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The Effects of Fatigue and Dissatisfaction on How Physicians Perceive Their Social Responsibilities



      To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians’ perceptions of their professional responsibilities in a time of upheaval in health care.


      From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment.


      A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9).


      Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians’ perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment.

      Abbreviations and Acronyms:

      AMA (American Medical Association), OR (odds ratio)
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      Linked Article

      • Dissatisfaction as a Unifying Force for Social Action
        Mayo Clinic ProceedingsVol. 90Issue 5
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          In their article published in the February 2015 issue of Mayo Clinic Proceedings, O’Donnell et al1 are right to mention dissatisfaction with the practice of medicine as a major factor that generates physicians’ lackluster interest in addressing health policy issues. However, there is another factor that must be mentioned, the fact that most medical students do not learn the importance of defending medicine’s ideals in medical school or in residency. They are too busy learning the basics of being doctors, and once they are in practice, the importance of participating in medical affairs seems like a waste of time compared with the demands of practice, personal life, and continuing medical education.
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