The manifestation of job satisfaction in doctor-patient communication; a ten-country European study

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J.M. Bensing
A. van den Brink-Muinen
W. Boerma
Sandra van Dulmen


Objective: Job satisfaction is a common problem in modern western health care. While a lot of studies analyzed the determinants of job (dis)satisfaction, less is known about the consequences of doctors’ job satisfaction for medical visits. The aim of this study is to examine - female and male - General Practitioners’ (GPs) satisfaction with their work in 10 European countries and to analyze whether the level of satisfaction manifests itself in the communication with their patients.Methods: Data used were from two EU-funded studies together covering ten countries: the Netherlands, United Kingdom, Spain, Belgium, Germany, Switzerland, Sweden, Estonia, Poland and Rumania. 302 GPs (165 male; 137 female) and 4446 patients (1756 male; 2690 female) gave written consent to videotape their consultation and completed short questionnaires. Videotaped consultations were analyzed on verbal communication, percentage patient-directed gaze and general affect measures. Data were analyzed at the aggregated GP-level; a multilevel model was used to check country-specific influences.Results: Job satisfaction differed slightly between countries. In most countries female GPs were more satisfied than men. Job satisfaction was clearly reflected in GPs’ and patients’ communication, both showing more verbal and nonverbal affect and talking more about psychosocial issues the higher the job satisfaction of the GP.Discussion: There is reciprocity between doctors’ and patients’ way of communicating, mediated by doctors’ job satisfaction and reflected in the affective atmosphere of the consultation.Conclusions: Although this study gives no indication of cause and effect, we may conclude that GPs’ job satisfaction does impact doctor-patient communication. This may foster research into determinants of job satisfaction that are amenable to change and may inspire intervention studies aimed at increasing job satisfaction.

Article Details

Regular Articles
Author Biography

Sandra van Dulmen

A.M. (Sandra) studied clinical psychology. After graduation in 1997 (cum laude), she started working as a researcher in different fields of health care, first at the Department of Clinical Psychology, then from 1988-1995, at the Department of General Practice at the University of Nijmegen. She obtained her PhD degree in 1996 with the thesis titled “Exploring cognitions in irritable bowel syndrome; implications for the role of the doctor”. For her thesis she received the dissertation award from the Netherlands School of Primary Care Research (CaRe). From 1995 onwards she works at NIVEL (Netherlands institute for health services research), first as a researcher, since 1999 as the co-ordinator of the research program Communication in Healthcare. In 2001 she was co-founder and since then the secretary of EACH (European Association for Communication in Healthcare). She obtained numerous grants for her communication studies, varying from observational research in general practices and hospitals to intervention studies among medical students, specialists, nurses as well as among patients with minor ailments, type 1 or type 2 diabetes, IBS, or cancer. A core feature of her work is the (video)observation and analysis of the communication in the consulting room between a patient and a health care professional. She collaborates within several international research projects. Currently Sandra van Dulmen supervises seven PhD students. She has published around 50 national and 100 international papers in peer-reviewed journals. A selection of these include:Oerlemans S, Van Cranenburgh O, Herremans P-J, Spreeuwenberg P, Van Dulmen S. Intervening on cognitions and behaviour in irritable bowel syndrome: a feasibility trial using PDAs. J Psychosom Res 2011 (in press)Weert J van, Jansen J, Spreeuwenberg P, Dulmen S van, Bensing J. Effects of a Communication Skills Training to improve Communication with Older Cancer Patients: A Randomized controlled trial . Critical Reviews in Oncology/Hematology 2011 (in press)Noordman J, Verhaak P, I. van Beljouw I van, Dulmen S van. Discussing patient’s (un)healthy lifestyle in the consulting room: analysis of GP-patient consultations between 1975 and 2008. BMC Fam Pract 2010; 11(1): 87Dulmen S van, Groot J de, Koster D, Heiligers Ph. Why seek complementary medicine? An observational study in homeopathic, acupunctural and naturopathic medical practices. Journal of Complementary and Integrative Medicine 2010; 7: 20Albada A, Dulmen S van, Otten R, Bensing JM, Ausems MGEM. The development of E-info geneca: a computer-tailored intervention prior to breast cancer genetic counselling. J Gen Couns 2009; 18: 326-338Morren M, Dulmen S van, Ouwerkerk J,  Bensing J. Compliance with momentary pain measurement using electronic diaries: A systematic review. Eur J Pain 2009; 13: 354-365Dulmen S van, Tromp F, Grosfeld F, Cate Th J ten, Bensing JM. The impact of assessing simulated bad news consultations on medical students’ stress response and communication performance. Psychoneuroendocrinology 2007;  32: 943–950Zwaanswijk M, Tates K, Dulmen S van, Hoogerbrugge PM, Kamps W, Bensing J. Young patients’, parents’, and survivors’ communication preferences in paediatric oncology: Using online focus groups to develop a structured questionnaire. BMC Pediatrics 2007; 7: 35Dijk L van, Heerdink ER, Somai D, Dulmen AM van, Ridder DT de, Sluijs EM, Griens AMGF, Bensing JM. Patient risk profiles and practice variation in nonadherence to antidepressants, antihypertensives and oral hypoglycemics. BMC Health Serv Res. 2007 Apr 10;7(1):51Dulmen S van, Sluijs E, Dijk L van, Ridder D de, Heerdink R, Bensing J. Patient Adherence to medical treatment: a review of reviews. BMC Health Services Research. BMC Health Services Research 2007, 7:55 


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