Trends in Indicators of Workplace Quality and Autonomy Among US Pediatricians: 2012-2017

Presented at the 2019 Pediatric Academic Societies Annual Meeting.

Background: Physician wellness and professional satisfaction are increasingly discussed topics. However, little is known about trends in pediatricians’ views on their workplace quality and autonomy, which may affect professional experiences.

Objective: Evaluate trends in pediatricians’ workplace quality and autonomy attitudes from 2012 to 2017.

Methods: Nationally representative Periodic Surveys of American Academy of Pediatrics post-residency, US members in 2012 (n=901; response rate=63%) and 2017 (n=715; RR=50%). Surveys included respondent demographics, 5 indicators of quality/autonomy adapted from the Community Tracking Study Physician Survey, and a global indicator of satisfaction adapted from the Physician Worklife Study (“I find my present work personally rewarding”). Predicted probabilities (PP) from separate multivariable logistic regression models examined the independent effect of survey year on agreeing/strongly agreeing to the workplace quality and autonomy indicators, controlling for age, gender, setting, area, hours worked per week, subspecialist status, and owner status (probabilities generated holding all controls at their sample means). All outcomes were originally measured on a 5-point Likert scale (strongly disagree to strongly agree).

Results: From 2012 to 2017, the predicted probability of pediatricians’ agreeing their present work is personally rewarding (an indicator of global satisfaction) remained stable at 86% (Figure 1). However, pediatricians’ reported attitudes towards other indicators declined, as the predicted probability of agreeing to statements like “It is possible to provide high-quality care to all my patients” (2012: PP=78.7%, 95% CI=75.6-81.8; 2017: 61.4%, 57.5-65.3), “I have adequate time to spend with my patients during office visits” (2012: 57.9%, 54.2-61.6; 2017: 45.7%, 41.8-49.6), and “It is possible to maintain continuing relationships with patients that promote high-quality care” (2012: 84.3%, 81.4-87.1; 2017: 69.8%, 66.0-73.6) decreased significantly.

Conclusion: In both 2012 and 2017, over 8 out of 10 respondents report they find their work personally rewarding, indicating a high, stable level of job satisfaction among US pediatricians. However, we also found pediatricians were less likely to report high rates of quality and autonomy over time. Taken together, our findings indicate that while there is strong reported global satisfaction, multiple dimensions – including quality and autonomy – should be considered when evaluating the professional experiences of pediatricians.