Background/Purpose: Practice improvement research routinely measures patient satisfaction and disease-specific outcomes but seldom considers the satisfaction of physicians who deliver the care. Studies suggest that physician dissatisfaction may pose a barrier to implementing quality improvement efforts. There is a paucity of succinct measures of physician satisfaction. As part of a Performance Improvement Project, in an academic rheumatology practice and an affiliated practice, we developed and piloted a simple questionnaire.

Methods: Thirty five rheumatologists in the academic or private setting were sent opened-ended questions to determine the factors that made them satisfied or dissatisfied with respect to their rheumatology practice. From the responses we formed a 14 questions 0 to 10 scale centering on satisfaction and dissatisfaction. We then administered the questionnaires to a small pilot of 30 rheumatologists in academic and/or private setting.

Results: Our sample included 30 rheumatologists, from whom 60% were faculty members, 27 % were fellows, 53% (N=16) were males and the majority (77%) were salaried. Racial distribution was 57% white, and 40% Asian, with 7% Hispanic/Latino ethnicity. The most common practice setting was academic medicine (80%, N=24), followed by multi-specialty group (10%, N=3), private practice (7%, N=2), and rheumatology group (3%, N=1). Forty percent (N=12) and 37% (N=11) had been in practice <5 and >30 years, respectively. Coefficient Alpha for each factor was 0.54 (raw) 0.66 (standardized) for satisfaction and 0.60 (raw) and 0.60 (standardized) for dissatisfaction. Based on the results of this survey, mean satisfaction factor in rheumatologists was high (8.6±0.99). 91.3% of rheumatologists (N=21) had mean satisfaction factor >8 (range 5.5-9.9). The ability to make a difference in patient’s life and having the opportunity to work with great colleagues were the strongest contributors to physicians’ satisfaction (mean 9.2±1.1 and 9.4±0.8, respectively). Time spent on documentation and getting inappropriate referrals that are not in the scope of practice were among the strongest contributors to physicians’ dissatisfaction (mean 3± 1.9 and 3.9±1.3, respectively). None of the items were highly correlated with each other.

Conclusion: A simple and practical questionnaire to measure physician satisfaction was developed and successfully piloted on a predominately academic sample of rheumatologists. The strongest correlates of physician satisfaction were the “ability to make a difference in a patient’s life” and to “work with great colleagues” whereas the greatest correlates of dissatisfaction were “time spent on documentation” and “inappropriate referrals.” It is hoped that with further testing on a larger sample, this scale will serve as a means to identifying potential barriers to the implementation of performance improvement projects in the practice of Rheumatology.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/development-and-validation-of-a-rheumatologist-satisfaction-with-practice-scale-the-rheumatologist-satisfaction-scale-rss/