Personal Financial Well-being of Family Medicine Residents and Residency Curricula: A CERA Study.

Introduction: Personal financial wellness is a milestone in graduate medical education. Prior surveys addressing financial wellness have not included family medicine (FM) residents and to date, no literature has explored the relationship between perceived financial well-being and personal finance curriculum in residency. Our study aimed to measure the financial well-being of residents and its association with the delivery of financial curricula in residency and other demographics. Methods: Our survey was included in the Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey sent to 5,000 FM residents. We use the Consumer Financial Protection Bureau (CFPB) financial well-being guide and scale to measure financial well-being and categorize into low, medium, and high ranges. Results: Two hundred sixty-six residents (response rate of 5.32%) responded with a mean financial well-being score of 55.7 (SD 12.1), in the medium score range. Financial well-being was positively associated with any form of personal financial curricula in residency, year in residency, income and citizenship. Most residents 204 (79.1%) agreed/strongly agreed that personal financial curricula are important to their education, and 53 (20.7%) never received personal financial curricula. Conclusions: Personal financial well-being scores of family medicine residents are considered medium per the CFPB ranges we assigned. We find a positive and significant association with the presence of personal financial curricula in residency. Future studies should evaluate the effectiveness of different formats of personal finance curriculum in residency on financial well-being.

Career satisfaction of psychiatrists.

OBJECTIVE: According to recent estimates, there is a shortage of around 45,000 psychiatrists in the United States. It will be very difficult to address this problem without attracting more medical students to psychiatry and motivating the current crop of psychiatrists to see more patients and delay retirement. In this study the authors sought to identify factors that have a significant impact on the career satisfaction of psychiatrists. METHODS: Data were gathered from 314 psychiatrists who participated in the 2008 Health Tracking Physician Survey conducted by the Center for Studying Health System Change. Independent variables were grouped as practice-related factors, compensation-related factors, patient-related factors, and demographic characteristics of psychiatrists. Career satisfaction of psychiatrists was the outcome measure of this study. RESULTS: Threat of malpractice and the need to consider in treatment decisions out-of-pocket cost to patients had a significant negative impact on career satisfaction. Adequate time with a patient had a significant positive impact on career satisfaction. None of the compensation-related factors was significant. Psychiatrists who worked in practices that accepted new Medicare patients reported significantly higher levels of career dissatisfaction, whereas those who worked in practices that accepted new Medicaid patients reported significantly higher levels of career satisfaction. Older psychiatrists were more satisfied than younger psychiatrists, and white, non-Hispanic psychiatrists were more satisfied than African-American or Hispanic psychiatrists. CONCLUSIONS: The results of this study highlight the need for policy makers and health care administrators to develop specific strategies to increase career satisfaction, which in return may help alleviate the shortage of psychiatrists.

A comparative analysis of factors that hinder primary care physicians' and specialist physicians' ability to provide high-quality care.

A study was undertaken to examine factors that hinder primary care physicians' and specialist physicians' ability to provide high-quality care. The study used data collected by the Center for Studying Health System Change's 2008 Health Tracking Physician Survey. The 2008 Health Tracking Physician data set consisted of 4720 physicians belonging to the American Medical Association. Both primary care physicians and specialists rated care decisions rejected by insurance (49%, 51%), followed by patient being unable to pay for needed care (45%, 43%), and patient noncompliance with treatment recommendation (43%, 37%) as the top major problem areas in providing quality care to patients. In addition, 36% of primary care physicians and 27% of specialists reported that inadequate time with patients during visit was a major problem in providing quality care to patients. Primary care physicians reported significantly more problems associated with having adequate time with patients during office visits, ability of patients to pay for needed care, availability of qualified specialists in the area, receiving timely reports from other doctors, and patient noncompliance with treatment recommendations. On the other hand, primary care physicians reported significantly lower communication difficulties with patients due to language or cultural barriers. Care decisions rejected by insurance, patient being unable to pay for care, and patient noncompliance with treatment recommendation were the top 3 hindrances in providing quality care to patients for both physician types. For 6 of the 8 hindrance factors, there were significant differences in the level of problems identified by primary care physicians and specialist physicians.

An empirical investigation of factors influencing career satisfaction of primary care physicians.

BACKGROUND: The purpose of this study was to examine factors that influence career satisfaction of 3 types of primary care physicians (PCPs): internal medicine (IM) physicians, family/general medicine (FGM) physicians, and pediatricians. METHODS: This was a secondary analysis of the Center for Studying Health System Change's 2008 Health Tracking Physician Survey. Regression analysis was done to examine the impact of environmental-, practice quality-, compensation-, and demographic-related factors on career satisfaction of IM physicians (n = 504), FGM physicians (n = 693), and pediatricians (n = 363). RESULTS: Nineteen percent of PCPs have been practicing for ≥30 years. Pediatricians had the highest career satisfaction. Although the threat of malpractice lawsuits significantly lowered career satisfaction (ß = -0.177, -0.153, and -0.146), patient interaction (ß = 0.242, 0.321, and 0.346) and income (ß = 0.132, 0.151, and 0.170) significantly increased career satisfaction of IM physicians, FGM physicians, and pediatricians, respectively. Ownership significantly lowered career satisfaction of IM physicians and pediatricians (ß = -0.168 and -0.114, respectively). Inadequate quality care significantly lowered career satisfaction of pediatricians (ß = -0.102). The 3 regression models accounted for only 16% (IM physicians), 17% (FGM physicians), and 21% (pediatricians) of the variance in career satisfaction. CONCLUSIONS: Steps like giving adequate time for interaction with patients, reducing potential threats of malpractice lawsuits, and improving income may increase PCPs' career satisfaction.