SATISFACTION OF PHYSICIAN ASSISTANTS AND OTHER NONPHYSICIAN PROVIDERSIN A MANAGED CARE SETTING

HEALTH MAINTENANCE ORGANIZATIONS have employed physician assistants, n urse practitioners, and other nonphysician providers for decades, yet there is little information on how satisfied these providers are with this form of practice. This paper examines how physician assistants ev aluate their experience practicing in a large group model health maint enance organization and compares their attitudes and satisfaction leve ls with those of other nonphysician providers-nurse practitioners, opt ometrists, mental health therapists, and chemical dependency counselor s. The data source is a 1992 survey of 5,000 nonphysician employees of a health maintenance organization. The survey instrument was a. self- administrated questionnaire that included both structured and open-end ed questions. The response rate averaged 88 percent for physician assi stants and the other nonphysician providers. Physician assistants expr essed the most satisfaction with the amount of responsibility support from coworkers, job security, working hours, supervision, and task var iety. They were less satisfied with workload, control over the pace of work-and opportunities for advancement. Most physician assistants wer e also satisfied with pay and fringe benefits. Compared with other non physician providers, chemical dependency counselors expressed the high est levels of satisfaction across the various dimensions of work and o ptometrists the lowest. Nurse practitioners, chemical dependency couns elors, and mental health professionals also tended to be satisfied wit h most aspects of practice in this setting. In a number of instances, they were more satisfied than the physician assistants. The findings a re consistent with other studies that found health maintenance organiz ations to be favorable practice settings for physician assistants, The limits of physician assistant involvement and their role satisfaction and efficient use in HMOs are more likely to relate to physician atti tudes and acceptance than to lack of support by coworkers and other at tributes of the work environment.