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J. Paul Leigh, PhD; Richard L. Kravitz, MD, MSPH; Mike Schembri, MS; Steven J. Samuels, PhD; Shanaz Mobley, BS

Arch Intern Med. 2002;162:1577-1584.

Background  The career satisfaction and dissatisfaction physicians experience likely influence the quality of medical care.

Objective  To compare career satisfaction across specialties among US physicians.

Methods  We analyzed data from the Community Tracking Study of 12 474 physicians (response rate, 65%) for the late 1990s. Data are cross-sectional. Two satisfaction variables were created: very satisfied and dissatisfied. Thirty-three specialty categories were analyzed.

Results  After adjusting for control variables, the following specialties are significantly more likely than family medicine to be very satisfying: geriatric internal medicine (odds ratio [OR], 2.04); neonatal-perinatal medicine (OR, 1.89); dermatology (OR, 1.48); and pediatrics (OR, 1.36). The following are significantly more likely than family medicine to be dissatisfying: otolaryngology (OR, 1.78); obstetrics-gynecology (OR, 1.61); ophthalmology (OR, 1.51); orthopedics (OR, 1.36); and internal medicine (OR, 1.22). Among the control variables, we also found nonlinear relations between age and satisfaction; high satisfaction among physicians in the west north Central and New England states and high dissatisfaction in the south Atlantic, west south Central, Mountain, and Pacific states; positive associations between income and satisfaction; and no differences between women and men.

Conclusions  Career satisfaction and dissatisfaction vary across specialty as well as age, income, and region. These variations are likely to be of interest to residency directors, managed care administrators, students selecting a specialty, and physicians in the groups with high satisfaction and dissatisfaction.

From the Center for Health Services Research in Primary Care, Sacramento, Calif (Drs Leigh, Kravitz, and Samuels and Ms Mobley), and the Department of Family and Community Medicine, University of California, San Francisco (Mr Schembri).

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