Managed care: An investigation of the relationship between the dimensions of de-professionalization and physician satisfaction

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are integral to the current health care delivery system. According to a January 2001 report by the American Association of Health Plans, most of the U.S. population receives its health care through some form of managed care. Changes in managed care have affected the physicians' willingness to work and contribute to the success of these changes. This resistance to change is thought to be the byproduct of physicians' dissatisfaction and feelings of de-professionalization Anderson, D. R. (2004). The peril of deprofessionalization.; Pellegrino, E. D. (2000). Medical professionalism: can it, should it survive? Current studies indicate an association among managed care, physician job satisfaction and the quality of patient care; however, few researchers have investigated the relationship between the dimensions of de-professionalization and physician satisfaction. Through an exploratory sequential mixed-methods research design this investigation sought to determine the extent to which physician de-professionalization and job satisfaction negatively impact the overall quality of healthcare a patient receives. Research questions focused on examining the extent to which such factors as managed care and de-professionalization has affected physicians' satisfaction. Additionally, the relationship between physician job satisfaction and the quality of patient healthcare was examined. In-depth interviews with thirty-six physicians with membership in the ABC State Physicians Association (APA) were conducted. The majority of physicians interviewed expressed the belief that because external forces are now the determinants of the doctor-patient relationship, managed care greatly affects satisfaction. Additionally, interviewees asserted that managed care has affected physician satisfaction through declining reimbursement and increased bureaucracy. Physician interviewees also commented on how managed care has extensively affected physicians' satisfaction by creating a place for generic doctors. Results of the survey indicated no significant statistical associations between physician satisfaction and level of managed care or between physician satisfaction and deprofessionalization. Statistical significance was found, however, between physician satisfaction and quality of patient care. The findings indicated that the greater the level of physician satisfaction, then the higher the quality of care a patient receives.