Mg. Warren et al., Physician satisfaction in a changing health care environment: The impact of challenges to professional autonomy, authority, and dominance, J HEALTH SO, 39(4), 1998, pp. 356-367
For some time, sociologists have debated whether physicians still retain do
minance in the health care world, public faith in their moral and scientifi
c authority, and the autonomy to set work conditions and make clinical deci
sions. Using ideas derived from this debate, we analyze the impact of chang
es in the health care environment on physician satisfaction. Our data come
from a a mailed survey of 510 Arizona physicians. Our results show that bac
kground physician attributes did not predict satisfaction, nor did most org
anizational attributes. However participation in IPAs (Individual Practice
Associations) predicted higher satisfaction, while payment according to a t
hird party payer's fee-for-service schedule predicted lower satisfaction. I
n addition, physicians were more likely to be satisfied if they wrote the o
rders that non-physicians had to follow, were paid what they wanted did not
need to subordinate their clinical judgment to that of non-physicians, and
believed that their patients had confidence in physicians. Our conclusions
discuss both theoretical and policy implications of our findings.