title: Association between satisfaction and stress with aspects of job and practice management among primary care physicians.
abstract: BACKGROUND
  Reforms introduced in the last decade in Italian general practice, have contributed to the changing role of primary care physicians (PCPs) within the Italian National Health Service, with potential difficulties adapting that may lead to job stress and dissatisfaction. The present study aims to compare job satisfaction and stress levels of PCPs working in primary healthcare teams (PHCTs) with those for practitioners operating in single ambulatory offices, and to assess potential associations with aspects of job and practice management.
  
  
  METHODS
  A postal survey was conducted between January and March 2005 among PCPs working in Tuscany. Data were collected by using a structured questionnaire containing questions concerning personal, professional, job and practice characteristics. The Warr-Cook-Wall scale and the Cooper test were used to assess job satisfaction and stress, respectively.
  
  
  RESULTS
  From 3043 PCPs, a response rate of 45.2% was achieved. Significant differences were found between PHCT physicians and solo practitioners in several aspects of their job. Physicians working in PHCTs appeared more satisfied in some aspects of their practice such as organisation, whereas they were less satisfied about workload and interaction with other healthcare providers. Multivariate modelling showed relevant aspects of dissatisfaction and stress, particularly the difficulties of collaboration with other healthcare providers, and access to specialised services.
  
  
  CONCLUSIONS
  Reform strategies aimed at improving the quality of care among PCPs needs to take into account the contextual determinants of physician satisfaction and stress, and should highlight programmes that might be pursued to improve the integration of PCPs within the Italian National Health System.
authors.affiliation: Regional Agency for Healthcare Services of Tuscany, Epidemiology Unit, Florence and Italian College of General Practitioners, Florence, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Mazzaglia
authors.forename: Francesco
authors.initials: F
authors.lastname: Lapi
authors.forename: Caterina
authors.initials: C
authors.lastname: Silvestri
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Roti
authors.forename: Saffi Ettore
authors.initials: SE
authors.lastname: Giustini
authors.forename: Eva
authors.initials: E
authors.lastname: Buiatti
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006123:Group Practice / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D011216:Practice Management, Medical / Q000458:organization & administration*; D011331:Private Practice / Q000458:organization & administration; D013315:Stress, Psychological / Q000453:epidemiology*