Physician job satisfaction and quality of care among hospital employed physicians in Japan.

Abstract

BACKGROUND: Physician job satisfaction is reportedly associated with interpersonal quality of care, such as patient satisfaction, but its association with technical quality of care, as determined by whether patients are offered recommended services, is unknown. OBJECTIVE: We explored whether the job satisfaction of hospital-employed physicians in Japan is associated with the technical quality of care, with an emphasis on process qualities as measured by quality indicators. DESIGN: Cross-sectional study linking data from physician surveys with data abstracted from outpatient charts. PARTICIPANTS: A total of 53 physicians working at 13 hospitals in Japan participated. Medical records covering 568 patients were reviewed. MEASUREMENTS: Disease-specific indicators related to the care of patients with hypertension, type 2 diabetes, and asthma, as well as disease-independent measures of the process of care were abstracted. We analyzed the association between the quality of care score for individual physicians, which is defined as the percentage of quality indicators satisfied among the total for which their patients were eligible, and physician job satisfaction, which was measured by a validated scale. RESULTS: No statistically significant association between physician job satisfaction and quality of care was observed. A 1-standard deviation (SD) increment in the physician job satisfaction scale was associated with an increase of only 0.3% for overall quality (P = 0.85), -3.0% for hypertension (P = 0.22), 2.5% for type 2 diabetes (P = 0.44), 8.0% for asthma (P = 0.21), and -0.4% for cross-cutting care (P = 0.76). CONCLUSION: Contrary to the positive association reported between physician job satisfaction and high quality of interpersonal care, no association was seen between physician job satisfaction and the technical quality of care.