Job satisfaction and its related factors among dentists: A cross-sectional study

1 Introduction

Job satisfaction is, according to the definitions of contemporary psychology, a state of positive or negative feelings that refer to a worker’s professional duties which result in his or her attitude towards work [1]. The satisfaction can be positive if the employee is satisfied with entrusted tasks and working conditions or negative if the job does not meet the expectations. Job satisfaction is a function of comparison of inputs and outputs from the perspective of an employee [2].

In the case of medical professions, many conditions affect the feeling of satisfaction. The terms contentment and satisfaction are often used interchangeably in many studies. This is not fully justified because while job contentment is a temporary feeling, satisfaction shows a strong sense of satisfaction felt over a longer period. By these definitions, it can be stated that contentment motivates the employee to work and consequently affects the quality of work [3]. However, various factors influence jobsatisfaction. Doctors are particularly exposed to many negative factors – enormous expectations of patients and society (so-called social mission realization), professional aspirations, and numerous limitations (organizational, financial, legal, technical, educational, competence or even physical). Professional satisfaction is considered to be a major factor that influences workforce retention [4].

The profession of a dental practitioner is recognized as extremely prestigious, providing both adequate income and work safety. On the other hand, this profession is exposed to the negative effects of numerous risk factors affecting dentists’ health [5, 6]. Dentistry has been associated with one of the most stressful work environments. It is important to note that the knowledge of modifiable work-environment factors related to job stress could lead to a strategy and policy that will provide better work conditions for dentists; this will also result in a higher quality of treatment for their patients.

Numerous studies have shown quite contradictory results regarding professional satisfaction. Some studies indicate a high level of satisfaction [7–9], others show moderate or low job satisfaction [10–12]. Dentists are also at a risk of burnout [13]. It should also be mentioned that dentists are a special group of medical professionals prone to musculoskeletal pain and disorders [14–16]. In the context of available studies, it is important to consider whether the profession of a dentist can be described as a “dream job” [17].

The study aims to assess the professional satisfaction among dentists and the factors that are associated with it. The questions were aimed at knowing the subjective feelings of doctors about their sense of satisfaction with their profession. The relationship between perceived work satisfaction and age, gender, working time, income, office location, public or private sector, types of medical practice settings were analyzed.

2 Material and methods

The results of a cross-sectional research work were used in this study. The study included 610 dentists. All participants expressed their consent to participate in the study. The examined doctors represented different organizational forms: solo practices, group practices, and medical facility. The entities were selected randomly. The dental offices selected for the study were recruited from locations within the following ranges of size:

rural municipality, up to 5 thousand inhabitants,

The study employed personal interview technique based on a specially prepared form of structured questionnaire. The questions included a 4-step scale that reflected the level of job satisfaction. Other questions included factors potentially related to the perceived job satisfaction. After gathering research material, statistical analyses were carried out. Quantitative variables were presented by arithmetic mean and standard deviation. The consistency of qualitative variables distribution was measured with the Shapiro-Wilk test. Qualitative variables were presented by absolute and relative frequency (rate) of their respective categories. The χ2 test was used to assess the differences between distributions of qualitative variables frequency. Due to a distribution varying from the normal, differences between quantitative variables were tested based on the Mann-Whitney U test, when comparing two groups, or the Kruskal-Wallis test, when comparing more than two groups. The Cramer’s V coefficient was used to measure the correlation between qualitative variables. Furthermore, the assessment of linear trend for qualitative variables on the basis of the Cochran-Armitage test for trend was carried out. The significance level α was set at 0.05. All statistical analyses were carried out using the SAS statistical package, release 9.4 (SAS Institute Inc., Cary, NC, USA).

3 Results

The results indicated that most of the dentists that participated in the survey were satisfied with their work. 33.8% of the respondents reported their occupational satisfaction as “definitely yes,” and 59.8% reported “rather yes.” Only 6.4% of the respondents reported a lack of job satisfaction: “rather not” and “definitely not” showed 5.9% and 0.5% respectively.

A statistically significant relationship was noted between the location of the dental office and professional satisfaction (p = 0.01). Those who run their clinics in small towns are four times more likely to be dissatisfied than doctors working in large cities, according to our survey results. There were also more dissatisfied doctors who run their clinics in small towns than doctors working in rural areas and in medium-sized cities.

A statistically significant relationship (p = 0.007) was found between job satisfaction and the form of dental services financing (NFZ contract or own patient’s measures; public or private sector). Dentists who do not have the NFZ (National Health Fund) contract and work in the private sector showed more satisfaction (41%); only 26.6% of dentists with contracts declared job satisfaction. The last group (dentists with contracts) showed slightly less satisfaction (Table 1).

Significant statistical correlation (p = 0.003) was found between the job satisfaction and sex. Women were slightly more satisfied with their work than men, 95.5% and 91% respectively.

