title: Work, career satisfaction, and the position of general internists in the south of Spain.
abstract: BACKGROUND
  A progressive dissatisfaction has been noted among many internists, and the future of the specialty represents a matter of concern. The objectives of this study were to analyze career satisfaction among 182 internists from 34 hospitals in the south of Spain and to assess the opinion of 47 other health care professionals who frequently interact with internists on the present and future role of the specialty.
  
  
  METHODS
  Ours was a multi-institutional, cross-sectional survey of internists that focused on demographics/practice characteristics, education/research, career satisfaction, and opinions regarding the future of internal medicine. Also included were interactive, interdisciplinary focus groups of family physicians, sub-specialists, and managers. The internists were asked to complete a questionnaire that contained items and factors that were measured on a 5-point Likert scale and quantitatively analyzed; the opinions of the focus groups were qualitatively analyzed.
  
  
  RESULTS
  The internists surveyed dedicated most of their time to treating hospitalized patients rather than to diagnostic procedures and technical assessment. Some 54% and 57% of the internists pursued continuing medical education and research, respectively, in their free time. The internists were satisfied with the content of their work and with their interpersonal relationships, but they were dissatisfied with their physical/instrumental environment, management policies, and degree of work stability. No differences were detected in relation to age, gender, community factor, or professional category. With regard to the future of the specialty, the main opportunity detected by internists was a closer collaboration with primary care. An analysis of the strengths, weaknesses, future opportunities and threats to internal medicine expressed by the seven focus groups was highly concordant and added worthwhile information and clear proposals for the development of the specialty.
  
  
  CONCLUSIONS
  Internists in the south of Spain were satisfied with the content of their work and dissatisfied with health care management and job stability. The future of internal medicine was felt to lie in a deeper collaboration between internists and their colleagues in primary care.
authors.affiliation: Department of Internal Medicine, Hospitales Universitarios Virgen del Rocío, Avda Manuel Siurot s/n, 41013 Sevilla, Spain. wittel@cica.es
authors.forename: Máximo
authors.initials: M
authors.lastname: Bernabeu-Wittel
authors.forename: Salvador
authors.initials: S
authors.lastname: García-Morillo
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Pérez-Lázaro
authors.forename: Inmaculada Mateo
authors.initials: IM
authors.lastname: Rodríguez
authors.forename: Manuel
authors.initials: M
authors.lastname: Ollero
authors.forename: Enrique
authors.initials: E
authors.lastname: Calderón
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González
authors.forename: José A
authors.initials: JA
authors.lastname: Cuello