Job satisfaction and guideline adherence among physicians: Moderating effects of perceived autonomy support and job control

Publication date: Available online 2 May 2019Source: Social Science & MedicineAuthor(s): Anthony C. Waddimba, David C. Mohr, Howard B. Beckman, Thomas L. Mahoney, Gary J. YoungAbstractValue-based purchasing of physician services aims to incentivize greater adherence to clinical practice guidelines. By increasing job demands, new reimbursement models could adversely affect job satisfaction and, indirectly, clinical performance. Studies of satisfaction-performance associations among healthcare practitioners have yielded inconsistent findings. We investigated whether physicians' perceptions of autonomy support and job control significantly moderate the relationship between practice satisfaction and guideline adherence in a pay-for-performance context. We performed secondary analysis of a study dataset created by merging prospective information on clinical services provided by Rochester (NY)-based primary physicians (N = 156) during the years 2001–2004 with census data on specific characteristics of their ambulatory-care populations, claims-sourced information on attributes of their primary care practices, and survey data on their work-related attitudes. Greater job satisfaction had a significant multivariate association with lower adherence (β = −0.139; p=<.0001) among physicians that perceived low autonomy support from the market-dominant payor organization. For physicians experiencing high autonomy support, a positive satisfaction-adherence association existed...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research