There was also a significant association between age and job satisfaction (p = 0.002). The feeling of dissatisfaction increased with age: the group with the lowest level of satisfaction is represented by the oldest people, over 60 years of age.

The study showed a correlation between working hours and job satisfaction (p < 0.001): job satisfaction was higher among doctors who work more.

No statistically significant relationship was indicated between the perceived professional satisfaction and the type of practice setting, income, as well as the assessment of the dental care system in Poland. It is important to note that a high level of job satisfaction was noted among dentists irrespective of their extremely critical assessment of the dental care system in Poland, as 74.26% of the respondents indicated that the system is very poorly organized. They particularly reported the huge underfunding of the public sector, instability, regulatory turmoil, bureaucracy, and lack of planned long-term health policy.

Much of literature analyzing different aspects of professional satisfaction achieved by dental practitioners provide general indications that most dentists feel a high level of job satisfaction, although these results are often ambiguous and contradictory to the relationship between occupational satisfaction and various psychophysical, cultural, organizational, and economic factors. It should also be highlighted that the oral health care system, working conditions, and other elements of the environment in which dentists operate vary between countries. The applied methodology of research also varies with the different studies. Also, some of the research looked at specific cohorts of dentists, and therefore the results cannot be generalized.

The results of this study found a high level of professional satisfaction amongst dentists. Similar studies in other countries provide various results. A study that involved 1,665 dentists in Lithuania showed that a vast majority of respondents (80.7%) felt a high level of professional satisfaction [7]. Similarly, a study conducted in a group of 107 dentists in India also showed a generally high level of job satisfaction [8]. However, a study in a group of 66 dentists in India indicated a low level of satisfaction (a mean of 3 on a 1–5 point scale) [11]. A similar study on a sample of 277 dentists in Egypt showed a low level of job satisfaction (3.2 on a 1–5 scale) [10]. Another research conducted on a group of 93 dentists employed in the public sector in Saudi Arabia also showed poor job satisfaction (3.3 on a 1–5-point scale) [12].

The form of activity can affect the level of professional satisfaction among doctors. A study carried out in a group of 2,171 dentists representing different forms of activity: individual practitioners, groups, and large companies in Germany have shown that the type of business activity has an impact on the level of job satisfaction. The highest level of professional satisfaction was observed in the group of doctors working in small group practice. Among dentists working in bigger entities, the most significant factor that influenced job satisfaction was the level of income, much more than among the dentists representing other forms of activity; this group also showed the lowest level of stress [18]. Similar results were seen in a study in England where job satisfaction was at a higher level among group practice dentists [9]. A study of 865 dentists in the USA representing two forms of activity, entities run by managers and dentists who own and manage themselves, have shown that doctors working in large units reported lower levels of satisfaction. These doctors were dissatisfied with the income level and felt emotionally exhausted, but they were more satisfied with free weekends and less time spent on organizational work [19].

Our research reported an existing strong relationship between professional satisfaction and work in the public and private sectors. Many other studies have shown such a relationship. For example, similar studies conducted in the Republic of Macedonia on a group of 118 dentists have shown that the differences in the perceived satisfaction of physicians working in the public and private sectors are in favour of doctors working in the private sector. A significant group of public sector doctors, i.e. about 90%, reported frequent stressful situations in the workplace [20]. Research in the UK also confirmed that dentists working for the NHS show less commitment to work. A study carried out on a group of 297 doctors in England also provided evidence that professional satisfaction was higher in the private sector and in the cities. Quality of care, respect for the professional, and free time have the greatest impact on job satisfaction [9].

Systemic changes and the organization of the oral health care sector could influence the satisfaction of dentists. This was confirmed by a study on a sample of 440 dentists working in the NHS: the job satisfaction was examined before and after the changes [21]. A study conducted on a group of 456 dentists employed in the public system of two Scandinavian countries, Denmark and Sweden, following reforms leading to more privatization of dental care, have shown that organizational factors influence the level of satisfaction felt among dentists [22]. A significant factor in Sweden was the number of staff at work, while in Denmark the amount of time a doctor can devote to the treatment of a patient influenced the level of job satisfaction. The smallest job satisfaction was reported in the group of dentists from Sweden born outside the country [22].

The findings of our study which show a high level of professional satisfaction, in the context of high instability and very low evaluation of the dental care system by respondents, probably confirm the thesis that the professional satisfaction of dentists depends more on the internal traits than on the external environment. Studies conducted in England on a group of 583 dentists have shown that strong professional aspirations have an impact on subjective well-being [23]. A study carried out among 147 doctors in Germany showed that the highest proportion of respondents was satisfied with the freedom of the profession and the small amount of income [24]. The impact of selected factors such as age, mean weekly working time, the period in practice, number of dentist’s assistant, and working atmosphere have also been analyzed. The most important factor affecting the high level of professional satisfaction was “the opportunity to use abilities” [24]. A study conducted in Malaysia on a group of 342 dentists showed a significant statistical correlation between job satisfaction and emotional intelligence, i.e. the ability to control one’s own emotions and recognize the emotional states of others [5].

