THE PSYCHIATRISTS ROLE AS MEDICAL DIRECTOR - TASK DISTRIBUTIONS AND JOB-SATISFACTION

Objectives: Previous surveys of the alumni of Columbia University's fe llowship in public psychiatry suggest that a large number of alumni fi ll positions as program medical directors. In contrast with agency med ical directors, program medical directors work within team structures and maintain a high degree of clinical involvement, The fellowship fac ulty surveyed the alumni the tasks performed by program medical direct ors, agency medical directors, and staff psychiatrists and to determin e the extent to which these tasks contribute to job satisfaction. Meth ods: A survey form was developed using a list of tasks derived from th e American Psychiatric Association's guidelines for psychiatrists work ing in organized mental health care delivery systems and from a recent article that surveyed job descriptions of psychiatrists in community mental health centers. The survey form was distributed to all current fellows and alumni in active practice (N = 89). Results and conclusion s: Seventy-two forms were returned, for a response rate of 81 percent, Respondents who were medical directors performed a greater variety of tasks and reported higher job satisfaction than those who were staff psychiatrists. Higher job satisfaction was related to a greater variet y of tasks performed, especially tasks involving clinical collaboratio n. Most of the respondents were program medical directors rather than agency medical directors, The position of program medical director con stitutes a relatively small and attainable step above that of staff ps ychiatrist, Agencies would do well to consider creating positions of p rogram medical directors for their staff psychiatrists whenever feasib le, and psychiatrists committed to public-sector careers should negoti ate to have such positions.