Table 3.
Relationship between Professionalism/Autonomy, Career Satisfaction, and Percentage of Practice Revenue from Managed Care (Unadjusted)
| Percent Managed Care Revenue | ||||||
|---|---|---|---|---|---|---|
| Primary Care Physicians | Specialists | |||||
| Low | Medium | High | Low | Medium | High | |
| Professionalism and autonomy, Percent who agree with statement* | ||||||
| I have the freedom to make clinical decisions that meet my patients' needs | 89.5 | 84.4† | 83.7† | 77.1 | 69.3† | 70.2† |
| I can make clinical decisions in the best interests of my patients without the possibility of reducing my income | 82.4 | 74.6† | 75.3† | 72.6 | 64.4† | 67.9†,‡ |
| I have adequate time to spend with my patients during their office visits | 73.6 | 66.6† | 61.0†,‡ | 77.8 | 70.1† | 68.9† |
| It is possible to provide high quality care to all of my patients | 80.8 | 83.1 | 80.5‡ | 76.7 | 71.1† | 71.1† |
| It is possible to maintain the kind of continuing relationships with patients over time that promote the delivery of high quality care | 83.1 | 76.4† | 74.5† | 65.1 | 52.3† | 54.0† |
| The level of communication I have with colleagues about the patients whom I refer or who are referred to me is sufficient to ensure the delivery of high quality of care | 88.1 | 86.4 | 85.1† | 76.4 | 73.9 | 74.1 |
| Career Satisfaction | ||||||
| Percent “very satisfied” with career | 44.7 | 42.4 | 40.4† | 46.0 | 41.2† | 41.2† |
Source: HSC Community Tracking Study 1996–1997 Physician Survey.
Managed care terciles: low = 0–25%, medium = 26–50%, high >50% of practice revenue from managed care.
*
Percent of physicians who agree somewhat or agree strongly with statement is reported in this table. Response scale was: agree strongly, agree somewhat, disagree somewhat, disagree strongly, and neither agree nor disagree.
†
Significantly different from Low Managed Care tercile, P < .05
‡
Significantly different from Medium Managed Care tercile, P < .05.