Abstract:
BACKGROUND:Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE:To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfaction, and clinical commitment, while accounting for established extrinsic motivators as well. DESIGN AND PARTICIPANTS:A nationally representative survey of 2000 US physicians, fielded October to December 2011. MAIN MEASURES:Outcome variables were five measures of physician well-being: career satisfaction, life satisfaction, high life meaning, commitment to direct patient care, and commitment to clinical practice. Primary explanatory variables were sense of calling, personally rewarding hours per day, meaningful, long-term relationships with patients, and burnout. Multivariate logit models with survey design provided nationally representative individual-level estimates. KEY RESULTS:Among 1289 respondents, 85.8% and 86.5% were satisfied with their career and life, respectively; 88.6% had high life meaning; 54.5% and 79.5% intended to retain time in direct patient care and continue clinical practice, respectively. Sense of calling was strongly positively associated with high life meaning (odds ratio [OR] 5.14, 95% confidence interval [95% CI] 2.87-9.19) and commitment to direct patient care (OR 2.50, 95% CI 1.53-4.07). Personally rewarding hours per day were most strongly associated with career satisfaction (OR 5.28, 95% CI 2.72-10.2), life satisfaction (OR 4.46, 95% CI 2.34-8.48), and commitment to clinical practice (OR 3.46, 95% CI 1.87-6.39). Long-term relationships with patients were positively associated with career and life satisfaction and high life meaning. Burnout was strongly negatively associated with all measures of physician well-being. CONCLUSIONS:Intrinsic motivators (e.g., calling) were associated with each measure of physician well-being (satisfaction, meaning, and commitment), but extrinsic motivators (e.g., annual income) were not associated with meaning or commitment. Understanding the effects of intrinsic motivators may help inform efforts to support physician well-being.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Tak HJ,Curlin FA,Yoon JDdoi
10.1007/s11606-017-3997-ysubject
Has Abstractpub_date
2017-07-01 00:00:00pages
739-746issue
7eissn
0884-8734issn
1525-1497pii
10.1007/s11606-017-3997-yjournal_volume
32pub_type
杂志文章abstract:PURPOSE:Anxiety is thought to affect test performance. Studies have shown that students with low levels of test anxiety achieve higher scores on multiple choice question (MCQ) examinations than those with high anxiety levels. Female students have been shown to have higher test anxiety levels than male students. Standar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00419.x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The gap in asthma prevalence, morbidity, and mortality is increasing in low-income racial/ethnic minority groups as compared with Caucasians. In order to address these disparities,alternative beliefs and behaviors need to be identified. OBJECTIVE:To identify causal models of asthma and the context of conven...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00624.x
更新日期:2006-12-01 00:00:00
abstract::Physicians and patients increasingly use social media technologies, such as Facebook, Twitter, and weblogs (blogs), both professionally and personally. Amidst recent reports of physician misbehavior online, as well as concerns about social media's potential negative effect on trust in the medical profession, several n...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2251-x
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Computerized physician order entry and clinical decision support systems are electronic prescribing strategies that are increasingly used to improve patient safety. Previous reviews show limited effect on patient outcomes. Our objective was to assess the impact of electronic prescribing strategies on medicat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s11606-019-05236-8
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum. OBJECTIVE:Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. DESIGN:Toolkit development included cogniti...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3763-6
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To compare specialist and primary care physician participation in California's Medicaid fee-for-service and managed care programs. DESIGN:Cross-sectional survey. PARTICIPANTS:A probability sample stratified by county and by race of 962 specialist physicians and 713 primary care physicians practicing in the ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract::Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcome...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-010-1347-4
更新日期:2010-07-01 00:00:00
abstract:MAIN RESULTS:Compared with younger patients, patients aged 50 years or older were less likely to have acquired HIV via intravenous drug use or homosexual contact (p = .0001). Older patients were more likely to have comorbid diseases (12% vs 4%; p = .0001), had more frequent neurologic findings on admission (19% vs 9%; ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599026
更新日期:1996-10-01 00:00:00
abstract::While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excelle...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2004.30329.x
更新日期:2004-10-01 00:00:00
abstract::This study examined patient acceptance of two different advance directives. Outpatients completed the two directives and a 12-item acceptability questionnaire for each, and then stated their directive preferences. Of 128 patients enrolled, 97 (76%) responded. Overall, 47% of the respondents were satisfied with the Let...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02599143
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE!® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-017-3987-0
