Motivation and satisfaction among Estonian family doctors working in different settings

Abstract

Introduction: As in many other Eastern European countries, the healthcare system in Estonia has undergone numerous changes, including the introduction of family doctors into a system previously dominated by speciality care. The success of these reforms depends on various preconditions and personal factors play a key role here, such as healthcare workers' motivation, willingness, ability to meet changes and job satisfaction. Aim: The aim of this study was to find out how many vocationally trained family doctors had started working as family doctors and to investigate their job motivation and job satisfaction as related to their current employment status and work setting. Methods: In March 1997, the questionnaires were posted to all 160 doctors who had completed an in-service training course for family doctors. Results: 84 doctors (79%) out of 105 respondents reported that they had started work as family doctors. 21 doctors (20%) continued as district doctors for adults or as district paediatricians. 19% of 105 respondents were working independently as private practitioners and the rest were in the employment of the health service. A well-organised practice, good-quality equipment, friendly relationships with co-workers and the opportunity to learn new things were the most highly valued aspects of work by all doctors. In general, 72% of the doctors were highly satisfied with their work, 23% were somewhat satisfied and 5% were dissatisfied. Independently working practitioners reported greater work satisfaction than employed doctors concerning 5 out of 16 measured items: direct working conditions, organisation of work, income, freedom to choose their own working methods and opportunities to use the skills to the maximum. Conclusion: The findings of this study indicate that a large majority of newly trained family doctors are well satisfied with most aspects of their practice as well as with their career in general. Independently working practitioners reported higher satisfaction than employees in several aspects of work, including income, work organisation, freedom and opportunities to use skills to the maximum. This information may have implications for the organisation of the primary care practice in the country.