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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Article info
Publication history
Accepted:
March 30,
2014
Received:
August 24,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
