BMJ Qual Saf 20:508-514 doi:10.1136/bmjqs.2009.038166
  • Original research

Is the job satisfaction of primary care team members associated with patient satisfaction?

Open Access
  1. Michel Wensing1,4
  1. 1Department of General Practice and Health Services Research, University Hospital, University of Heidelberg, Germany
  2. 2AQUA-Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
  3. 3National Primary Care Research and Development Centre, University of Manchester, UK
  4. 4IQ Health Care, University Medical Centre St Radboud, Nijmegen, The Netherlands
  1. Correspondence to Joachim Szecsenyi, Professor Head of Department and of AQUA-Institute, Department of General Practice and Health Services Research, University Hospital, University of Heidelberg, Vossstrasse 2, D-69115 Heidelberg, Germany; joachim.szecsenyi{at}
  1. Contributors Joachim Szecsenyi and Katja Goetz contributed equally to this work. All authors contributed in drafting and commenting on the manuscript.

  • Accepted 25 October 2010
  • Published Online First 24 January 2011


Background Previous research has shown a correlation between physician job satisfaction and patient satisfaction with quality of care, but the connection between job satisfaction of other primary care team members and patient satisfaction is yet unclear.

Objective To evaluate whether there is an association between patient satisfaction and job satisfaction of the members of patient care teams.

Design The study was based on data from the European Practice Assessment and used an observational design.

Setting 676 primary care practices in Germany.

Participants 47 168 patients, 676 general practitioners (practice principals), 305 physician colleagues (trainees and permanently employed physicians) and 3011 non-physician practice members (nurses, secretaries).

Main outcome measures Patient evaluation was measured using the 23-item EUROPEP questionnaire. Job satisfaction was measured using the 10-item Warr–Cook–Wall job satisfaction scale and further items relating to practice structure. Bivariate correlations were applied in which factors of patient satisfaction and practice structure were compared with physicians and non-physicians satisfaction.

Results Patient satisfaction correlates positively with the general job satisfaction of the non-physician (r=0.25, p<0.01) and no significant correlation was found for the general job satisfaction of practice principals and physician colleagues. Patients' satisfaction with the practice organisation correlates positively with the general job satisfaction of the non-physicians (r=0.30, p<0.01) and their view of practice structure (r=0.29, p<0.01).

Conclusions The correlation between non-physician team member satisfaction and patient satisfaction was higher than the correlation between satisfaction of physicians and patients. Patients seem to be sensitive to aspects of practice structure.


  • Funding University of Heidelberg.

  • Competing interests Bjoern Broge is employed by the AQUA-Institute which disseminates EPA in Germany. Joachim Szecsenyi is its director and a stockholder.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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