Measurement and prediction issues regarding job satisfaction among rural physician assistants

As increasing numbers of physicians are being trained in specialized medicine and health professional shortage areas remain a common occurrence in the United States, the roles of physician assistants (PAs) in health services provision have become increasingly important, especially in rural/underserved areas of the country. By all accounts, there is a shortage of PAs in the U.S., particularly in rural areas. In response to demand, the number of PAs is projected to increase more than 70% by the year 2000, from its 1993 figure of 24,800 to 42,700.;Recruitment is a critical issue in providing adequate health services in rural areas, but equally important is retaining currently-practicing health care personnel, including PAs. Given the well-founded association between work satisfaction and retention for health professionals, it becomes increasingly important to learn more about factors that are related to job satisfaction among these providers. Some research has focused on job satisfaction among PAs, but three problems stand out: (1) none of these studies are national in scope; (2) few if any have utilized PAs that were systematically selected to strive toward representativeness and generalizability; and (3) few if any of these studies were conducted in the past five years--meaning no known efforts have been made to understand present-day PAs and their attitudes toward practice.;This study involved 1,263 PAs who practiced in rural (nonmetropolitan) areas of the U.S. A 15-item scale was developed and used to measure job satisfaction. A revised theoretical model was examined as to its ability to predict levels of job satisfaction using multiple regression analysis. Independent variables included demographics, practice and community factors.;Findings indicated that rural PAs were satisfied with their work. Factors found to be significant predictors of satisfaction included practice importance factors (importance of autonomy and good relationship with one's supervising physician), extent of practice responsibilities (weekly on-call hours, percent of PAs' patient load that is not discussed with one's supervising physician), and community factors (community satisfaction). Implications of the findings are discussed.