Professor Peter Armstrong (retd) - MIR-Online

MIR - 15 April 2010Job Satisfaction in RadiologyProfessor Peter Armstrong (retd)St Bartholomew’s Hospital

External Factors contributing to stress anddissatisfaction at work:• Family stresses/disputes• Financial issues• Psychological illness/ drugs/ alcohol, etc

A personal view, informed by:• what research there is• having worked closely with a Professor ofPsychology with a special interest in workrelated problems (Dr David B Waters)• personal experience of advising radiologists

A word about workload• The relationship between workload and jobsatisfaction is far from simple• If tasks are rushed and quality falls, then stressand dissatisfaction increase substantially in allspecialties, but• Stress can be caused by having less work thanone’s colleagues.• Surveys show that busier doctors (up to alimit) are more satisfied than their less busycolleagues!

Job satisfactionA major motivating force amongst workers ingeneral and doctors in particular is to beperceived by themselves and others as doinga good job.• In other words, they cherish praise andrespect (including self-respect)• When various jobs are compared, hairdressersare said to have the highest job satisfaction!

The significant factors for job satisfactionfor doctors in general are:• their own estimation of the quality of theirwork• complimentary feedback from colleagues,trainees etc• positive relationships with patients andrelatives• autonomy over their own work

What does the available researchreveal ?

Radiologists have the same frequency ofpsychiatric morbidity as other specialties.However, burnout (Maslach Burnout Inventory) isgreater in radiologists than in clinical specialties.The major factors for burnout are:• lower job satisfaction scores• lower perceived levels of “personalaccomplishment”J Graham et al: Clinical Radiology 2000:55:182

Comparison of responses from consultantradiologists and clinical consultants showsthat radiologists more frequently:• feel their skills and experience are not putto good use/appreciated• rate their involvement with patients andrelatives as less satisfying• believe others are in controlJ Graham et al: Clinical Radiology 2000:55:182

Having a good relationship withpatientsSatisfactionsRadiologistsOther specialties85 98High level of autonomy 50 64Job security 43 54Feeling one does well withrelativesContribution to development ofspecialty42 7338 52Having facilities to do a good job 30 43Deriving satisfaction fromresearch27 44J Graham et al: Clinical Radiology 2000:55:182

satisfaction scoreRadiologists 58Surgeons 68Taylor et al.Lancet 2005; 366:742

satisfaction scorestress scoreRadiologists 58 39Surgeons 68 45Taylor et al.Lancet 2005; 366:742

Stresses particular to radiologists are :• coping with expectations to do workimmediately• dealing with inappropriate requests fromclinicians

Personality can contribute to personal stressExamples:• Perfectionism• Idealism• Rigidity

Coping with complaints• It can be very stressful to be the object of acomplaint• Defending the indefensible can ruin lives• Acknowledge your mistakes and acceptcounseling from colleagues and friends• Understand the relevant procedures• Try not to take the claims too personally andleave medico-legal issues to MDOs,experts/lawyers

• attend, lead (share) MDMs• reduce excessive expectations• make oneself available for consultation• encourage a sense of interdependence• be sensible and proportionate whencomplaining/pointing out problems. Don’tmake yourself miserable or disrupt/ruin yourcareer

The end

% responding that particular stress levelis“quite a bit” or “a lot”Too great a volume of work /longhours disrupting home lifeRadiologists Other75consultants75Conflicting demands 58 75Meeting deadlines 57 56Threat of law suits 9 23Dealing with distressedpts/relatives/junior staffPoor relationships with otherconsultants13 2030 23Feeling that skills not put to good use 39 27

Survey of radiologists by Grahamet al 1996• 5 % said job not at all satisfying• 2l % said job only somewhat satisfying• 52% said job only moderately satisfying• 23 % said job very satisfying

Survey by Graham et al 1996• 1% said work not at all stressful• 24 % said work slightly stressful• 35% said work moderately stressful• 6% said work extremely stressful• 5 % said job not at all satisfying• 2l % said job somewhat satisfying• 52% (58 % in 2005) said job moderately satisfying• 23 % said job extremely satisfying