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Editor's Correspondence |

Physician Career Satisfaction Across Specialties: Are We Getting the True Picture?—Reply

J. Paul Leigh, PhD; Richard L. Kravitz, MD, MSPH
Arch Intern Med. 2003;163(2):244. doi:10.1001/archinte.163.2.244-a.
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In reply. We are grateful to Drs Atreja and Mehta for their suggestions and insights. In our study on physician satisfaction, we chose to control for income because we wanted to rank specialties' career satisfaction according to intrinsic reward, independent of income.1 Given the strong correlation between income and satisfaction, our rankings provide information beyond the well-known rankings of specialties by income in the American Medical Association's studies on socioeconomic status.2 Our rankings should not be the sole criteria used for assessing the overall attractiveness of specialties. Nevertheless, in an early version of the manuscript, we included univariate rankings (ie, rankings that did not adjust for any covariates). The statistically significant results on "very satisfied" were virtually identical except that pediatricians and "all other specialties" traded places: "all other specialties" became fourth and pediatricians became fifth. The findings for "dissatisfied" were altered somewhat. General practice and psychiatry replaced ophthalmology and orthopedic surgery on the statistically significant list. These altered findings may be the result of excluding income as a covariate. General practice and psychiatry are not as well paid as ophthalmology and orthopedic surgery.

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