The Influence of Service Lines on Physician’s Professional Interest Identification

Mohr DC, Charns MP, Meterko MM, Young GJ. The Influence of Service Lines on Physician’s Professional Interest Identification. Poster session presented at: AcademyHealth Annual Research Meeting; 2009 Jun 28; Chicago, IL.

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• IIR 05-221 – Team Process and Performance in Primary Care

Research Objective: The goal of this study was to examine the extent that working in a clinical service line has on physician's professional interest activities. It has been speculated that service lines may decrease professional identification, but this has not been tested to date. Many hospitals have embarked on significant re-organization efforts to create service line structures as a way to provide care to a specific patient population (e.g. children) or disease (i.e. cardiology). As compared to a service focus (e.g. nursing), in a service line structure, heath care professionals need to coordinate activities with a greater number of other professionals with different backgrounds and across a larger number of departments to ensure a full array of services are provided for patients. A possible result of this broad and multi-disciplinary focus in service lines may be a reduction in professional identification with one's own occupation. Study Design: We obtained data from a survey conducted in 2000 at Veterans Health Administration. The survey randomly sampled approximately150 respondents at 141 medical centers across the United States. A total of 7,058 completed responses were received and 417 respondents (7%) identified themselves as physicians. One section of the survey asked four questions on professional interest identification (i.e. reading journals, attending conferences, professional idealism) using a five point-scale ranging from "Strongly Disagree" to "Strongly Agree". We found a one factor solution among those items, a Cronbach's alpha of .76 and a normal response distribution. Respondents to the survey also indicated if they worked in a service line, clinical setting, authority level, tenure, and type of facility (i.e. medical center, community clinic). We also linked a variable indicating hospital teaching affiliation to the individual-level responses. Population Studied: Physicians sampled during a 2000 national survey administration within the Veterans Health Administration. Principle Findings: Physicians reported higher scores on the professional interest identification scale (M = 4.11, SD = .67) compared to all other respondents (e.g. RNs, psychologists, non-clinical) (M = 3.41, SD = .84). This finding was expected due to the emphasis placed on continuing medical education credits for physicians. In the regression model, we found a negative association between working in a service line and professional interest identification (b = -.25, p < .01). We also found a positive association between the variable of "section chief" and professional interest identification (b = .18, p = .05). No other variables were significant in the model; r-squared = .07, F(10,398) = 2.71, p < .01. Conclusions: The results of this study indicated that compared to other hospital staff, physicians expressed higher scores on professional interest identification. Working in a service line appeared to have a negative effect on professional interest identification for physicians. Implications for Policy, Delivery, or Practice: Although service line structures may provide a competitive marketplace advantage, one consequence may be a decreased sense of professional interest identification for physicians. This may present a challenge when recruiting new physicians to join the health care organization.