assistance, therapeutic listening, general health advice, and biomedical treatment. Physicians reviewed questionnaires with patients during the visit.Measurements and main results
We used audiotapes of encounters to quantify the duration of the encounter and measured the number and type of diagnoses discussed in the visit, and patient and physician satisfaction with the encounter. Intervention visits were 34% longer (increase of 6.8 minutes; 95% confidence interval, [CI] 0.4, 13.2) than control visits with most of the additional time spent in discussion of biomedical diagnoses (3.35 minutes; 95% CI 0.00, 6.72) and in the performance of the physical examination (2.7 minutes; 95% CI 0.5 4.9). The number of diagnoses discussed per visit was 30% higher in intervention visits (increase of 1.7 diagnoses per visit; 95% CI 0.3, 3.2), but patients’ satisfaction with these visits tended to be lower.Conclusions
Using a previsit questionnaire to increase awareness of the patients’ concerns may entail a trade-off between conflicting goals: trying to respond to patient concerns while not significantly increasing the cost per visit. A future challenge is to develop and refine techniques with sufficient efficacy to justify the expense of implementing the intervention and the longer visit needed to respond adequately to patients’ concerns. 相似文献10.
Bruce D. Bialor MD Phyllis A. Gimotty PhD Roy M. Poses MD Mark J. Fagan MD 《Journal of general internal medicine》1997,12(12):776-780
This study examines the association between type of internal medicine training and satisfaction ratings among 509 patients who visited the clinic of an urban teaching hospital over a 3-month period in 1994. When controlling for patient, health-system, and other resident factors, primary care training was significantly associated with higher satisfaction ratings (cumulative odds ratio 1.53; 95% confidence interval 1.04, 2.25; p = .031) than categorical training. Using satisfaction ratings to rank the residents without adjusting for patient and health-system factors would have correctly classified only 27% of the residents in the lowest quartile. These findings have implications for both the education and potential employment of internists. 相似文献
11.
Dr. Valerie E. Stone MD MPH Joel S. Weissman PhD Paul D. Cleary PhD 《Journal of general internal medicine》1995,10(5):239-245
OBJECTIVE: To examine the relation of patient characteristics and site of care to the perception of ambulatory care quality by persons
with AIDS (PWAs).
DESIGN: Patient surveys and medical record review were used to determine PWAs’ perceptions of their ambulatory care, self-perceived
health status, primary care relationships, sociodemographic characteristics, and severity of illness.
SETTING: A public-hospital HIV clinic, an academic group practice, and a staff-model health maintenance organization (HMO) that together
care for 20% of all Massachusetts PWAs.
PATIENTS: All active patients as of February 12, 1990, and all new AIDS patients at each of the three sites during the subsequent 13
months.
MEASUREMENTS AND MAIN BESULTS: The primary outcome measure was a six-item scale of patient-rated quality of care (PRQC), a newly developed measure that
combined patients’ ratings of their physician care, nursing care, involvement in medical decisions, and overall quality of
care. Multiple logistic regression was carried out with low PRQC (lowest quart He) as the dependent variable, to identify
correlates of patient perceptions of poor quality. Patients who had a primary nurse were significantly less likely to have
low PRQC scores (OR=0.50, 95% CI=0.26 to 0.97). Black patients and patients who used injection drugs were significantly more
likely to rate their care in the lowest quartile (OR=2.22, 95% CI=1.04 to 4.78; and OR=2.43, 95% CI=1.13 to 5.23, respectively),
as were those who had lower self-perceived health status, after controlling for confounders; no association was found by site
or severity.
CONCLUSIONS: These results show that primary nursing may be an important determinant of how PWAs rate the quality of their ambulatory
care. Furthermore, PWAs who are black or who are injection drug users are less satisfied than are others with the quality
of their ambulatory AIDS care.
Presented in part at the annual meeting of the Society of General Internal Medicine, April 30, 1993, Arlington, Virginia.
