Does micropractice lead to macrosatisfaction?

BACKGROUND: Physician quality of work life is a key factor in career choice, satisfaction, and retention. The majority of physicians are currently employed by large health care organizations where physician loss of autonomy is common, yet some physicians have opened micropractices. There have been no previous studies comparing physician satisfaction between employed physicians and micropractice physicians. METHODS: A previously validated survey of physician satisfaction was sent to 72 physicians practicing in a residency setting, 111 physicians in community, nonresidency setting, and 42 physicians in a micropractice setting. RESULTS: Physicians in micropractices had the lowest satisfaction with income, but the highest satisfaction with family time and the ability to provide continuity of care. Micropractice physicians rated the overall quality of medical care they provide higher than employed physicians. Micropractice physicians reported a much smaller scope of practice. CONCLUSIONS: Overall, physicians in micropractices found more satisfaction in their work at the cost of decreased income and a narrower scope of practice.

Reproductive health care of adolescent women.

Reproductive health care of adolescent women is focused on prevention of disease. Adolescents are at higher risk for pelvic inflammatory disease than adult women; therefore, screening regularly for sexually transmitted infections is important. Immunization for human papillomavirus is the primary means of cervical cancer prevention because new guidelines recommend not initiating Papanicolaou smears until the age of 21. Contraception for adolescents is a challenge, and clinicians should focus on long-acting, reversible contraception in this group. The treatment of pelvic pain and menstrual disorders in adolescent women is distinct from adult women and is related to differing prevalence of conditions. Lastly, this article discusses the importance of confidential care when treating adolescent women.