• Eric S Williams, Thomas R Konrad, Mark Linzer, Julia McMurray, Donald E Pathman, Martha Gerrity, Mark D Schwartz, William E Scheckler, Jeff Douglas, and SGIM Career Satisfaction Study Group.
• Department of Management and Marketing, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa 35487-0225, USA.
• Health Serv Res. 2002 Feb 1; 37 (1): 121-43.

ObjectiveTo study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, and physical health.Data SourcesBased 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 DesignA 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 FindingsThe 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.ConclusionsThese 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.

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