TY - JOUR
T1 - Physician work intensity among medical specialties
T2 - Emerging evidence on its magnitude and composition
AU - Horner, Ronnie D.
AU - Szaflarski, Jerzy P.
AU - Ying, Jun
AU - Meganathan, Karthikeyan
AU - Matthews, Gerald
AU - Schroer, Brian
AU - Weber, Debra
AU - Raphaelson, Marc
PY - 2011/11
Y1 - 2011/11
N2 - BACKGROUND:: Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. OBJECTIVE:: To determine the magnitude and important dimensions of physician work intensity for 4 specialties. RESEARCH DESIGN:: Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. SUBJECTS:: A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. MEASURES:: Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. RESULTS:: Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P < 0.001), and significantly lower intensity on the performance dimensions of the NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). CONCLUSIONS:: Level of physician work intensity seems to be similar among specialties.
AB - BACKGROUND:: Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. OBJECTIVE:: To determine the magnitude and important dimensions of physician work intensity for 4 specialties. RESEARCH DESIGN:: Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. SUBJECTS:: A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. MEASURES:: Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. RESULTS:: Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P < 0.001), and significantly lower intensity on the performance dimensions of the NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). CONCLUSIONS:: Level of physician work intensity seems to be similar among specialties.
KW - DSSQ
KW - MRQ
KW - NASA-TLX
KW - SWAT
KW - medical specialties
KW - personal health services
KW - stress
KW - workload
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UR - http://www.scopus.com/inward/citedby.url?scp=80054895542&partnerID=8YFLogxK
U2 - 10.1097/MLR.0b013e31822dcdc7
DO - 10.1097/MLR.0b013e31822dcdc7
M3 - Article
C2 - 21897300
AN - SCOPUS:80054895542
SN - 0025-7079
VL - 49
SP - 1007
EP - 1011
JO - Medical Care
JF - Medical Care
IS - 11
ER -