The findings of our study have indicated that the level of professional satisfaction decreases as the age of doctors increases. It was also higher in the group of doctors having longer weekly working time. Many studies have provided other results. Among doctors in Lithuania, the risk of nervousness and depression decreased, and the levels of professional satisfaction increased with age. The greater the number of working hours the greater the risk of burnout, loneliness, and anxiety [7]. Similar results were obtained in a study involving 66 dentists in India, where job satisfaction increased with the age of physicians [11].

The working environment of doctors contains many psychological and physiological stressors, and their cumulative negative impact can contribute to lowering job satisfaction, productivity, consequent emotional distress, and chronic fatigue syndrome which can lead to burnout syndrome [25]. About 12% of dentists in the UK are exposed to professional burnout, while 13–16% of Dutch dentists report high levels of burnout, and 3% of dentists have been diagnosed with total burnout, although they are still working [26]. Studies done in the group of 444 dentists in South Korea have shown that professional burnout is a significant problem, as more than 40% of respondents indicated that they were emotionally burnt-out [27]. Research conducted in Northern Ireland has shown that 1/4 of dentists are highly exposed to burnout [28].

The results of our study confirmed that gender is an important factor in professional satisfaction. Research carried out on a group of 66 dentists in India has confirmed that men have a lower level of satisfaction than women. Male practitioners showed less satisfaction with staff, income, and more satisfaction in professional relations and time when compared to females [11]. Similar studies, done in the group of 371 dentists, also in India, showed higher mean outcomes of work engagement and its dimensions i.e. absorption, dedication, in females [29]. A study conducted in the USA on a sample of 955 dentists, facial and dental specialists representing various forms of employment (residents, academics and private practitioners) showed significant differences between the perceived job satisfaction of men and women in one group – resident practitioners. In the resident practitioner group, women reported significantly lower levels of satisfaction than men [30].

Doctors have identified various factors that influence their job satisfaction. In a study conducted on a group of 93 dentists in Saudi Arabia, four factors were identified: quality of dental care, patient relationships, sex, and leisure. These factors affected 40% of the job satisfaction recorded; the most important factor was quality of care, while the least important was free time [12]. In a study of 277 dentists in Egypt, the important factors affecting job satisfaction indicated were: patient relationships, income levels, leisure time, support staff, and the opportunity to attend specialist courses. The relationship with the patients was indicated as the most important factor affecting the level of professional satisfaction; the factor of least importance was free time [10]. In a study conducted on a group of 107 dentists in India, limited private time was indicated as a major problem because of its bad influence on family relationships [8]. Another study suggested that patient relations, the perception of income, personal time, and staff are the most important factors for job satisfaction among dentists; the most satisfying aspect was income, and the least satisfying aspect was staff [11].

In addition to the key and most commonly defined factors that have a significant impact on professional satisfaction, various research indicates less common ones, for example, electronic documentation, which also has a significant impact on job satisfaction (positive and negative) [31].

Although the research has reached its purposes authors are aware of some unavoidable limitations. First of all, this study was conducted in a group of dentists not sufficiently uniform, i.e. general dentists and specialists, doctors working in public and private sector, about 60% of respondents were female. We did not include representative sample of dentists from all regions of the country, the majority of respondents were from south part of Poland. Therefore not to generalize the results the study should have involved participants working in similar conditions. Further research is required to identify the problems of individual groups of dental professionals. The results of the professional satisfaction survey of dentists and other specialists should be a valuable source of information for health policymakers and health care providers for effective human resources management. The findings of this study could be also helpful in the design of plans to increase the level of job satisfaction among dental professionals. Public health researchers are convinced that the priority of their work is the dissemination of the very established evidence because it is not widely known, even to the medical professionals. This study provide evidence concerning work-environment factors associated with job satisfaction in dentists, some of them are modifiable, but most of them not. Dentists through the course of their studies and during their professional career should be equipped with the knowledge to help them prevent physical and emotional health disorders more effectively, promote well-being and enhance job satisfaction.

5 Conclusion

Overall, our study suggests that the majority of surveyed dentists are satisfied with their job. More than 90% of respondents reported a high level of professional satisfaction. There was a statistically significant relationship between job satisfaction and age, gender, working hours, the location of the office, and working for dentists in the public and private sector. Higher professional satisfaction was observed among a group of younger doctors, doctors that work longer hours, doctors in the private sector, and doctors in large cities. More women reported job satisfaction than men. The income and the oral health care system instability had no impact on professional satisfaction.

Conflict of interest

None declared.