Involvement in Research Associated with Increased Satisfaction and Decreased Intent to Leave among VA Physicians

BACKGROUND:
Physician job satisfaction is a key performance indicator for US healthcare organizations. Physician job attitudes are linked to both healthcare system performance and workforce sustainability. Moreover, physician job satisfaction, intent to leave, and burnout are important indicators of physician retention, particularly for healthcare organizations, which often have multiple missions (i.e., clinical care, research, and teaching). This study examined the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among inpatient medicine physicians (n=373) from 36 VA medical centers. A web-based survey collected measures that included physicians' self-reported overall job satisfaction, intention to leave, and burnout. Investigators also examined provider characteristics (i.e., tenure, board certification), and perceived staffing for nurses and physicians. Organizational characteristics included rurality, teaching hospital affiliation, inpatient bed size, and performance-based compensation.

FINDINGS:

• Physicians' ratings of perceived quality of care and adequacy of physician staffing were the strongest predictors of overall job satisfaction and intent to leave. Adequacy of physician staffing was the strongest predictor of burnout.
• Among the job tasks that physicians spent their time on, research (involvement reported by 46% of respondents) was significantly associated with increased job satisfaction and decreased intent to leave. Research time showed a non-significant negative relation with burnout.
• Teaching involvement was reported by 72% of the respondents, and time spent in this activity showed a similar pattern with job attitudes as described above, but was not significant.
• Physicians' perception of having sufficient registered nurse staffing also did not affect physicians' attitudes about their job.
• Regarding organizational characteristics, inpatient bed size showed a significant positive association with overall job satisfaction and a significant negative association with intention to leave and burnout.

IMPLICATIONS:

• Expanding opportunities for physician involvement with research may lead to more positive work experiences, which could potentially reduce turnover and improve system performance.

LIMITATIONS:

• The cross-sectional design of the study limits causal inferences.
• The opinion-based attitude survey is limited to a strict set of responses.

AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (IIR 08-067). Drs. Mohr and Restuccia and Ms. Stolzmann are part of HSR&D's Center for Healthcare Organization and Implementation Research (CHOIR) in Boston, MA.

Mohr D, Eaton J, Meterko M, Stolzmann K, and Restuccia J. Factors Associated with Internal Medicine Physician Job Attitudes in the Veterans Health Administration. BMC Health Services Research. April 5, 2018;18(1):244.