Satisfaction with Life amongst Psychiatrists and General Physicians: demographic and career variables

doi:10.4236/ojpsych.2011.13018

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Open Journal of Psychiatry, 2011, 1, 122-125

doi:10.4236/ojpsych.2011.13018 Published Online October 2011 (http://www.SciRP.org/journal/OJPsych/ OJPsych

Published Online October 2011 in SciRes. http://www.scirp.org/journal/OJPsych

Satisfaction with life amongst psychiatrists and general

physicians: demographic and career variables

Yo ram Barak1*, Moshe Tishler2, Dov Aizenberg3

1Abarbanel Mental Health Center, Bat-Yam, Israel;

2Asaf-HaRofe Medical Center, Rishon LeZion, Israel;

3Geha Mental Health Center, Petah-Tikva, Israel.

Email: *[email protected]

Received 1 July 2011; revised 12 August 2011; accepted 22 August 2011.

ABSTRACT

Background: positive psychology and the science of

happiness have impacted many realms in academia,

including medicine. Recent reports from several

countries suggest that physicians are unhappy with

their profession. Aim: to assess levels of happiness

amongst Israeli physicians and its’ correlates. Me-

thod: participants in professional meetings endorsed

the Satisfaction with Life Scale (SWLS) and a ques-

tionnaire detailing personal data (age, gender, marital

status, number of children), specialty years as a phy-

sician and their state of health. Results: 223 physi-

cians (131 psychiatrists, 92 primary care) completed

the survey. The response rate was higher than 75%.

Mean SWLS score for all 223 physicians was 23.6 ±

5.7 and did not differ between specialties’ (p = 0.39).

No differences from reported norms amongst the

general population were found. The only signifycant

association with SWLS scores was number of chil-

dren (r = 0.23; p = 0.0006). Selection bias was in-

herent in this type of survey. Conclusion: satisfaction

with life amongst Israeli physicians is equal to re-

ported national means and may be supported by var-

iables outside the professional sphere.

Keywords: Physicians; Satisfaction with Life; Happi-

ness

1. INTRODUCTION

Happiness and satisfaction with life are two of the main

constructs studied in the emerging field of positive psy-

chology. Satisfaction with life is defined as “a person’s

cognitive and affective evaluations of his or her life” and

denotes the presence of positiv e emotion, the absence of

negative emotion, and a cognitive judgment of satisfac-

tion and fulfillment [1]. The construct of happiness is an

unwieldy term involving positive emotion and pleasure.

Happy people have better quality o f life, and research in

the behavioral, social, and medical sciences is continu-

ing to identify other benefits of happiness, including

better health [2]. However some reports of doctors that

are unhappy with their careers in medicine, with a sig-

nificant minority of junior doctors considering leaving

medicine have caused concern [3,4]. While most physic-

cians continue to report overall career satisfaction, only

a small fraction of physicians are very satisfied with the

practice of medic i ne [5] .

Physician career satisfaction and morale has received

focused attention recently. Publications deal with the

growing discontent of physicians and attempt to unravel

the causes underlying this attitude [6-8]. There are rea-

sons for this attention. Physicians who are satisfied with

their careers are likely to provide better health care than

dissatisfied physicians. High physician satisfaction is

also likely to result from good outcomes with patients.

Moreover, dissatisfaction, if prolonged, may result in

health problems for the physicians themselves [9].

The most obvious cause of doctors’ unhappiness is

that they feel overworked and undersupported [3].

Trained in pathophysiology, diagnosis, and treatment,

doctors spend more time involved with issues like man-

agement, improvement, finance, law, ethics, and com-

munication. Workload and pay, though important, do not

fully explain the problem. A key factor seems to be a

change in the psychological compact between the pro-

fession, employers, patients, and society so that the job

is now different from what doctors expected [10]. On the

other hand, the causes for physicians unhappiness herein

mentioned might be partly offset by taking into account

communication and ethical aspects in the primary educa-

tion of medical students during recent years [11,12].

The last decade had witnessed an on-going struggle

between the Israel Medical Association and governmental

Y. Barak et al. / Open Journal of Psychiatry 1 (2011) 122-125 123

agencies focusing on the state of affairs of practicing

medicine in an era of cutbacks and reform. As satisfac-

tion with life reflects the cognitive judgment of one’s

happiness it will reveal insight into physicians’ inner

perception of their social and professional roles. Thus

we aimed to evaluate the association between several

career and demographic characteristics and satisfaction

with life amongst physicians.

