PRACTICE AND CAREER SATISFACTION AMONG PHYSIATRISTS - A NATIONAL SURVEY

(T)o evaluate physiatrist career satisfaction and current practice pat terns, a 15-page survey was mailed randomly to 400 fellow members of t he American Academy of Physical Medicine and Rehabilitation. The 208 q uestionnaires (52%) returned revealed respondents' level of satisfacti on with career choice, current practice, relationships with other phys icians, their own residency training, and problems experienced that im pede their practice. Factor analysis identified six areas of satisfact ion: time demands, organizational support, current practice, current s pecialty, profession, and training. Problems with work consisted of fo ur factors: external intrusions into practice, having to deal with non -rehabilitation problems, dealing with PM&R problems, and insufficient time for patients. Results showed that 75% of physiatrists were satis fied with their practice/profession. Satisfaction with current practic e was greater with fewer external intrusions into practice, a larger p ercentage of income from traditional non-managed payment sources (incl uding Medicaid), and less competition. Changes in health care, such as managed care, competition, and increased external regulations, appear to interfere with current practice. Variation in satisfaction was not significantly correlated with size of community, variation in rates o f payment denials, workloads of greater than 50 hours per week, and a number of other factors that one might expect to affect satisfaction. Physiatrists had made many changes in their practice in response to th e changes in the health care environment but had not cut care for indi gent patients. Needs for greater residency training in outpatient clin ics, physicians' offices, managed care, and long-term care settings we re expressed. This is the first comprehensive published report on phys iatric satisfaction in a changing health care environment. Further res earch in some of the areas will be required.