Happier Doctors Are Better Doctors: New Study

Half of all orthopedic surgeons may not enjoy their work—and that depressing statistic prompted a team from The University of Texas at Austin to develop and test a new “happiness” measure which, the team hopes, will capture the “positive attributes to which a team aspires.” Their work, “Development of a Brief, Positively Framed Care Team Experience Measure,” was published in the December 3, 2024 edition of Clinical Orthopaedics and Related Research.

Co-author David Ring, M.D., Ph.D., professor and associate chair for Faculty Academic Affairs at Dell Medical School at The University of Texas at Austin, told OTW, “We have a long-standing interest in the importance of enjoying one’s work and feeling appreciated and useful. The process started with University of Texas Health Austin at Dell Medical School seeking a brief, positively framed, team-oriented measure of clinician and care team experience to monitor our culture and the results of interventions to improve it.”

Existing methods of measuring a clinician’s sense of personal fulfillment and/or work engagement, according to the research team, are long and overly burdensome. Additionally, existing measurement tools were usually negatively framed or addressed personal well-being at the expense of measuring care team status.

OTW asked Dr. Ring to expand on his assertion that current measures are “negatively framed,” and he explained, “Many current measures ask about personal factors from a negative frame. For instance, asking respondents to consider phrases like ‘A sense of dread when I think about work I have to do’ or ‘I feel emotionally drained by my work.’ Items like this could be influenced by personal circumstances, workplace climate, or job demands among other things. Those are all important. When the goal is enhancement of care team experience, it helps to use aspirational, positively framed items (this is where we’re headed), and ask about the team rather than one’s personal experience.”

A New Measure of Job Satisfaction: ‘Care Team Experience Measure’

The University of Texas team then set out to craft a new and, they hoped, a better measure—the “Care Team Experience Measure”—and put it to the test in a large, 274 physician practice. Forty-four percent of those physicians (n=120) participated in the test. The study control was the Team Climate Inventory questionnaire, which measures team climate in healthcare organizations.¹

The survey of 120 clinicians in the multispecialty test group practice asked about three factors that affect the care team experience:

“collaboration” (nine items),
“enjoyment of work” (six items), and
“effectiveness” (six items).

The researchers then obtained data from 493 patient-facing employees of a statewide musculoskeletal specialty practice, who rated 12 items and completed the Team Climate Inventory.

For their test, the research team also stratified the results according to clinical and administrative roles:

physical, occupational, or hand therapy;
imaging;
nurse practitioner or physician assistant;
medical assistant;
physician; and
“other” clinical roles such as cast technician.
Administrative roles such as:
- management,
- marketing,
- patient services,
- coding and billing, and
- “other” administrative role.

Clearly, this was a comprehensive look at “Care Team”, broadly defined, experience.

Using factor analysis, the team identified two groups of items representing “effectiveness” (nine items, including “I am proud of the work we do”) and “collaboration” (three items, including “Our team encourages everyone’s input before making changes”). The best-performing items of “effectiveness” (two items) and “collaboration” (one item) were selected to form the three-item Care Team Experience Measure.

Study Results

The data the team pulled from their survey provided evidence of a strong correlation between the Care Team Experience Measure and the Team Climate Inventory, which is a measure of four factors:

clear and realistic objectives,
participative safety,
support for innovation, and
commitment to high standards of performance.²

The authors opined that these items can be characterized as addressing humility, curiosity, collaboration, and a collective growth mindset.

“Patients will get better care from teams that feel appreciated and effective,” explained Dr. Ring to OTW. “This measure can be used periodically with limited burden to monitor and enhance care team experience in your organization or unit.”

OTW asked if he might alter the study in any way, he added, “The most difficult part is to get enough engaged people willing to complete surveys. Much gratitude to Lonestar Orthopedics for their collaboration. Additional validation in other settings and with other groups is warranted.”

“If organizations put effort into the well-being of their teams,” said Dr. Ring to OTW, “both those teams and the patients they serve will benefit. Given the evidence that a safety culture and joy in work go hand in hand, such efforts, including routine measurement using the Care Team Experience Measure, have the potential to increase the quality, safety, and effectiveness of care.”

“This simple, aspirational, team-oriented clinician experience measure might be useful for routine measurement of clinician experience with the aim of improving enjoyment in patient care,” wrote the authors. “It would be straightforward to send these three items and a verbatim text inquiry regarding care team experience via email, internal communication software, or text every 3 months or so and track trends and themes for improvement. This would also measure improvement or decline in experience with quality improvement initiative or other changes in the organization, facilitating more specific and effective attention to care team experience.”

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