2. METHOD

The present study utilized the Satisfaction with Life

Scale (SWLS) originally developed by Diener et al. [13].

The SWLS was developed to assess satisfaction with

people’s lives as a whole. The scale does not assess sat-

isfaction with specific life domains, such as health or

finances, but allows subjects to integrate and weigh

these domains in whatever way they choose. The SWLS

is a short, 5-item instrument designed to measure global

cognitive judgments of one’s lives. It takes only a few

minutes to complete. The scale’s items are: 1) In most

ways my life is close to my ideal, 2) The conditions of

my life are excellent, 3) I am satisfied with my life, 4)

So far I have gotten the important things I want in life

and 5) If I could live my life over, I would change al-

most nothing. Items are rated on a 1 - 7 basis as follows:

1—Strongly disgree, 2—Disgree, 3—Slightly disagree,

4—Neither agree nor disgree, 5—Slightly agree, 6—

Agree and 7—Strongly agree. The final score is the

arithmetic total of all item scores reflecting satisfaction

with life as follows: 35 - 31 Extremely satisfied, 26 - 30

Satisfied, 21 - 25 Slightly satisfied, 20-Neutral, 15 - 19

Slightly dissatisfied, 10 - 14 Dissatisfied and 5 - 9 Ex-

tremely dissatisfied [14,15].

During the period Jan, 2007 to Dec, 2007 we pre-

sented the aims of the survey to physicians attending

professional meetings. Regional meetings for the Israel

Medical Association (IMA) family physicians, internists

and psychiatric association were attended by one of the

researchers. The Tel-Aviv chapter of the IMA holds a

regional meeting every 4 months usually attended by 50

to 100 participants. Participan ts were than asked to com-

plete the SWLS as well as a short questio nnaire d etailin g

personal data (age, gender, marital status, number of

children), medical specialty years as a physician and the

state of their health reflected in the following question:

“Do you have medical problems that adversely affect

your satisfaction with life?” This q uestion was answered

on the same 1 to 7 scoring as that of the SWLS items.

Survey forms were handed to the participants and col-

lected at the end of the meeting. Response rates were

greater than 75% (ranging from 78% to 97%).

We sampled various specialists: psychiatrists, general

practitioners, internists working in general hospital set-

tings and family physicians practicing in the community.

There are 850 psychiatrists and 3000 primary care phy-

sicians registered with the IMA.

The study was approved by the local IRB.

S tatistical Analysis

Data were analyzed using a paired-samples and inde-

pendent-samples approach. The two-tailed t-test and

non-parametric test were undertaken to test for differ-

ences between the evaluations for quantitative parame-

ters. Examination of differences between the categorical

parameters were based on the Pearson Chi-square and

Fisher’s Exact tests. All tests applied were two-tailed,

and p value of 5% or less was considered statistically

significant.

The data was analyzed using the Statistical Analysis

System software, SAS Institute 6th version, [16].

3. RESULTS

During the study period 223 physicians completed the

survey. Th ere were 131 psychiatrists and 92 primary care

physicians. Mean age (±SD) for the group was 52.3 ±

11.5 years and there were 97 women and 126 men. The

majority of participants, 182 (82%) were married while

there were 17 divorced, 11 widowed and 15 were single.

There were 2.2 children per participant (median 2.0,

range 0 to 7) . On av erag e the p artic ipants had b een pr ac-

ticing their specialty for 21.5 ± 11.7 years (range: 6 -

46).

The mean total SWLS score for all 223 physicians

was 23.6 ± 5.7 and did not differ significantly between

the various specialties (p = 0.39). Categorically this tran -

slates to 84% of participants being “satisfied” with their

lives (the sum of “slightly satisfied”, “satisfied” and

“very satisfied”). The SWLS total score was analyzed in

order to identify correlations to demographic and clinical

variables. Pearson correlation coefficients were calcu-

lated for: age, gender, number of children, years in prac-

tice and medical problems. The only statistically signifi-

cant finding among all physicians (n = 223) was a linear

correlation with the number of children (r = 0.23; p =

0.0006). There was an overall trend towards a positive

correlation with increasing age (p = 0.06) reaching sig-

nificance only for the psychiatrists’ group (r = 0.23; p =

0.01).