Supported by the Agency for Health Care Policy and Research, grant number HS06239. 相似文献
12.
Bell RA Kravitz RL Thom D Krupat E Azari R 《Journal of general internal medicine》2002,17(11):817-824
OBJECTIVE: To profile patients likely to have unmet expectations for care, examine the effects of such expectations, and investigate how physicians' responses to patients' requests affect the development of unfulfilled expectations. DESIGN: Patient and physician questionnaires were administered before and after outpatient visits. A follow-up telephone survey was administered 2 weeks post visit. SETTING: The offices of 45 family practice, internal medicine, and cardiology physicians. PATIENTS: Nine hundred nine adults reporting a health problem or concern. MEASUREMENTS AND MAIN RESULTS: Before their visits, patients rated their general health and trust in the index physician. After the visit, patients reported upon 8 types of unmet expectations and any request they made. Two weeks thereafter, patients rated their visit satisfaction, improvement, and intention to adhere to the physician's advice. They also reported any postvisit health system contacts. Overall, 11.6% of patients reported >/=1 unmet expectation. Visits in which a patient held an unmet expectation were rated by physicians as less satisfying and more effortful. At follow-up, patients who perceived an unmet expectation for care also reported less satisfaction with their visits, less improvement, and weaker intentions to adhere. Patients with an unmet expectation related to clinical resource allocation had more postvisit health system contacts. Unmet expectations were typically reported by a patient whose request for a resource was not fulfilled. CONCLUSIONS: Unmet expectations adversely affect patients and physicians alike. Physicians' nonfulfillment of patients' requests plays a significant role in patients' beliefs that their physicians did not meet their expectations for care. 相似文献
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Dr. William S. Yancy Jr. MD MHS David S. Macpherson MD MPH Barbara H. Hanusa PhD Galen E. Switzer PhD Robert M. Arnold MD Raquel A. Buranosky MD Wishwa N. Kapoor MD MPH 《Journal of general internal medicine》2001,16(11):755-762
OBJECTIVE: To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. DESIGN: A cross-sectional survey using a questionnaire derived from the Visit-Specific Satisfaction Questionnaire (VSQ) and Patient Satisfaction Index (PSI) distributed from March 1998 to May 1998. SETTING: Four clinics based at a university teaching hospital and the associated Veterans' Affairs (VA) hospital. PARTICIPANTS: Two hundred eighty-eight patients of 76 resident and 25 attending physicians. RESULTS: Patients of resident physicians at the university site were more likely to be African American, male, have lower socioeconomic status and have lower physical and mental health scores on the Short Form-12 than patients of university attendings. Patients of resident and attending physicians at the VA site were similar. In multivariate analyses, patients of university attending physicians were more likely to be highly satisfied than patients of university residents on the VSQ-Physician (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.6 to 7.8) and the PSI-Physician (OR, 10.1; 95% CI, 3.7 to 27.4) summary scores. Differences were not seen on the summary scores at the VA site. Two individual items displayed significant differences between residents and attendings at both sites: "personal manner (courtesy, respect, sensitivity, friendliness) of the doctor" (P 相似文献
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16.
H.P. French MSc B. Physio F. Keogan MSc B. Sc C. Gilsenan MSc BSc L. Waldron P. O'Connell MB FRCPI 《Musculoskeletal care》2010,8(2):61-67
Objectives. To assess patient satisfaction with exercise for knee osteoarthritis (OA). Methods. A convenience sample of 27 patients recruited to a randomized controlled trial (RCT) comparing open kinetic chain and closed kinetic chain exercises for knee OA were reassessed at nine months post‐randomization. Clinical outcomes included self‐report and physical performance measures of function and pain severity. Patients also completed the Physiotherapy Outpatient Survey (POPS), which is a multi‐dimensional measure of patient satisfaction with physiotherapy. Results. There was no significant difference in satisfaction between the two intervention groups. Overall mean satisfaction for the entire cohort was 4.07 of a maximum score of 5 (standard deviation (SD) = 0.52). Lower levels of satisfaction with outcome (mean = 3.56, SD = 0.8) were reported compared with other domains of expectations, communication, organization and the therapist (mean = 3.79–4.49; SDs = 0.42–0.92). Both intervention groups improved from baseline on clinical outcomes of pain, self‐report function and walking distance, with no significant differences between the two groups. Conclusions. High levels of satisfaction were reported in this subsample of knee OA patients participating in an RCT evaluating the effects of different exercise approaches for knee OA. Satisfaction varied depending on the satisfaction domain, with lower satisfaction with outcome compared with other aspects of care. The POPS questionnaire can be used to measure the multi‐dimensional aspects of satisfaction with physiotherapy. Copyright ? 2010 John Wiley & Sons, Ltd. 相似文献
17.
