LEFO - Legeforskningsinstituttet

Institute for Studies of the Medical Profession

Doktoravhandlinger - PhD theses

Doctors´ job satisfaction during early career and economic recession. Prospective and cross-national studies in Norway and Iceland

Cand.med. Ingunn Bjarnadottir Solberg ved Institutt for medisinske basalfag, Avdeling for medisinsk atferdsvitenskap, Universitetet i Oslo (UiO), forsvarte 21. august 2017 sin avhandling for graden dr. philos. (doctor philosophiae).
31. august 2017

Sammendrag av doktoravhandlingen (hentet fra UiOs nettsider):
Legers arbeidstilfredshet kan påvirke pasientbehandlingen deres. Legers og andre helsearbeideres jobb er utsatt for stadige endringer og innsparinger. Vi vet for lite om hvordan dette påvirker arbeidstilfredsheten deres. Unge leger blir utsatt for høyt stress i arbeidet, derav stress relatert til balansen mellom jobb og hjem. Island ble rammet hardt av den økonomiske krisen i 2008. Vi fant at majoriteten av islandske leger opplevde at innsparinger påvirket jobben deres to år senere. Dette førte til lavere tilfredshet i legejobben. Islandske leger må ta spesialisering i utlandet og de fleste har betydelig gjeld når de vender tilbake til Island. Innsparinger som gikk utover jobben og i tillegg stress relatert til personlig økonomi hadde også sammenheng med at majoriteten av spesialister på Island vurderte å flytte fra Island. Sammenlignet med Norske leger var Islandske leger spesielt mindre fornøyd med lønnen, muligheten til å bruke egne evner, og lengden på arbeidstiden. Blant unge norske leger fant vi at arbeidstilfredshet økte fra 10 til 15 år etter endt studium.

Leger på tvers av landegrenser er generelt fornøyde med faktorer knyttet til selve legejobben som ansvar og variasjon i arbeidet. Dette kan i tråd med ‘The Job Characteristics Model’ forklare generell høy arbeidstilfredshet blant leger i de fleste land. Det leger er generelt minst fornøyd med, er ytre faktorer som lønn, arbeidstid og annerkjennelse for jobben de gjør. Både tidlig i karrieren og under økonomiske innstramminger må spesielt disse aspektene få økt fokus. Det er noe alarmerende at yngre leger er mindre fornøyde med arbeidet enn eldre leger. Dette kan skyldes naturlig karriere utvikling, men også større forskjell mellom ønsket og opplevd arbeidssituasjon blant unge leger (‘Locke’s Value-Percept Theory’). Vår studie viser at bytte av type jobb og reduksjon i stress relatert til arbeid-hjem balansen kan øke arbeidstilfredsheten blant yngre leger.

The thesis is written in English. Read more about it at the website from University of Oslo.

Abstract
The empirical research in this thesis is based on three papers on doctors’ job satisfaction and migration considerations. Together with reviewed literature the thesis provides a detailed picture of doctors’ job satisfaction. The theoretical discussion of this thesis is guided by two different approaches: The Job Characteristics Model and Locke’s Value-Percept Theory. In the end of the Discussion the results are also discussed in the light of the Job Demand-Control model and the Effort-Reward Imbalance model. These theories and models focus on workrelated factors that can, with a positive psychology approach, increase employees’ job satisfaction. In our papers we mainly focus on work-related factors linked to doctors’ job satisfaction. Paper I aimed at investigating the course of doctors’ job satisfaction from early career to mid-career and exploring the effects of change in job position and reduction in workhome stress and working hours. The data for Paper I was from a longitudinal study on Norwegian doctors (NORDOC). The data for Paper II and III were collected among all Icelandic doctors in 2010, during the economic recession. The aim of Paper II was to explore whether the recession influenced the job satisfaction of Icelandic doctors. The aim of paper III was to explore the migration considerations among the doctors and whether economic factors were related to these considerations. Results from Paper I show that doctors’ job satisfaction increased from early to mid-career. The results also show that a change in job position and a reduction in work-home stress predicted an increase in job satisfaction. Results from Paper II and III show that economic factors influenced the doctors’ job satisfaction and migration considerations. Paper II also shows that the Icelandic doctors were less satisfied in their job than Norwegian doctors, particularly with extrinsic elements, and that job satisfaction of doctors during the recession was lower than before the recession. The results from Paper III also show that over half of the Icelandic specialists had considered migration during the recession. The Job characteristics model provides a theoretical element in the discussion on the intrinsic aspects of doctors’ job satisfaction, and the conclusion is that our doctors’ jobs include many of the core characteristics of the model. This is to some extent a validation of this model and our job satisfaction concept as not being very different. The characteristics in the model are also discussed in relation to the doctors’ age and different job positions. Locke’s value-percept theory provides a theoretical framework in the discussion about change in 1) job satisfaction, 2) job position, and 3) work-home stress. The effect of economic factors on doctors’ job satisfaction and migration considerations as well as the increase in job satisfaction among early to mid-career doctors is also discussed in the light of the Demand- Control model and the Effort-Reward Imbalance model. We have not included any of these models/theories in our papers so these are only reflections, but the theoretical discussion and reflections in this thesis lead to the assumption that future studies on doctors’ job satisfaction and migration should include validated theoretical models. Also, several topics in positive psychology are recognized for future research on doctors’ well-being at work.