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美国家庭医生对其执业情况、健康状况及医疗保健的观察。

Family physicians' observations of their practice, well being, and health care in the United States.

作者信息

Shearer S, Toedt M

机构信息

Department of Family Practice, Franklin Square Hospital Center, Baltimore, MD, 21237, USA.

出版信息

J Fam Pract. 2001 Sep;50(9):751-6.

Abstract

OBJECTIVE

Our goal was to characterize how family physicians perceive recent changes in the health care system and how content they are with various factors.

STUDY DESIGN

We performed a cross-sectional mailed survey.

POPULATION

The survey was completed by a random sample of 361 family physicians practicing in the United States.

OUTCOME MEASURES

The survey evaluated attitudes about corporate managed care, health care reform, career satisfaction, compensation, personal life satisfaction, workload stress, personal well-being, and residency training. We reported percentages for Likert-rated survey items, factor analysis of the survey, and a regression model for statistical prediction of the 4 major factors.

RESULTS

Relative to survey data gathered in 1996, fewer family physicians in our survey reported that they were satisfied with their careers (59% vs 82%); fewer were satisfied with their compensation (55% vs 65%); and fewer would again choose family practice as their specialty (66% vs 75%). Thirty-one percent worried that they were "burning out" as physicians, and 48% reported that they had experienced more stress-related symptoms in the past year. Only 7% agreed that corporate managed care is the best way to provide the health care America needs at a cost society can afford, but only 36% unequivocally endorsed the concept of a national health plan. Forty-two percent of the respondents reported that they had witnessed bad patient outcomes they perceived to be attributable to managed care business processes.

CONCLUSIONS

The morale and career satisfaction of family physicians seems to have eroded in recent years, and discontent is common. As a group, family physicians are unhappy with the current health care system and quite unified about certain specific reforms, yet they are far from such consensus about more sweeping reform.

摘要

目的

我们的目标是描述家庭医生如何看待医疗保健系统最近的变化以及他们对各种因素的满意程度。

研究设计

我们进行了一项横断面邮寄调查。

研究对象

该调查由在美国执业的361名家庭医生的随机样本完成。

观察指标

该调查评估了对企业管理式医疗、医疗保健改革、职业满意度、薪酬、个人生活满意度、工作压力、个人幸福感和住院医师培训的态度。我们报告了李克特量表评分调查项目的百分比、调查的因素分析以及4个主要因素的统计预测回归模型。

结果

与1996年收集的调查数据相比,我们调查中报告对自己职业满意的家庭医生更少(59%对82%);对薪酬满意的更少(55%对65%);再次选择家庭医学作为其专业的更少(66%对75%)。31%的人担心自己作为医生会“倦怠”,48%的人报告在过去一年中经历了更多与压力相关的症状。只有7%的人同意企业管理式医疗是在社会能够承受的成本下提供美国所需医疗保健的最佳方式,但只有36%的人明确支持国家医疗计划的概念。42%的受访者报告说他们目睹了他们认为可归因于管理式医疗业务流程的不良患者结局。

结论

近年来,家庭医生的士气和职业满意度似乎有所下降,不满情绪很普遍。作为一个群体,家庭医生对当前的医疗保健系统不满意,并且在某些具体改革方面相当一致,但对于更全面的改革,他们远未达成这样的共识。

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