title: Tracking career satisfaction and perceptions of quality among US obstetricians and gynecologists.
abstract: OBJECTIVE
  To assess recent trends in professional satisfaction, perceptions of ability to provide high-quality care, and perceptions of ability to obtain needed services for patients in a national sample of obstetricians and gynecologists; to compare obstetrician-gynecologists with physicians in other specialties; and to identify demographic, professional, and practice characteristics associated with high career satisfaction.
  
  
  METHODS
  We used data from the 1996-1997 (n=12,385; response rate, 65%) and 1998-1999 (n=12,280; response rate, 61%) waves of the nationally representative Community Tracking Study physicians' survey. The principal outcome measures were one item related to overall career satisfaction, six items measuring physicians' perceptions of their ability to provide high-quality care, and five items measuring physicians' perceptions of their ability to obtain needed services for patients. All results were weighted and adjusted to reflect the complex survey design.
  
  
  RESULTS
  In 1996-1997, 34% of obstetrician-gynecologists (n=545) were very satisfied with their careers, and 24% were very or somewhat dissatisfied. Up to 45% perceived significant barriers to the delivery of high-quality care, and up to 58% were unable to "almost or almost always" obtain necessary services for patients. Results in 1998-1999 (n=484 obstetricians and gynecologists) were similar, except for a deterioration in perceived amount of time with patients and ability to obtain high-quality ancillary services. In comparison with primary care physicians, obstetrician-gynecologists were less satisfied (P=.001); in comparison with both primary care physicians and general surgeons, they had more problems delivering high-quality care (P<.001) and greater difficulties obtaining needed services for patients (P<.001). Controlling for selected demographic and professional characteristics, higher career satisfaction was associated with age greater than 65 years, practicing in small metropolitan areas and in academic settings, and having better perceptions of quality and ability to obtain services (P<.05).
  
  
  CONCLUSIONS
  Although most obstetricians and gynecologists are satisfied with their careers, many are experiencing significant professional distress.
authors.affiliation: Center for Health Services Research in Primary Care, Division of General Internal Medicine, University of California, Davis Medical Center, Sacramento, California 95817, USA. Rlkravitz@ucdavis.edu
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
authors.forename: J Paul
authors.initials: JP
authors.lastname: Leigh
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Samuels
authors.forename: Michael
authors.initials: M
authors.lastname: Schembri
authors.forename: William M
authors.initials: WM
authors.lastname: Gilbert
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006176:Gynecology / Q000592:standards* / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008511:Medicine / Q000592:standards / Q000639:trends; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards* / Q000639:trends; D010822:Physicians, Women; D010818:Practice Patterns, Physicians'; D017009:Professional Autonomy; D011787:Quality of Health Care; D013038:Specialization; D011795:Surveys and Questionnaires; D014481:United States