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Determinants of Career Satisfaction Among Pediatric Hospitalists: A Qualitative Exploration

      Abstract

      Objective

      To characterize determinants of career satisfaction among pediatric hospitalists working in diverse practice settings; to develop a framework to conceptualize factors influencing career satisfaction.

      Methods

      Semistructured interviews were conducted with community and tertiary care hospitalists, using purposeful sampling to attain maximum response diversity. We used closed- and open-ended questions to assess levels of career satisfaction and its determinants. Interviews were conducted by telephone, recorded, and transcribed verbatim. Emergent themes were identified and analyzed using an inductive approach to qualitative analysis.

      Results

      A total of 30 interviews were conducted with community and tertiary care hospitalists, representing 20 hospital medicine programs and 7 Northeastern states. Qualitative analysis yielded 657 excerpts, which were coded and categorized into 4 domains and associated determinants of career satisfaction: 1) professional responsibilities; 2) hospital medicine program administration; 3) hospital and health care systems; and 4) career development. Although community and tertiary care hospitalists reported similar levels of career satisfaction, they expressed variation in perspectives across these 4 domains. Although the role of hospital medicine program administration was consistently emphasized by all hospitalists, community hospitalists prioritized resource availability, work schedule, and clinical responsibilities, while tertiary care hospitalists prioritized diversity in nonclinical responsibilities and career development.

      Conclusions

      We illustrate how hospitalists in different organizational settings prioritize both consistent and unique determinants of career satisfaction. Given associations between physician satisfaction and health care quality, efforts to optimize modifiable factors within this framework, at both community and tertiary care hospitals, may have broad impacts.

      Keywords

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      References

        • Embriaco N.
        • Hraiech S.
        • Azoulay E.
        • et al.
        Symptoms of depression in ICU physicians.
        Ann Intensive Care. 2012; 2: 34
        • Johnson J.V.
        • Hall E.M.
        • Ford D.E.
        • et al.
        The psychosocial work environment of physicians. The impact of demands and resources on job dissatisfaction and psychiatric distress in a longitudinal study of Johns Hopkins Medical School graduates.
        J Occup Environ Med. 1995; 37: 1151-1159
        • Renzi C.
        • DiPietro C.
        • Tabolli S.
        Pyschiatric morbidity and emotional exhaustion among hospital physicians and nurses: associations with perceived job related factors.
        Arch Environ Occup Health. 2012; 67: 117-123
        • Scheurer D.
        • McKean S.
        • Miller J.
        US physician satisfaction: a systematic review.
        J Hosp Med. 2009; 4: 560-568
        • Sutherland V.J.
        • Cooper C.L.
        Identifying distress among general practitioners: predictors of psychological ill-health and job dissatisfaction.
        Soc Sci Med. 1993; 37: 575-581
        • Williams E.S.
        • Konrad T.R.
        • Linzer M.
        • et al.
        Physician, practice, and patient characteristics related to primary care physician physical and mental health: results from the Physician Worklife Study.
        Health Serv Res. 2002; 37: 121-143
        • Doan-Wiggins L.
        • Zun L.
        • Cooper M.A.
        • et al.
        Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.
        Acad Emerg Med. 1995; 2: 556-563
        • Glasheen J.J.
        • Misky G.J.
        • Reid M.B.
        • et al.
        Career satisfaction and burnout in academic hospital medicine.
        Arch Intern Med. 2011; 171: 782-785
        • Hinami K.
        • Whelan C.T.
        • Wolosin R.J.
        • et al.
        Worklife and satisfaction of hospitalists: toward flourishing careers.
        J Gen Intern Med. 2012; 27: 28-36
        • Hinami K.
        • Whelan C.T.
        • Miller J.A.
        • et al.
        Job characteristics, satisfaction, and burnout across hospitalist practice models.
        J Hosp Med. 2012; 7: 402-410
        • Keeton K.
        • Fenner D.E.
        • Johnson T.R.
        • Hayward R.A.
        Predictors of physician career satisfaction, work–life balance, and burnout.
        Obstet Gynecol. 2007; 109: 949-955
        • Weng H.C.
        • Hung C.M.
        • Liu Y.T.
        • et al.
        Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction.
        Med Educ. 2011; 45: 835-842
        • Wright J.G.
        • Khetani N.
        • Stephens D.
        Burnout among faculty physicians in an academic health science centre.
        Paediatr Child Health. 2011; 16: 409-413
        • Pathman D.E.
        • Konrad T.R.
        • Williams E.S.
        • et al.
        Physician job satisfaction, dissatisfaction, and turnover.
        J Fam Pract. 2002; 51: 593
        • Mainous 3rd, A.G.
        • Ramsbottom-Lucier M.
        • Rich E.C.
        The role of clinical workload and satisfaction with workload in rural primary care physician retention.
        Arch Fam Med. 1994; 3: 787-792
        • Haas J.S.
        • Cook E.F.
        • Puopolo A.L.
        • et al.
        Is the professional satisfaction of general internists associated with patient satisfaction?.
        J Gen Intern Med. 2000; 15: 122-128
        • DeVoe J.
        • Fryer Jr., G.E.
        • Straub A.
        • et al.
        Congruent satisfaction: is there geographic correlation between patient and physician satisfaction?.
        Med Care. 2007; 45: 88-94
        • Williams E.S.
        • Manwell L.B.
        • Konrad T.R.
        • Linzer M.
        The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study.
        Health Care Manage Rev. 2007; 32: 203-212
        • DiMatteo M.R.
        • Sherbourne C.D.
        • Hays R.D.
        • et al.
        Physicians’ characteristics influence patients’ adherence to medical treatment: results from the Medical Outcomes Study.
        Health Psychol. 1993; 12: 93-102
        • Grembowski D.
        • Paschane D.
        • Diehr P.
        • et al.
        Managed care, physician job satisfaction, and the quality of primary care.
        J Gen Intern Med. 2005; 20: 271-277
        • Rauch D.A.
        • Lye P.S.
        • Carlson D.
        • et al.
        Pediatric hospital medicine: a strategic planning roundtable to chart the future.
        J Hosp Med. 2012; 7: 329-334
        • Lye P.S.
        • Rauch D.A.
        • Ottolini M.C.
        • et al.
        Pediatric hospitalists: report of a leadership conference.
        Pediatrics. 2006; 117: 1122-1130
        • Freed G.L.
        • Dunham K.M.
        Research Advisory Committee of the American Board of Pediatrics. Pediatric hospitalists: training, current practice, and career goals.
        J Hosp Med. 2009; 4: 179-186
      1. Society of Hospital Medicine Career Satisfaction Task Force. A challenge for a new specialty: a white paper on hospitalist career satisfaction. December 2006. Available at: http://www.hospitalmedicine.org/AM/Template.cfm?Section=Practice_Resources&Template=/CM/ContentDisplay.cfm&ContentID=14631. Accessed September 12, 2012.

        • Pane L.A.
        • Davis A.B.
        • Ottolini M.C.
        Association between practice setting and pediatric hospitalist career satisfaction.
        Hosp Pediatr. 2013; 3: 285-293
        • Curry L.A.
        • Nembhard I.M.
        • Bradley E.H.
        Qualitative and mixed methods provide unique contributions to outcomes research.
        Circulation. 2009; 119: 1442-1452
        • Levinson W.
        • Kaufman K.
        • Bickel J.
        Part-time faculty in academic medicine: present status and future challenges.
        Ann Intern Med. 1993; 119: 220-225
        • Varner C.
        • Ovens H.
        • Letovsky E.
        • Borgundvaag B.
        Practice patterns of graduates of a CCFP(EM) residency program: a survey.
        Can Fam Physician. 2012; 58: e385-e389
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 378-382
        • Guest G.
        • Bunce A.
        • Johnson L.
        How many interviews are enough? An experiment with data saturation and variability.
        Field Methods. 2006; 18: 59-82
        • Bronfenbrenner U.
        Toward an experimental ecology of human development.
        Am Psychol. 1977; 32: 513-531
        • Brofenbrenner U.
        The ecology of human development: experments by nature and design.
        Harvard University Press, Cambridge, MA1979
        • Pane L.A.
        • Davis A.B.
        • Ottolini M.C.
        Career satisfaction and the role of mentorship: a survey of pediatric hospitalists.
        Hosp Pediatr. 2012; 2: 141-148
        • Suchman A.L.
        • Deci E.L.
        • McDaniel S.H.
        • Beckman H.B.
        Relationship-centered administration: basic principles and examples from a community hospital.
        in: Frankel R.M. Quill T.E. McDaniel S.H. The Biopsychosocial Approach: Past, Present, Future. University of Rochester Press, Rochester, NY2003: 180-198
        • Coltart C.E.
        • Cheung R.
        • Ardolino A.
        • et al.
        Leadership development for early career doctors.
        Lancet. 2012; 379: 1847-1849
        • Stucky E.R.
        • Maniscalco J.
        • Ottolini M.C.
        • et al.
        The Pediatric Hospital Medicine Core Competencies Supplement: a framework for curriculum development by the Society of Hospital Medicine with acknowledgement to pediatric hospitalists from the American Academy of Pediatrics and the Academic Pediatric Association.
        J Hosp Med. 2010; 5 (i–xv): 1-114
      2. Dorgan S, Layton D, Bloo N, et al. Management in healthcare: why good practice really matters. Available at: http://cep.lse.ac.uk/textonly/_new/research/productivity/management/pdf/management_in_Healthcare_Report.pdf. Accessed September 12, 2012.

        • Sofaer S.
        Qualitative methods: what are they and why use them?.
        Health Serv Res. 1999; 34: 1101-1118