Open Journal of Psychiatry, 2011, 1, 122-125
doi:10.4236/ojpsych.2011.13018 Published Online October 2011 ( OJPsych
Published Online October 2011 in SciRes.
Satisfaction with life amongst psychiatrists and general
physicians: demographic and career variables
Yo ram Barak1*, Moshe Tishler2, Dov Aizenberg3
1Abarbanel Mental Health Center, Bat-Yam, Israel;
2Asaf-HaRofe Medical Center, Rishon LeZion, Israel;
3Geha Mental Health Center, Petah-Tikva, Israel.
Email: *
Received 1 July 2011; revised 12 August 2011; accepted 22 August 2011.
Background: positive psychology and the science of
happiness have impacted many realms in academia,
including medicine. Recent reports from several
countries suggest that physicians are unhappy with
their profession. Aim: to assess levels of happiness
amongst Israeli physicians and its’ correlates. Me-
thod: participants in professional meetings endorsed
the Satisfaction with Life Scale (SWLS) and a ques-
tionnaire detailing personal data (age, gender, marital
status, number of children), specialty years as a phy-
sician and their state of health. Results: 223 physi-
cians (131 psychiatrists, 92 primary care) completed
the survey. The response rate was higher than 75%.
Mean SWLS score for all 223 physicians was 23.6 ±
5.7 and did not differ between specialties’ (p = 0.39).
No differences from reported norms amongst the
general population were found. The only signifycant
association with SWLS scores was number of chil-
dren (r = 0.23; p = 0.0006). Selection bias was in-
herent in this type of survey. Conclusion: satisfaction
with life amongst Israeli physicians is equal to re-
ported national means and may be supported by var-
iables outside the professional sphere.
Keywords: Physicians; Satisfaction with Life; Happi-
Happiness and satisfaction with life are two of the main
constructs studied in the emerging field of positive psy-
chology. Satisfaction with life is defined as “a person’s
cognitive and affective evaluations of his or her life” and
denotes the presence of positiv e emotion, the absence of
negative emotion, and a cognitive judgment of satisfac-
tion and fulfillment [1]. The construct of happiness is an
unwieldy term involving positive emotion and pleasure.
Happy people have better quality o f life, and research in
the behavioral, social, and medical sciences is continu-
ing to identify other benefits of happiness, including
better health [2]. However some reports of doctors that
are unhappy with their careers in medicine, with a sig-
nificant minority of junior doctors considering leaving
medicine have caused concern [3,4]. While most physic-
cians continue to report overall career satisfaction, only
a small fraction of physicians are very satisfied with the
practice of medic i ne [5] .
Physician career satisfaction and morale has received
focused attention recently. Publications deal with the
growing discontent of physicians and attempt to unravel
the causes underlying this attitude [6-8]. There are rea-
sons for this attention. Physicians who are satisfied with
their careers are likely to provide better health care than
dissatisfied physicians. High physician satisfaction is
also likely to result from good outcomes with patients.
Moreover, dissatisfaction, if prolonged, may result in
health problems for the physicians themselves [9].
The most obvious cause of doctors’ unhappiness is
that they feel overworked and undersupported [3].
Trained in pathophysiology, diagnosis, and treatment,
doctors spend more time involved with issues like man-
agement, improvement, finance, law, ethics, and com-
munication. Workload and pay, though important, do not
fully explain the problem. A key factor seems to be a
change in the psychological compact between the pro-
fession, employers, patients, and society so that the job
is now different from what doctors expected [10]. On the
other hand, the causes for physicians unhappiness herein
mentioned might be partly offset by taking into account
communication and ethical aspects in the primary educa-
tion of medical students during recent years [11,12].
The last decade had witnessed an on-going struggle
between the Israel Medical Association and governmental
Y. Barak et al. / Open Journal of Psychiatry 1 (2011) 122-125 123
agencies focusing on the state of affairs of practicing
medicine in an era of cutbacks and reform. As satisfac-
tion with life reflects the cognitive judgment of one’s
happiness it will reveal insight into physicians’ inner
perception of their social and professional roles. Thus
we aimed to evaluate the association between several
career and demographic characteristics and satisfaction
with life amongst physicians.