The majority of physicians reported: “no medical

problem that adversely affects satisfaction with life”

(53%). Medical problems “very much affecting” satis-

faction with life were reported by a small minority of

participants (4%).

4. DISCUSSION

In the present study physicians from several specialties

Y. Barak et al. / Open Journal of Psychiatry 1 (2011) 122-125

124

were surveyed and as a group reported mean levels of

satisfaction with life equal to the Israel national mean for

adults. In 2002 the government appointed the Bank of

Israel to conduct a nationwide research as to happiness

and satisfaction with life of Israel citizens [17]. The sur-

veyors approached 9404 citizens 20 years of age and

older. The majority of participants—83% reported that

they are “satisfied” with their lives from slightly satis-

fied to very satisfied. The questions used in this survey

are similar to those presented in the SWLS. The level of

such satisfaction with life was 84% in our sample com-

pletely in accord with the findings among the general

population. The number of children was directly associ-

ated with increased level of satisfaction in physicians

participating in the present study and in the general

population of Israel [17]. Interestingly, while age was

associated with decrease in life satisfaction in the gen-

eral population it positively contributed to physicians’

happiness. We may tentatively suggest that factors not

related to career such as the number of children operate

in the samples compared while older age indirectly re-

flects experience and possibly higher professional stan-

ding thereby co ntributing to physicians’ satisfaction.

The satisfaction of medical specialists is affected by

many variables such as family, stress, quality of services

and professional rewards. Canadian researchers have

compared psychiatrists to surgeons emphasizing that ex-

planatory variables associated with their satisfaction

with careers are among others intrinsic and extrinsic

rewards and workload. In addition, their study demon-

strated that variance associated with career satisfaction

can be explained using various factors reported directly

by physicians [18]. In Israel the IMA specifically inter-

viewed a representativ e sample of 500 physicians focus-

ing on professional satisfaction [19]. Only 59% of phy-

sicians reported satisfaction with their work in this IMA

survey. This again emphasizes that the high rates of sat-

isfaction with life amongst physicians are influenced by

extrinsic rewards such as ch ildren, religion and others in

contrast to intrinsic service related variables [15,20].

These findings are supported by work undertaken in the

USA evaluating the changing culture in modern medi-

cine with special focus on the interactions and economic

consequences of managed care, health service delivery

systems, academic medicine, and psychiatry. In west-

ernized medicine, especially the USA, improved tech-

nology and therapeutics profoundly impact medical cul-

ture; but medical economics is as significant. Physicians’

roles blur with duties delegated to lesser qualified

healthcare professionals to maximize patients seen and

generated incomes Doctors need to understand that in

entering medicine they enter a life’s career in which they

serve others, do not expect to become wealthy, but at

life’s end are able to state their satisfaction with their

professional achievements [21,22].

Limitations of the present study include: 1) the data

are self-reported; 2) the data are cross-sectional so that

causal relations are subject to interpretation; 3) the sam-

pling undertaken in professional academic meetings fa-

vors physicians who are possibly more socially and aca-

demically conscious and with a higher interest in their

profession and therefore a higher satisfaction; 4) this

sample is of small size only; 5) other specialties were not

surveyed; 6) the SWLS does not specifically quantify

satisfaction with ones’ profession; and finally 7) no spe-

cific career related questions were posed. The SWLS

scale reflects happiness indirectly. The association be-

tween career satisfaction and satisfaction with life may

not be straight forward and we caution in overlapping

these two concepts [23]. However, this is true for all

survey data sets. Strengths of this study include: 1) easy

to use measurement to assess global satisfaction; 2) high

completion rate of surveys and 3) ability to co mpare date

to a national study of satisfaction and happiness

In conclusion, satisfaction with life amongst Israeli

physicians was very close to that of the general public.

However, our findings suggest that happiness of physi-

cians may be sustained by factors related to the personal

and social domains unrelated to the professional sphere.

The present small study sheds light on an important is-

sue for all practicing physicians. It should be considered

as a preliminary research and we aim to replicate this

work with a much greater sample size and a variety of

specialties.

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