Family physician job satisfaction in different medical care organization models

Objectives. The aim of the present study was to estimate physician job sati sfaction at the Mexican Institute of Social Security (IMSS), the Ministry o f Health (SSA) and in the private sector, and to measure the association be tween these different family medical care organization models. Methods. A comparative cross-sectional design was used to investigate the j ob satisfaction of family physicians in private and institutional family me dicine clinics. Satisfaction was measured with a previously constructed and validated instrument. The instrument measures the satisfaction in four are as:'global satisfaction', 'institution where the physician works','the pati ents' and 'themselves as physicians'. Results. One hundred and seven IMSS physicians, 106 SSA physicians and 97 p rivate physicians were selected randomly from a census according to the sam ple size. The sample was weighted. Fifty-one percent of IMSS and SSA physic ians were dissatisfied, against 25% in the private sector, in the first thr ee areas. Comparing the private model and the IMSS, differences were found (P < 0.0001) in the area of 'global satisfaction' [odds ratio (OR) = 2.47, 95% confidence interval (CI) 1.69-3.67], 'institution where the physician w orks' (OR = 2.12, CI 1.45-3.13) and 'themselves as physicians' (OR = 1.84, CI 1.28-2.65). When the private/SSA groups were compared, the differences w ere similar(P< 0.0001). No differences were found in terms of 'the patients '. When stratifying, the risks increased in females, in the group aged 31-4 0 years and in specialists in family medicine. Conclusions. The organization model is associated with dissatisfaction in a ll areas, except in 'the patients'.