The present study utilized the Satisfaction with Life
Scale (SWLS) originally developed by Diener et al. [13].
The SWLS was developed to assess satisfaction with
people’s lives as a whole. The scale does not assess sat-
isfaction with specific life domains, such as health or
finances, but allows subjects to integrate and weigh
these domains in whatever way they choose. The SWLS
is a short, 5-item instrument designed to measure global
cognitive judgments of one’s lives. It takes only a few
minutes to complete. The scale’s items are: 1) In most
ways my life is close to my ideal, 2) The conditions of
my life are excellent, 3) I am satisfied with my life, 4)
So far I have gotten the important things I want in life
and 5) If I could live my life over, I would change al-
most nothing. Items are rated on a 1 - 7 basis as follows:
1—Strongly disgree, 2—Disgree, 3—Slightly disagree,
4—Neither agree nor disgree, 5—Slightly agree, 6—
Agree and 7—Strongly agree. The final score is the
arithmetic total of all item scores reflecting satisfaction
with life as follows: 35 - 31 Extremely satisfied, 26 - 30
Satisfied, 21 - 25 Slightly satisfied, 20-Neutral, 15 - 19
Slightly dissatisfied, 10 - 14 Dissatisfied and 5 - 9 Ex-
tremely dissatisfied [14,15].
During the period Jan, 2007 to Dec, 2007 we pre-
sented the aims of the survey to physicians attending
professional meetings. Regional meetings for the Israel
Medical Association (IMA) family physicians, internists
and psychiatric association were attended by one of the
researchers. The Tel-Aviv chapter of the IMA holds a
regional meeting every 4 months usually attended by 50
to 100 participants. Participan ts were than asked to com-
plete the SWLS as well as a short questio nnaire d etailin g
personal data (age, gender, marital status, number of
children), medical specialty years as a physician and the
state of their health reflected in the following question:
“Do you have medical problems that adversely affect
your satisfaction with life?” This q uestion was answered
on the same 1 to 7 scoring as that of the SWLS items.
Survey forms were handed to the participants and col-
lected at the end of the meeting. Response rates were
greater than 75% (ranging from 78% to 97%).
We sampled various specialists: psychiatrists, general
practitioners, internists working in general hospital set-
tings and family physicians practicing in the community.
There are 850 psychiatrists and 3000 primary care phy-
sicians registered with the IMA.
The study was approved by the local IRB.
S tatistical Analysis
Data were analyzed using a paired-samples and inde-
pendent-samples approach. The two-tailed t-test and
non-parametric test were undertaken to test for differ-
ences between the evaluations for quantitative parame-
ters. Examination of differences between the categorical
parameters were based on the Pearson Chi-square and
Fisher’s Exact tests. All tests applied were two-tailed,
and p value of 5% or less was considered statistically
The data was analyzed using the Statistical Analysis
System software, SAS Institute 6th version, [16].
During the study period 223 physicians completed the
survey. Th ere were 131 psychiatrists and 92 primary care
physicians. Mean age (±SD) for the group was 52.3 ±
11.5 years and there were 97 women and 126 men. The
majority of participants, 182 (82%) were married while
there were 17 divorced, 11 widowed and 15 were single.
There were 2.2 children per participant (median 2.0,
range 0 to 7) . On av erag e the p artic ipants had b een pr ac-
ticing their specialty for 21.5 ± 11.7 years (range: 6 -
The mean total SWLS score for all 223 physicians
was 23.6 ± 5.7 and did not differ significantly between
the various specialties (p = 0.39). Categorically this tran -
slates to 84% of participants being “satisfied” with their
lives (the sum of “slightly satisfied”, “satisfied” and
“very satisfied”). The SWLS total score was analyzed in
order to identify correlations to demographic and clinical
variables. Pearson correlation coefficients were calcu-
lated for: age, gender, number of children, years in prac-
tice and medical problems. The only statistically signifi-
cant finding among all physicians (n = 223) was a linear
correlation with the number of children (r = 0.23; p =
0.0006). There was an overall trend towards a positive
correlation with increasing age (p = 0.06) reaching sig-
nificance only for the psychiatrists’ group (r = 0.23; p =
The majority of physicians reported: “no medical
problem that adversely affects satisfaction with life”
(53%). Medical problems “very much affecting” satis-
faction with life were reported by a small minority of
participants (4%).
