Department of Family Medicine, University of Washington, Seattle, WA, USA.
J Am Board Fam Med. 2012 Jul-Aug;25(4):470-6. doi: 10.3122/jabfm.2012.04.110295.
Community health centers (CHCs) receive $2.9 billion in federal funding to provide primary care to 20 million people annually, and these numbers are increasing. Understanding of physician satisfaction in CHCs may help guide recruitment and retention efforts aimed at expanding CHC programs. The objective of this study was to contrast the satisfaction of family physicians working in CHCs with the satisfaction of family physicians working in other practice settings.
Analysis of 4 cross-sectional surveys of recent residency graduates from the Washington, Wyoming, Alaska, Montana, and Idaho Family Medicine Residency Network. Surveys were conducted approximately every 3 years from 2000 to 2010. Main outcome measures included self-reported satisfaction with residency training, practice, and specialty on a 1 (low) to 5 (high) scale.
Eight hundred ninety-three family physician responded (response rate, 61%), of whom 129 were CHC physicians and 764 were non-CHC physicians. Compared with non-CHC physicians, higher proportions of CHC physicians reported being highly satisfied with their residency training (79% vs 61%; P < .01) and choice of specialty (74% vs 60%; P < .01). In contrast, lower proportions of CHC physicians were highly satisfied with their employers (62% vs 72%; P = .05). [corrected]. There were no differences in satisfaction with practice partners, income, practice location, or work hours. After adjustment for physician, practice, and community characteristics, CHC physicians were more likely to be highly satisfied with their residency training (odds ratio, 2.6; P = .001) and their choice of specialty (odds ratio, 1.7; P = .03). CHC physicians were less likely to be highly satisfied with their employers (odds ratio, 0.5; P < .01).
The lower level of satisfaction reported by CHC physicians has implications for workforce recruitment and retention in CHC settings. In an era of CHC growth, efforts to improve physician relationships with employers may be a potential target for enhancing the physician workforce in CHCs.
社区卫生中心（CHC）获得 29 亿美元的联邦资金，每年为 2000 万人提供初级保健，而且这个数字还在增加。了解 CHC 医生的满意度有助于指导旨在扩大 CHC 项目的招聘和留用工作。本研究的目的是对比在 CHC 工作的家庭医生和在其他工作环境工作的家庭医生的满意度。
对来自华盛顿、怀俄明、阿拉斯加、蒙大拿和爱达荷家庭医学住院医师网络的最近的住院医师的 4 项横断面调查进行分析。调查于 2000 年至 2010 年期间每 3 年进行一次。主要结果指标包括自我报告的住院医师培训、实践和专业的满意度，分值为 1（低）至 5（高）。
893 名家庭医生做出了回应（回应率为 61%），其中 129 名是 CHC 医生，764 名是非 CHC 医生。与非 CHC 医生相比，更高比例的 CHC 医生报告对住院医师培训（79%对 61%；P<.01）和专业选择（74%对 60%；P<.01）非常满意。相比之下，较低比例的 CHC 医生对他们的雇主非常满意（62%对 72%；P=.05）。[纠正]。在与实践伙伴、收入、实践地点或工作时间有关的满意度方面没有差异。在调整医生、实践和社区特征后，CHC 医生更有可能对住院医师培训（优势比，2.6；P=.001）和专业选择（优势比，1.7；P=.03）非常满意。CHC 医生对雇主的满意度较低（优势比，0.5；P<.01）。
CHC 医生报告的满意度较低，对 CHC 环境中的劳动力招聘和留用有影响。在 CHC 增长的时代，努力改善医生与雇主的关系可能是增强 CHC 医生劳动力的一个潜在目标。
