Physicians' perceptions of institutional and leadership factors influencing their job satisfaction at one academic medical center

Purpose. Academic physicians' perceptions about their institution's function and leadership should provide insights toward improving faculty recruitment and retention. Method. The authors surveyed 105 non-management and non-emeritus physicians who had been hired by (57%) or left (43%) the University of Missouri-Columbia School of Medicine (MUHC) in 1991-1998. The questionnaire measured both the importance and the availability of 14 institutional and leadership factors and the physicians' perceptions of satisfaction with their careers. Open-ended questions assessed additional concerns. Results. In all, 56% of the overall satisfaction scores were unfavorable and, when grouped by faculty department, correlated inversely with departure rates (p=.04). Scores were surprisingly similar between those who left and those who remained at the institution. "Protected time for research or personal use" was the highest faculty priority regardless of level of overall satisfaction. "Equitable distribution of salary/resources" (p=.007) and "trust-communication with chair/division head" (p=.003) predicted good satisfaction independently. Opens ended responses for remaining at the university related to the pleasant local community (49%), intellectual issues (46%), and humanitarian issues (5%). Responses for considering opportunities elsewhere were administrative frustration (59%), income enhancement (18%), career advancement (9%), academic frustration (9%), and other (5%). Recommendations for enhancing recruitment and retention were fix administrative concerns (45%); improve research (20%), income (9%), physician support (9%), clinical programs (8%), and autonomy (5%); and other (4%). Conclusions. Surveying physicians who were recently hired or who have left an institution provides useful information to promote organizational changes that could improve physician retention.