Medical practice mergers: An initial exploration into the factors contributing to physician satisfaction

It is hypothesized by this study that merged physicians will be less satisfied with their practice arrangement than those who choose not to merge and remain autonomous. Physician satisfaction is an important area to explore because it is possible that it could impact the quality of healthcare delivered to the patient. The design of this study utilized 2 versions of a 63-question survey (one for merged physicians, one for non-merged physicians), which were either mailed or hand delivered to the physicians who agreed to participate. The survey was designed to explore 16 research hypotheses in addition to social psychological theories mentioned earlier, and determine if there were any differences between merged and non-merged physicians. Statistical methods such as regression analysis and correlations were utilized to answer the following research questions: What are the factors contributing to physician satisfaction with a medical-practice merger?, and, Is there a difference in the factors that contribute to physician satisfaction between merged and non-merged physicians? The same statistical methods were utilized to determine if the 16 research hypotheses were supported or not. The results of the study indicated that all of the "amount" survey items (e.g., how much clinical autonomy do you have now?) contribute to satisfaction for the merged physicians. They also showed that the merged physicians consider autonomy and control over their practice to be an important contributor to satisfaction while the non-merged physicians don't. Gender emerged as a consistent contributing factor to satisfaction in most of the analyses. Males were found to feel less loyal to their practice group; females had lower commitment to their practice group, lower satisfaction with physician and hospital allegiances, were less trustful of their partners, and had overall lower satisfaction with their practice arrangement. Another significant finding was related to merged status: merged physicians experienced more conflict than non-merged physicians. The way a physician is paid also had an impact on some of the analyses. Non-merged salaried physicians had less group-management autonomy, and fee-for-service merged physicians experienced more bureaucracy than non-merged physicians. Finally, in many of the regression analyses, the older the physician was, the less satisfied he/she was. The issue of physician satisfaction is a concern from a public policy perspective if it were found to have an impact on the quality of patient care. The findings of this study could also provide some insight for physicians and practice managers who are contemplating a merger. The non-business variables explored in this study highlighted some possible contributing factors to dissatisfaction with a practice merger.