Job Satisfaction of Nurse Practitioners in Retail Clinics vs. Primary Care Settings

In the constantly evolving health care world, there many different settings in which advanced practice clinicians, such as nurse practitioners, can choose to work. Advanced practice clinicians can choose a retail clinic setting, the hospital, a primary care physician’s practice, as well as other settings. While the retail clinic setting is usually for minor illnesses and preventative care, the traditional primary care setting is more specialized and tends to be the primary point of care for patients. Choosing a setting is typically based on personal preference, but is there a difference in job satisfaction among the different settings? In a recent study, published in theJournal of the American Association of Nurse Practitioners, researchers set out to compare the job satisfaction of nurse practitioners in the retail clinic setting with those in the traditional primary care setting.¹

The researchers used both the Misener NP Job Satisfaction Scale (MNPJSS) and the Dempster Practice Behavior Scale (DPBS) to determine job satisfaction and autonomy perceptions in a convenience sample of nurse practitioners recruited from the 2013 annual American Association of Nurse Practitioners conference. “Job satisfaction” was defined as how content one is with his or her employer. The researchers also looked at the level of autonomy the nurse practitioners felt, as increased autonomy is known to correlate positively with job satisfaction. “Autonomy” was defined as the feeling of being able to work independently.

Both autonomy and social interaction with patients were positively related to job satisfaction. While the results of the study did not show a difference in overall job satisfaction between the two settings, nurse practitioners in the traditional primary care setting reported higher job satisfaction in relation to social/community interaction. This can provide insight on areas to address when looking to improve job satisfaction for nurse practitioners in the retail setting.

It can be more difficult for nurse practitioners to interact with their patients and build relationships in the retail setting since patients may use multiple retail clinics and may not follow up with the clinicians on a regular basis. An added pressure to see more patients in a day also cuts down on the time practitioners have to spend with their patients to build important relationships, however, research has shown that patient outcomes improve when patients have positive relationships with their primary care provider. In a study published in theJournal of Family Practice,researchers looked at how a patient-centered visit affects recovery, self-reported health, and subsequent medical care. They found that when patients perceive their visit as patient-centered, they find more common ground with the physician, which can be associated with positive health outcomes and decreased levels of discomfort. The researchers also found that patients with a patient-centered visit received fewer diagnostic tests and referrals.²Another study published inMedical Carefound that when there is good communication between the patient and the physician, the patient’s diabetes and hypertension is under better control (as measured by hemoglobin A1_cand diastolic blood pressure.)³

These results suggest that clinicians should focus on building long-term relationships with their patients, leading to better care for the patients and higher overall job satisfaction for the nurse practitioners.

References

1. Lelli VR, Hickman RL Jr, Savrin CL, Peterson RA. Retail clinics versus traditional primary care: employee satisfaction guaranteed?J Am Assoc Nurse Pract.Published February 20, 2015. doi: 10.1002/2327-6924.12220. Accessed July 28, 2015.
2. Stewart, Moira et al The impact of patient-centered care on outcomes,Journal of Family Medicine.2000; 49(9): 796-804. http://web.a.ebscohost.com.libproxy.temple.edu/ehost/pdfviewer/pdfviewer?sid=d3860810-30e9-4766-bd44-4bcf2f46208b%40sessionmgr4004&vid=1&hid=4114. Accessed July 28, 2015.
3. Kaplan, Sherrie H et al. Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease.Medical Care.1989; 27(3): S110-S127. http://www,jstor.org/page/info/about/policies/terms.jsp. Accessed July 28, 2015.