In the present study physicians from several specialties
opyright © 2011 SciRes. OJPsych
Y. Barak et al. / Open Journal of Psychiatry 1 (2011) 122-125
were surveyed and as a group reported mean levels of
satisfaction with life equal to the Israel national mean for
adults. In 2002 the government appointed the Bank of
Israel to conduct a nationwide research as to happiness
and satisfaction with life of Israel citizens [17]. The sur-
veyors approached 9404 citizens 20 years of age and
older. The majority of participants—83% reported that
they are “satisfied” with their lives from slightly satis-
fied to very satisfied. The questions used in this survey
are similar to those presented in the SWLS. The level of
such satisfaction with life was 84% in our sample com-
pletely in accord with the findings among the general
population. The number of children was directly associ-
ated with increased level of satisfaction in physicians
participating in the present study and in the general
population of Israel [17]. Interestingly, while age was
associated with decrease in life satisfaction in the gen-
eral population it positively contributed to physicians’
happiness. We may tentatively suggest that factors not
related to career such as the number of children operate
in the samples compared while older age indirectly re-
flects experience and possibly higher professional stan-
ding thereby co ntributing to physicians’ satisfaction.
The satisfaction of medical specialists is affected by
many variables such as family, stress, quality of services
and professional rewards. Canadian researchers have
compared psychiatrists to surgeons emphasizing that ex-
planatory variables associated with their satisfaction
with careers are among others intrinsic and extrinsic
rewards and workload. In addition, their study demon-
strated that variance associated with career satisfaction
can be explained using various factors reported directly
by physicians [18]. In Israel the IMA specifically inter-
viewed a representativ e sample of 500 physicians focus-
ing on professional satisfaction [19]. Only 59% of phy-
sicians reported satisfaction with their work in this IMA
survey. This again emphasizes that the high rates of sat-
isfaction with life amongst physicians are influenced by
extrinsic rewards such as ch ildren, religion and others in
contrast to intrinsic service related variables [15,20].
These findings are supported by work undertaken in the
USA evaluating the changing culture in modern medi-
cine with special focus on the interactions and economic
consequences of managed care, health service delivery
systems, academic medicine, and psychiatry. In west-
ernized medicine, especially the USA, improved tech-
nology and therapeutics profoundly impact medical cul-
ture; but medical economics is as significant. Physicians’
roles blur with duties delegated to lesser qualified
healthcare professionals to maximize patients seen and
generated incomes Doctors need to understand that in
entering medicine they enter a life’s career in which they
serve others, do not expect to become wealthy, but at
life’s end are able to state their satisfaction with their
professional achievements [21,22].
Limitations of the present study include: 1) the data
are self-reported; 2) the data are cross-sectional so that
causal relations are subject to interpretation; 3) the sam-
pling undertaken in professional academic meetings fa-
vors physicians who are possibly more socially and aca-
demically conscious and with a higher interest in their
profession and therefore a higher satisfaction; 4) this
sample is of small size only; 5) other specialties were not
surveyed; 6) the SWLS does not specifically quantify
satisfaction with ones’ profession; and finally 7) no spe-
cific career related questions were posed. The SWLS
scale reflects happiness indirectly. The association be-
tween career satisfaction and satisfaction with life may
not be straight forward and we caution in overlapping
these two concepts [23]. However, this is true for all
survey data sets. Strengths of this study include: 1) easy
to use measurement to assess global satisfaction; 2) high
completion rate of surveys and 3) ability to co mpare date
to a national study of satisfaction and happiness
In conclusion, satisfaction with life amongst Israeli
physicians was very close to that of the general public.
However, our findings suggest that happiness of physi-
cians may be sustained by factors related to the personal
and social domains unrelated to the professional sphere.
The present small study sheds light on an important is-
sue for all practicing physicians. It should be considered
as a preliminary research and we aim to replicate this
work with a much greater sample size and a variety of
[1] Diener, E. and Seligman, M.E. (2002) Very happy people.
Psychological Science, 13, 81-84.
[2] Lyubomirsky, S., King, L. and Diener, E. (2005) The
benefits of frequent positive affect: Does happiness lead
to success? Psychological Bull, 131, 803-855.