Is the professional satisfaction of general internists associated with patient satisfaction? 总被引:15,自引:0,他引:15
Haas JS Cook EF Puopolo AL Burstin HR Cleary PD Brennan TA 《Journal of general internal medicine》2000,15(2):122-128
BACKGROUND: The growth of managed care has raised a number of concerns about patient and physician satisfaction. An association between
physicians’ professional satisfaction and the satisfaction of their patients could suggest new types of organizational interventions
to improve the satisfaction of both.
OBJECTIVE: To examine the relation between the satisfaction of general internists and their patients.
DESIGN: Cross-sectional surveys of patients and physicians.
SETTING: Eleven academically affiliated general internal medicine practices in the greater-Boston area.
PARTICIPANTS: A random sample of English-speaking and Spanish-speaking patients (n=2,620) with at least one visit to their physician (n=166) during the preceding year.
MEASUREMENTS: Patients’ overall satisfaction with their health care, and their satisfaction with their most recent physician visit.
MAIN RESULTS: After adjustment, the patients of physicians who rated themselves to be very or extremely satisfied with their work had higher
scores for overall satisfaction with their health care (regression coefficient 2.10; 95% confidence interval 0.73–3.48), and
for satisfaction with their most recent physician visit (regression coefficient 1.23; 95% confidence interval 0.26–2.21).
In addition, younger patients, those with better overall health status, and those cared for by a physician who worked part-time
were significantly more likely to report better satisfaction with both measures. Minority patients and those with managed
care insurance also reported lower overal satisfaction.
CONCLUSIONS: The patients of physicians who have higher professional satisfaction may themselves be more satisfied with their care. Further
research will need to consider factors that may mediate the relation between patient and physician satisfaction.
This work was supported by a grant from the Harvard Risk Management Foundation. Dr. Haas was the recipient of a Clinical Investigator
Award from the National Institute of Child Health and Human Development (K08-HD01029) at the time that this work was initiated. 相似文献
18.
The Relationship Between Measured Performance and Satisfaction with Care Among Clinically Complex Patients 下载免费PDF全文
Background Recent work has shown that clinically complex patients are more likely to receive recommended care, but it is unknown whether
higher achievement on individual performance goals results in improved care for complex patients or detracts from other important
but unmeasured aspects of care, resulting in unmet needs and lower satisfaction with care.
Objective To examine the relationship between measured performance and satisfaction with care among clinically complex patients
Design and Participants An observational analysis of a national sample of 35,927 veterans included in the External Peer Review Program in fiscal years
2003 and 2004.
Measurements First, compliance with individual performance measures (breast cancer screening with mammography, colorectal cancer screening,
influenza vaccination, pneumococcal vaccination, lipid monitoring, use of ACE inhibitor in heart failure, and diabetic eye
examination), as well as overall receipt of recommended care, was estimated as a function of each patient’s clinical complexity.
Second, global satisfaction with care was estimated as a function of clinical complexity and compliance with performance measures.