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Little is known about how providers communicate recommendations when scientific uncertainty exists. OBJECTIVES:To compare provider recommendations to those in the scientific literature, with a focus on whether uncertainty was communicated. DESIGN:Qualitative (inductive systematic content analysis) and quan...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3667-5
更新日期:2016-08-01 00:00:00
abstract::In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-3161-x
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To assess, from the patient's perspective, selected aspects of the quality of inpatient hospital care in the United States. DESIGN:A cross-sectional survey, using telephone interviews of patients discharged from the medical services of a probability sample of 62 public and private, nonprofit, nonfederal acut...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02602763
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. OBJECTIVE:To better unde...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2006.00485.x
更新日期:2006-06-01 00:00:00
abstract::This study was designed to determine the clinical characteristics of hypertensive patients whose blood pressures are substantially higher in the medical office than in their natural environments. Thirty-nine percent of patients enrolled in a nonpharmacologic hypertension treatment program had systolic or diastolic off...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599528
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Studies examining the effectiveness of pay-for-performance programs to improve quality of care primarily have been confined to bonus-type arrangements that reward providers for performance above a predetermined threshold. No studies to date have evaluated programs placing providers at financial risk for perf...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0185-5
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific inst...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2566-2
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:In response to the landmark report "Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering," the NIH Office of Research on Women's Health issued a request for applications that funded 14 R01 grants to investigate causal factors to career success for women in STEM. Fol...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-018-4547-y
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control gr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
abstract::The American Board of Internal Medicine suggests use of a standard form to rate residents on nine dimensions (such as clinical judgment and overall clinical competence) on a scale of 1 to 9. The authors examined the psychometric evidence for reliability and validity of 1,039 ratings of 85 residents by 135 attendings i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600537
更新日期:1990-05-01 00:00:00
abstract::Evaluations of intensive care have largely focused on survival, cost, or functional status; however, these may not be the only outcomes of interest to patients, families, and health care providers. Quality of life is an important consideration in evaluating intensive care because it influences decisions about the use ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596335
更新日期:1988-05-01 00:00:00
abstract::The quality of diabetes care delivered to patients falls below the expectations of practice guidelines and clinical trial evidence. Studies in many jurisdictions with varying health care systems have shown that recommended processes of care occur less often than they should; hence, outcomes of care are inadequate. Man...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-006-0027-x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To examine the impact of the New Haven Community Health Care Van (CHCV), a mobile needle exchange-based health care delivery system, in reducing emergency department (ED) use among out-of-treatment injection drug users (IDUs) between January 1, 1996 and December 31, 1998. DESIGN:A pre-post comparison of ED u...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::Hospitalists provide a significant amount of direct clinical care in both academic and community hospitals. Peer feedback is a potentially underutilized and low resource method for improving clinical performance, which lends itself well to the frequent patient care handoffs that occur in the practice of hospital medic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-020-06235-w
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer. OBJECTIVE:We examined the relative need for palliative care in the two conditions by comparing symptom burden, psychological well-being, and spiritual well-being in heart failure and ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-009-0931-y
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:In countries with public health system, hospital bed reductions and increasing social and medical frailty have led to the phenomenon of "outliers" or "outlying hospital in-patients." They are often medical patients who, because of unavailability of beds in their clinically appropriate ward, are admitted wher...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05008-4
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:Recent reports have emphasized the importance of delivery systems in improving health care quality. However, few prior studies have assessed differences in primary care quality between physician groups that differ in size and organizational configuration. We examined whether larger physician group size and affi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0234-0
更新日期:2007-10-01 00:00:00
abstract::A lack of access to critical drugs in the USA, either due to exorbitant prices or shortages, has become a troubling norm that threatens the quality and safety of healthcare. In 2017, there were shortages of 146 commonly used drugs including electrolytes, chemotherapy, cardiovascular, and antibiotic agents. For example...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-018-4548-x
更新日期:2018-11-01 00:00:00