"I Can't Get No Satisfaction"

Esta história de hospitalista como quebra-galho do médico assistente, para realizar transcrições de prescrições e relatórios de convênios, atestados ou declarações para pacientes e acompanhantes pode ser muito ruim para muita gente. Algumas desvantagens em relação ao verdadeiro modelo de Medicina Hospitalar são: fragmentação da assistência intra-hospitalar, coordenador segue fora do hospital, aumento de custos, quem trabalha dedicado ao hospital segue não valorizado.

So what is a scutmonkey? Termo tão utilizado nas últimas postagens

There are versions of scutmonkeys in most professions. The entertainment business has its production assistants, the mob has its “button men,” and in medicine, we have our scutmonkeys - the hungry, scrabbling masses charged to do the jobs no one else wants. Sometimes these jobs are distasteful, almost always these jobs are menial, and not infrequently, these jobs are just flat-out boring, which is probably why SCUT is perhaps best understood as an acronym one of my residents passed on to me: “Sub-Cerebral Use of Time”. Nobody goes into medicine to be a scutmonkey!

Mas será que MÉDICO hospitalista trabalhar satisfeito é importante?

 As opiniões sobre as conseqüências da felicidade no trabalho diferem. Mas não há como negar muitas pesquisas sobre a ligação entre satisfação profissional e desempenho.

Entendo que gerir eficazmente processos de mudança organizacional representa um imperativo de sucesso para organizações competitivas, bem como uma solução de resposta aos constrangimentos internos e externos que lhes são impostas. A forma como os processos de mudança organizacional são geridos influencia positiva ou negativamente o vínculo afetivo com a organização, o que, por sua vez, conduz a uma maior satisfação com o trabalho ou não. Uma equipe de funcionários mais satisfeita pode vir a ser um ingrediente muito importante para o sucesso do negócio, principalmente quando se trata de uma atividade complexa e qualidade e segurança estão em jogo.

Predictors of job satisfaction among doctors in Norwegian hospitals: relevance for micro unit culture. Human Resources for Health 2006, 4:3

The strongest predictor of doctors' job satisfaction was working in a culture of professional development. Having a leader who knows the work situation and gives feedback on the work was also seen as important. In the perspective of an interdependent ward culture, the doctors' knowledge and professional responsibility are valuable contributions. Implications for quality improvement: A common strategy for bridging the gap between managerial and clinical rationalities in hospitals has been to train doctors and nurses in managerial theory and methods. The undesirable side effects of losing clinical responsibility and caring morale integrated in the clinical cultures have hardly been discussed. A supplementary strategy would be to teach managers to recognize clinical values and cultures and thus to use the strength of each professional group. The respondents in our study pointed clearly to the importance of having leaders know and understand the different working situations. We also suggest that leaders pay attention to the values of the different professions of the micro team. This supports the point in what Firth-Cozens calls a fundamental conflict of leadership for quality: the necessity for hospital leaders to get close to the patient and staff experience.

Leia também:

Degeling P, Kennedy J, Hill M: Mediating the cultural boundaries between medicine, nursing and management - the central challenge in hospital reform. Health Serv Manage Res JID - 8811549 2001, 14:36-48. Publisher Full Text

Degeling P, Maxwell S, Kennedy J, Coyle B: Medicine, management, and modernisation: a "danse macabre"? BMJ 2003, 326:649-652. PubMed Abstract

So Why Does Hospitalist (Dis)Satisfaction Matter?

Empirical studies have identified associations between physician satisfaction and a variety of measures of quality of care. E.S. Williams and A.C. Skinner, "Outcomes of Physician Job Satisfaction: A Narrative Review, Implications, and Directions for Future Research," Health Care Management Review 28, no. 2 (2003): 941–946.

Patients of physicians with higher levels of job satisfaction have exhibited superior adherence to medical treatment. M.R. DiMatteo et al., "Physicians’ Characteristics Influence Patients’ Adherence to Medical Treatment: Results from the Medical Outcomes Study," Health Psychology 12, no. 2 (1993): 93–102. [Medline]

Satisfied physicians tend to be more attentive to patients and to have higher levels of satisfaction among their patients. L.S. Linn et al., "Health Status, Job Satisfaction, Job Stress, and Life Satisfaction among Academic and Clinical Faculty," Journal of the American Medical Association 254, no. 19 (1985): 2775–2782 [Abstract/Free Full Text]; J.S. Haas et al., "Is the Professional Satisfaction of General Internists Associated with Patient Satisfaction?" Journal of General Internal Medicine 15, no. 2 (2000): 122–128 [Medline]; D. Pilpel and L. Naggan, "Evaluation of Primary Health Services: The Provider Perspective," Journal of Community Health 13, no. 4 (1988): 210–221 [Medline]; and R. Grol et al., "Work Satisfaction of General Practitioners and the Quality of Patient Care," Family Practice 2, no. 3 (1985): 128–135. [Abstract/Free Full Text]

Physician dissatisfaction, on the other hand, has been linked to riskier prescribing practices. A. Melville, "Job Satisfaction in General Practice: Implications for Prescribing," Social Science and Medicine 14A, no. 6 (1980): 495–499; and Grol et al., "Work Satisfaction of General Practitioners."

Dissatisfied physicians are also more likely to leave clinical practice or relocate, disrupting continuity of care and jeopardizing access to services in underserved regions. R. Lichtenstein, "The Job Satisfaction and Retention of Physicians in Organized Settings: Literature Review," Medical Care Review 41, no. 3 (1984): 139–179 [Medline]; and S.S. Mick et al., "Physician Turnover in Eight New England Prepaid Group Practices: An Analysis," Medical Care 21, no. 3 (1983): 323–337. [Medline]