Main Results Higher clinical complexity was predictive of slightly higher overall performance (OR 1.13, 95% CI 1.09 to 1.18) and higher
performance on most individual performance measures, an effect that was mediated by increased visit frequency. High measured
performance was associated with higher satisfaction with care among patients with high clinical complexity. In fact, as complexity
increased, the effect of achieving high performance on the odds of being satisfied with care also increased
Conclusions Not only was measured performance higher in clinically complex patients, but satisfaction with care was also higher among
clinically complex patients with high measured performance, suggesting that compliance with performance measures in clinically
complex patients does not crowd out unmeasured care. 相似文献
19.
Professional Characteristics and Job Satisfaction Among SGIM Members: A Comparison of Part-time and Full-time Physician Members 下载免费PDF全文
Levine RB Harrison RA Mechaber HF Phillips C Gallagher TH 《Journal of general internal medicine》2008,23(8):1218-1221
BACKGROUND As more physicians work part-time (PT), the faculty, institutions, and organizations that represent them should understand
the factors that motivate and satisfy these physicians.
OBJECTIVE Compare factors associated with job satisfaction among PT and full-time (FT) academic physicians.
DESIGN Cross-sectional survey.
PARTICIPANTS Members of the Society of General Internal Medicine (SGIM), a national, academic Internal Medicine organization.
RESULTS Fifty percent (1,396 of 2,772) of SGIM members responded, 11% work PT. Compared to FT, PT physicians were more often female
(85% vs 38%, p < .001), clinicians (Cs) or clinician–educators (CEs) (84% vs 56%, p < .001), and of a lower rank (77% vs 61%, p = .001). Job satisfaction was similar between PT and FT Cs and CEs. For PT Cs and CEs, record of publication (11% vs 21%,
p = .04) and local and national recognition (24% vs 36%, p = .03) were less important to overall job satisfaction compared to FT Cs and CEs. In multivariate analysis, academic rank
(odds ratio [OR] = 7.18, 95%CI = 1.40–36.50) was associated with higher satisfaction among PT Cs and CEs.
CONCLUSIONS PT and FT C and CE SGIM members report similar satisfaction, but different factors contribute to satisfaction. Knowing what
motivates and satisfies PT physicians may allow medical centers to retain faculty and create positions to help them to fulfill
their potential.
Portions of this paper were presented at the 2006 Society of General Internal Medicine national meeting, Los Angeles, CA,
USA. 相似文献
20.
Barry DT Moore BA Pantalon MV Chawarski MC Sullivan LE O'Connor PG Schottenfeld RS Fiellin DA 《Journal of general internal medicine》2007,22(2):242-245
Background Factors associated with satisfaction among patients receiving primary care–based buprenorphine/naloxone are unknown.
Objective To identify factors related to patient satisfaction in patients receiving primary care–based buprenorphine/naloxone that varied
in counseling intensity (20 vs 45 minutes) and office visit frequency (weekly vs thrice weekly).
Design and Participants One hundred and forty-two opioid-dependent subjects.
Measurements Demographics, drug treatment history, and substance use status at baseline and during treatment were collected. The primary
outcome was patient satisfaction at 12 weeks.
Results Patients’ mean overall satisfaction score was 4.4 (out of 5). Patients were most satisfied with the medication and ancillary
services and indicated strong willingness to refer a substance-abusing friend for the same treatment. Patients were least
satisfied with their interactions with other opioid-dependent patients, referrals to Narcotics Anonymous, and the inconvenience
of the treatment location. Female gender (β = .17, P = .04) and non-White ethnicity/race (β = .17, P = .04) independently predicted patient satisfaction. Patients who received briefer counseling and buprenorphine/naloxone
dispensed weekly had greater satisfaction than those whose medication was dispensed thrice weekly (mean difference 4.9, 95%
confidence interval 0.08 to 9.80, P = .03).
Conclusions Patients are satisfied with primary care office-based buprenorphine/naloxone. Providers should consider the identified barriers
to patient satisfaction.
The findings of this study were presented in part at the 67th annual scientific meeting of the College on Problems of Drug
Dependence, Orlando, FL, 22 June 2005. 相似文献