title: Determinants of career satisfaction among pediatric hospitalists: a qualitative exploration.
abstract: OBJECTIVE
  To characterize determinants of career satisfaction among pediatric hospitalists working in diverse practice settings; to develop a framework to conceptualize factors influencing career satisfaction.
  
  
  METHODS
  Semistructured interviews were conducted with community and tertiary care hospitalists, using purposeful sampling to attain maximum response diversity. We used closed- and open-ended questions to assess levels of career satisfaction and its determinants. Interviews were conducted by telephone, recorded, and transcribed verbatim. Emergent themes were identified and analyzed using an inductive approach to qualitative analysis.
  
  
  RESULTS
  A total of 30 interviews were conducted with community and tertiary care hospitalists, representing 20 hospital medicine programs and 7 Northeastern states. Qualitative analysis yielded 657 excerpts, which were coded and categorized into 4 domains and associated determinants of career satisfaction: 1) professional responsibilities; 2) hospital medicine program administration; 3) hospital and health care systems; and 4) career development. Although community and tertiary care hospitalists reported similar levels of career satisfaction, they expressed variation in perspectives across these 4 domains. Although the role of hospital medicine program administration was consistently emphasized by all hospitalists, community hospitalists prioritized resource availability, work schedule, and clinical responsibilities, while tertiary care hospitalists prioritized diversity in nonclinical responsibilities and career development.
  
  
  CONCLUSIONS
  We illustrate how hospitalists in different organizational settings prioritize both consistent and unique determinants of career satisfaction. Given associations between physician satisfaction and health care quality, efforts to optimize modifiable factors within this framework, at both community and tertiary care hospitals, may have broad impacts.
authors: Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass. Electronic address: jleyenaar@tuftsmedicalcenter.org.
authors: JoAnna K
authors: JK
authors: Leyenaar
authors: Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass.
authors: Lisa A
authors: LA
authors: Capra
authors: Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass.
authors: Emily R
authors: ER
authors: O'Brien
authors: Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Mass.
authors: Laurel K
authors: LK
authors: Leslie
authors: Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Mass; Heller School for Social Policy and Management, Brandeis University, Waltham, Mass.
authors: Thomas I
authors: TI
authors: Mackie
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002322:Career Mobility; D005260:Female; D020445:Hospitalists / Q000523:psychology*; D006764:Hospitals, Community; D006801:Humans; D007407:Interviews as Topic; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009511:New England; D010372:Pediatrics; D024382:Professional Role; D062606:Tertiary Care Centers
keywords: children's hospital; community hospital; hospital medicine; physician satisfaction; qualitative methods