Professional Communication Networks and Job Satisfaction in Primary Care Clinics

Marlon P. Mundt, PhD; Larissa I. Zakletskaia, MA


Ann Fam Med. 2019;17(5):428-435. 

In This Article

Abstract and Introduction


Purpose: Whereas communication among health care professionals plays an important role in providing the best quality of care for primary care patients, little evidence exists regarding how professional communication contributes to job satisfaction among health care providers, including physicians and clinical staff, in primary care clinics. This study evaluates the extent to which professional communication networks contribute to job satisfaction among health care professionals in primary care clinics.

Methods: A total of 143 health care professionals, including physicians and clinical staff, at 5 US primary care clinics participated in a cross-sectional survey on their communication connections regarding patient care with other care team members and their job satisfaction. Social network analysis calculated core-periphery measures to identify individuals located in a dense cohesive core and in a sparse, loosely connected periphery in the communication network. Generalized linear mixed modeling related core-periphery position of clinic employees in the communication network to job satisfaction, after adjusting for job title, sex, number of years working at the clinic, and percent full-time employment.

Results: Average job satisfaction was 5.8 on a scale of 1 to 7. Generalized linear mixed modeling showed that individuals who were in the core of the communication network had significantly greater job satisfaction than those who were on the periphery. Female physicians had lesser overall job satisfaction than other clinic employees.

Conclusions: Interventions targeting professional communication networks might improve health care employee job satisfaction at primary care clinics.


Job satisfaction among primary care professionals, including physicians and clinical staff, can have a significant effect on patient satisfaction with care and patient care quality.[1,2] Close to 68% of family physicians and 73% of general internists report job dissatisfaction.[3] Less than 40% of family and internal medicine physicians indicated satisfaction with work-life balance in 2014.[4] Increasing regulations, electronic health records (EHRs), hectic pace, long hours, and increasing workload contribute to lower job satisfaction among health care professionals.[5] In addition, worse job satisfaction in primary care is closely related to professional burnout characterized by loss of emotional, mental, and physical energy in the context of job-related stress and could lead to reduced patient outcomes.[1,6–8] Whereas clinicians' job satisfaction is recognized as an important goal to aim for, there is a gap in understanding the ways in which team care delivery could enhance clinicians' job satisfaction in primary care.

Notably, little is known about how professional communication in primary care teams contributes to job satisfaction among health care professionals including physicians and clinical staff. Primary care team members rely on team communication as a sensemaking process to assign meaning to experience and to collaborate during health care delivery.[9] Team communication helps teams form shared understanding of clinical situations under the conditions of interdependency and time constraints that are inherent to primary care practices. Effective team communication allows health care practitioners to develop coordination, which is the capacity to predict, anticipate, and respond to one another in high-stress and restricted-time environments such as primary care and, in turn, may increase job satisfaction.[10] Flexible professional communication between team members that is not constricted by authority gradients could enhance professional job satisfaction because it leverages the strengths of all health care practitioners.[11–14] Ineffective professional communication might hinder job satisfaction and severely limit sensemaking, coordination, and collaboration if there are clinic hierarchies for communication and/or if there are bottlenecks in clinic communication flow.[15,16] Poor team communication among primary care professionals might lead to worse job satisfaction if there is a dual organization, for example, in which some team members are isolated from interacting with the rest of the clinic staff.[16] To improve job satisfaction among primary care professionals, including physicians and clinical staff, there is a need to place analytic focus on how team professional communication flow relates to job satisfaction among primary care practitioners.

To fill this gap in the link between team professional communication flow and job satisfaction among primary care practitioners, we aimed to investigate the following research question: How does professional communication flow in primary care clinics relate to job satisfaction among health care professionals?