Family physician job satisfaction in different medical care organization models.
OBJECTIVE
The aim of the present study was to estimate physician job satisfaction at the Mexican Institute of Social Security (IMSS), the Ministry of Health (SSA) and in the private sector, and to measure the association between these different family medical care organization models.


METHODS
A comparative cross-sectional design was used to investigate the job satisfaction of family physicians in private and institutional family medicine clinics. Satisfaction was measured with a previously constructed and validated instrument. The instrument measures the satisfaction in four areas: 'global satisfaction', 'institution where the physician works', 'the patients' and 'themselves as physicians'.


RESULTS
One hundred and seven IMSS physicians, 106 SSA physicians and 97 private physicians were selected randomly from a census according to the sample size. The sample was weighted. Fifty-one percent of IMSS and SSA physicians were dissatisfied, against 25% in the private sector, in the first three areas. Comparing the private model and the IMSS, differences were found (P < 0.0001) in the area of 'global satisfaction' [odds ratio (OR) = 2.47, 95% confidence interval (CI) 1.69-3.67], 'institution where the physician works' (OR = 2.12, CI 1. 45-3.13) and 'themselves as physicians' (OR = 1.84, CI 1.28-2.65). When the private/SSA groups were compared, the differences were similar (P < 0.0001). No differences were found in terms of 'the patients'. When stratifying, the risks increased in females, in the group aged 31-40 years and in specialists in family medicine.


CONCLUSIONS
The organization model is associated with dissatisfaction in all areas, except in 'the patients'.
Department of Epidemiological and Health Services Research and Medical Research Coordination, Mexican Institute of Social Security (IMSS) and Psychology Faculty, National University of Mexico.
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C
García-Peña
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Reyes-Frausto
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Reyes-Lagunes
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O
Muñoz-Hernández
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007325:Institutional Practice / Q000706:statistics & numerical data*; D007588:Job Satisfaction; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010821:Physicians, Family / Q000523:psychology*; D011331:Private Practice / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires