Physician, Practice, and Patient Characteristics Related to Primary Care Physician Physical and Mental Health: Results from the Physician Worklife Study

  • Eric S. Williams, Thomas R. Konrad, Mark Linzer, Julia McMurray, Donald E. Pathman, Martha Gerrity, Mark D. Schwartz, William E. Scheckler, and Jeff Douglas, for the SGIM Career Satisfaction Study Group

Eric S. Williams Ph.D. Assistant Professor, Department of Management and Marketing, Culverhouse College of Commerce and Business Administration, The University of Alabama, 164 Alston Hall, Box 8870225, Tuscaloosa, AL 35487–0225. Thomas R. Konrad Ph.D. Senior Fellow and Director of Program on Health Professions and Primary Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina. Mark Linzer M.D. Professor and Chief, Section of General Internal Medicine, University of Wisconsin. Julia McMurray M.D. Associate Professor of Medicine, Section of General Internal Medicine, University of Wisconsin. Donald E. Pathman M.D., M.P.H. Research Director and Associate Professor of Family Medicine and Senior Research Fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC. Martha Gerrity M.D., Ph.D. Associate Professor of Internal Medicine, Department of Medicine, Oregon Health Sciences University, Portland, OR. Mark D. Schwartz M.D. Assistant Professor of Medicine and Director of Primary Care Fellowship Program, Department of Medicine, New York University, New York University, NY. William E. Scheckler M.D. Professor of Family Medicine, Department of Family Medicine, University of Wisconsin. Jeff Douglas Ph.D. Assistant Professor of Biostatistics, Department of Biostatistics, University of Wisconsin, Madison, WI.


Objective. To study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, and physical health.

Data Sources. Based on a survey of over 5,000 physicians nationwide. Four waves of surveys resulted in 2,325 complete responses. Elimination of ineligibles yielded a 52 percent response rate; 1,411 responses from primary care physicians were used.

Study Design. A conceptual model was tested by structural equation modeling. Physician job satisfaction and stress mediated the relationship between physician, practice, and patient characteristics as independent variables and physician physical and mental health as dependent variables.

Principle Findings. The conceptual model was generally supported. Practice and, to a lesser extent, physician characteristics influenced job satisfaction, whereas only practice characteristics influenced job stress. Patient characteristics exerted little influence. Job stress powerfully influenced job satisfaction and physical and mental health among physicians.

Conclusions. These findings support the notion that workplace conditions are a major determinant of physician well-being. Poor practice conditions can result in poor outcomes, which can erode quality of care and prove costly to the physician and health care organization. Fortunately, these conditions are manageable. Organizational settings that are both “physician friendly” and “family friendly” seem to result in greater well-being. These findings are particularly important as physicians are more tightly integrated into the health care system that may be less clearly under their exclusive control.