Certain specialties have higher satisfaction rates
While recent surveys cite low job satisfaction as one of the causative factors of the growing nursing shortage, the job satisfaction picture is not nearly so dire in other areas of health care. In fact, in some areas the picture is quite the opposite. In two recent surveys, physician assistants (PAs) and physicians in selected specialties indicated a relatively high level of satisfaction.
Researchers at the University of California, Davis (UC Davis) School of Medicine and Medical Centers conducted a study of more than 12,000 physicians representing 33 medical disciplines and found that more than 70% were "satisfied" or "very satisfied" with their careers, while about 20% were dissatisfied. And in a survey conducted by the Alexandria, VA-based American Academy of Physician Assistants (AAPA), 86% of the respondents said they would become a PA if they had to choose their career over again.
Not all specialties equal
In the UC Davis study, one of the more interesting findings was the difference in satisfaction levels between physicians in various specialties. For example, specialties reporting a relatively high level of career satisfaction include pediatrics, perinatal medicine, neonatal care, geriatric internal medicine, and dermatology. High levels of dissatisfaction were more commonly reported in obstetrics/gynecology, ophthalmology, orthopedic surgery, internal medicine, and otolaryngology.
"These findings have important implications for physicians, their professional organizations, residency directors, managed care administrators and students selecting a specialty," notes J. Paul Leigh, professor of epidemiology and preventive medicine at UC Davis and lead author of the study, which appeared in the July 22 issue of the Archives of Internal Medicine.
Other factors also figured into job satisfaction for physicians. For example, high levels of career satisfaction were linked to higher incomes, living in the Northeastern and West North-Central regions of the United States, practicing in a rural area or small town, and having little involvement with managed care.
Happy across the board
By contrast, PAs across the board expressed high levels of satisfaction. Asked if they would become PAs if they were to choose their careers today, 50% said they "definitely would," and 36% said they "probably would."
"We’ve sliced and diced the data by specialty, age, geography — you name it," says Steve Crane, PhD, AAPA executive director, "and it’s virtually no different in any subcategory. It’s a study we’ve done over a three-year period, and it’s been virtually the same over the past three years. It’s a truly a uniform result — it’s not just occupational medicine PAs, or those in some other area of specialty who are happy."
There are a number of reasons for these high satisfaction levels, says Crane. For one thing, PAs are broadly trained in primary care, but learn the basic elements of medicine all the way through surgery, so they can function in a wide variety of settings. "If you end up somewhere you don’t like, you can easily move because of your primary-care base of training," Crane explains.
In fact, on the average PAs will work in three different specialty areas over their career, says Crane, while most nurse practitioners and most physicians end up working in a more limited area. "PAs can use their training to find an optimal position," he explains. In addition, he notes, the way the profession is structured is critical. "PAs always work with physician supervision, and their scope of work is dictated by what is delegated to them," he observes. "As they grow in knowledge and experience, the physicians usually give them more to do, so the job, if you will, is never the same. Its scope expands steadily."
Then there are lifestyle issues. People choose the profession because they want to practice medicine with physician supervision, and they can get their training in a two-year period instead of eight, yet they can still get the same satisfaction in terms of patient/physician relationships. "PAs work on the average 44 or 45 hours a week so they can still have a life," adds Crane.
PAs also appreciate what they see as a very high level of respect shown to them both by physicians and by patients, as well as from other health workers, says Crane. "Pay levels are also good; the average salary is $71,000 nationwide, with entry level pay at about $58,000," he says.
It also is a young profession. The average age of a practicing PA is 41, and in the last seven years, the number of PA programs has more than doubled. In addition, 45% of the profession has graduated in the last five years. At present, 53% of PAs are women and 47% are men. "The profession had been male-dominated," says Crane, "But in our schools today, 67% of the students are women and 33% are men."
The profession also is a diverse group, with 12% of all PAs being minorities. Occupational medicine, says Crane, is one of the fastest-growing areas. "The demand for the profession is strong, and we see a bright future," he concludes.
[For more information about the AAPA survey, contact: Nancy Hughes, Vice President — Communications and Information Services, American Academy of Physician Assistants, 950 N. Washington St., Alexandria, VA 22314-1552. Telephone: (703) 836-2272, ext. 3505. Fax: (703) 684-1924. E-mail: [email protected]. Web site: www.aapa.org.]
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