[3] Smith, R. (2001) Why are doctors so unhappy? British
Medical Journal, 322, 1073-1074.
[4] Moss, P.J., Lambert, T.W., Goldacre, M.J. and Lee, P.
(2004) Reasons for considering leaving UK medicine:
Questionnaire study of junior doctors’ comments. British
Medical Journal, 329, 1263-1265.
[5] Mechanic, D. (2003) Physician discontent: Challenges
and opportunities. Journal of the American Medical As-
soiation, 290, 941-946.
[6] Chew, M. and Williams, A. (2001) Australian general
practitioners: Desperately seeking satisfaction: Is the sat-
isfied GP an oxymoron? Medicine Journal, 175, 85-86.
[7] Kassirer, J.P. (1998) Doctor discontent. New England
Copyright © 2011 SciRes. OJPsych
Y. Barak et al. / Open Journal of Psychiatry 1 (2011) 122-125
Copyright © 2011 SciRes.
Journal of Medicine, 339, 1543-1545.
[8] Edwards, N., Kornacki, M.J. and Silversin, J. (2002)
Unhappy doctors: What are the causes and what can be
done? British Medical Journal, 324, 835-838.
[9] Sundquist, J. and Johannsson, S.E. (2000) High demand,
low control, and impaired general health: Working condi-
tions in a sample of Swedish general practitioners. Scand
Journal of Public Health, 28, 123-131.
[10] Silversin, J. and Kornacki, M.J. (2002) Creating a physi-
cian compact that drives group success. Medicine Group
Management Journal, 47, 54-62.
[11] Carufel-Wert, D.A., Younkin, S., Foertsch, J., Eisenberg,
T., Haq, C.L., Crouse, B.J. and Frey, I.J.J. (2007) LO-
CUS: Immunizing medical students against the loss of
professional values. Family Me dicine, 39, 320-325.
[12] Kumagai, A.K. (2008) A conceptual framework for the
use of illness narratives in medical education. Academic
Medicine, 83, 653-658.
[13] Diener, E., Emmons, R.A., Larson, R.J. and Griffin, S.
(1985) The satisfaction with life scale. Journal of Per-
sonality Assess, 49, 71-75.
[14] Pavot, W.G., Diener, E., Colvin, C.R. and Sandvik, E.
(1991) Further validation of the satisfaction with life
scale: Evidence for the cross-method convergence of
well-being measures. Journal of Personality Assess, 57,
149-161. doi:10.1207/s15327752jpa5701_17
[15] Pavot, W. and Diener, E. (1993) Review of the satisfac-
tion with life scale. Psychological Assess , 5, 164-172.
[16] SAS/STAT Users’ Guide (1990) Version 6, 4th Edition,
Cary, NC, SAS Institute.
[17] Zusmann, N. and Romanov, D. (2004) Peoples happiness:
Satisfaction with life of Israeli citizens. Research dept.,
bank of Israel. Jerusalem, Israel.
[18] Lepnurm, R., Dobson, R., Backman, A. and Keegan, D.
(2006) Factors explaining career satisfaction among psy-
chiatrists and surgeons in Canada. Canada Journal of
Psychiatry, 51, 243-255.
[19] Dgani, A. and Dgani, R. (2007) Satisfaction of Israeli
physicians: Across several domains. GeoCartography.
Israel medical association.
[20] Murray, A., Montgomery, J.E., Chang, H., Rogers, W.H.,
Inui, T. and Safran, D.G. (1997) Doctor discontent. A
comparison of physician satisfaction in different delivery
system settings, 1986 and 1997. Journal of General In-
ternal Meddicine, 16, 452-459.
[21] Kaufman, K.R. (2000) Academic and private practice
medicine and health service delivery systems: A psychi-
atric commentary. Annals Clinical Psychiatry, 12, 175-
177. doi:10.3109/10401230009147109
[22] Kaufman, K.R. (2008) The changing culture in modern
medicine: A psychiatrist’s perspective. The Open Social
Science Journal, 1, 1-4.
[23] Carrese, J.A. and Ibrahim, M.A. (2008) Success, regret,
and the struggle for balance. Annals Family Medicine, 6,
171-172. doi:10.1370/afm.777