A cross-sectional job satisfaction survey of physicians in Bhutan to address the problem of retention

Abstract

Introduction: A persistent shortage of physicians and relatively high attrition (>10% over 7 years) have been longstanding challenges for Bhutan despite efforts at improvement. Little is known about physicians’ job satisfaction. The study was done to assess level of job satisfaction amongst physicians in Bhutan and identify factors affecting it, thereby be able to better understand factors affecting physician retention. Methods: A national, cross-sectional study on job satisfaction of all Bhutanese physicians was conducted in 2016. Physicians were defined as satisfied if they answered yes to >50% of general survey questions about job satisfaction and and associations between demographic or job characteristics (e.g., married vs. unmarried, clinical vs. non- clinical) and job satisfaction were examined. Physicians were also queried about specific elements of their jobs (e.g., pay, working conditions) and explored associations between demographic or job characteristics and job elements. Results: Of 147 physicians who completed the job survey, 94 (64%) were classified as satisfied. There were significant differences in job satisfaction between married and unmarried physicians (72% vs 49%, p=0·01), specialists and generalists (73% vs 55%, p=0·04), nonclinical and clinical physicians (89% vs 61%, p=0·02), and physicians in referral and district hospitals (75% vs 48%, p <0·01). Across all demographic and job characteristics, salary satisfaction was low (11%). In multivariable analysis, non-clinicians had significantly greater satisfaction than clinicians with salary, annual leave, and work-family balance. Physicians in referral hospitals had significantly greater satisfaction than physicians in district facilities with work hours and working conditions. Conclusion: Survey findings suggest that, although job satisfaction appeared high, improved physician retention may require increased pay, opportunities for promotion to desired settings and job categories, and improved staffing and work conditions in district healthcare facilities.