Andrew Jager | American Medical Association (original) (raw)
Papers by Andrew Jager
Supplemental material, sj-pdf-1-mcr-10.1177_10775587211007748 for Motivational Mechanisms Underly... more Supplemental material, sj-pdf-1-mcr-10.1177_10775587211007748 for Motivational Mechanisms Underlying Physicians' Occupational Health: A Self-Determination Theory Perspective by Arlen C. Moller, Anja H. Olafsen, Andrew J. Jager, Audiey C. Kao and Geoffrey C. Williams in Medical Care Research and Review
Journal of Health Communication, 2012
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients ’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites ’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17 % reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting non-allowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing ...
The Annals of Family Medicine, 2018
With the US health care system facing a primary care physician shortage, we evaluated whether med... more With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the “practice of medicine is a calling.” Students who strongly agreed that medicine was a calling had higher odds (P=.003) of selecting a primary care-related residency. Identifying with medicine as a calling may increase the likelihood of pursuing a primary care career.
Journal of health disparities research and practice, 2013
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting nonallowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing pati...
Variable success with quality improvement (QI) efforts in ambulatory care is often attributed to ... more Variable success with quality improvement (QI) efforts in ambulatory care is often attributed to differences in local contexts. Identifying and addressing patient-, practice-, or community-level contextual factors might improve implementation of QI projects. The authors developed and validated a framework for a Practice Context Assessment (PCA), and then created the PCA instrument to glean insights from staff on contextual factors and distributed it at 10 ambulatory practice sites. The PCA framework showed acceptable expert-assessed content validity, with content validity index scores ranging from 0.74 (community engagement) to 0.97 (leadership). The PCA instrument comprised several scales grouped into 7 domains with Cronbach α scores from 0.83 (leadership) to 0.95 (patient and family engagement). The PCA framework provides a valid construct to help ambulatory practices understand contextual issues that might influence QI projects. A revised version of the PCA instrument is now read...
Medical Care Research and Review
Numerous studies have documented deteriorating occupational health among practicing physicians. T... more Numerous studies have documented deteriorating occupational health among practicing physicians. This trend poses a serious risk not only for physicians but also for the many patients under their care. Past research finds that one protective factor involves the quality of physicians’ motivation. When physicians are more autonomously motivated, they tend to experience better occupational health. However, few studies have identified antecedent factors that support physicians’ autonomous work motivation. To identify and model potential root causes of physicians’ autonomous work motivation and occupational health, the current study assessed physicians’ intrinsic aspirations and need satisfaction at work. Hypotheses were tested in a sample of 2,116 U.S. practicing physicians. Structural equation modeling showed that physicians who endorsed intrinsic aspirations more strongly reported better occupational health, and that this association was mediated by physicians’ need satisfaction and au...
Journal of Health Disparities Research and Practice, 2013
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients' choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites' policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting non-allowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing patient support persons and those with no policy or one in development. Most patients report being allowed a support person, but African Americans and those speaking a language other than English or Spanish have greater odds of reporting not being allowed a support person. Reliable methods of informing all patients of this right are needed.
Journal of general internal medicine, Jan 29, 2018
Primary care physicians generally earn less than specialists. Studies of other occupations have i... more Primary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health. Three thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions. Total compensation was self-reported, and we used validated measures of work satisfaction, likelihood of leaving current practice, and health status. Hierarchical logistic regressions were used to assess the associations between pay fairness perceptions and work/life-related outcomes. A total of 2263 physicians completed surveys. Fifty-seven percent believed their compensation was fair; there was no difference between physicians in internal medicine and non-primary care specialties (P = 0.5...
Mayo Clinic proceedings, 2017
To evaluate the association between degree of professional burnout and physicians' sense of c... more To evaluate the association between degree of professional burnout and physicians' sense of calling. US physicians across all specialties were surveyed between October 24, 2014, and May 29, 2015. Professional burnout was assessed using a validated single-item measure. Sense of calling, defined as committing one's life to personally meaningful work that serves a prosocial purpose, was assessed using 6 validated true-false items. Associations between burnout and identification with calling items were assessed using multivariable logistic regressions. A total of 2263 physicians completed surveys (63.1% response rate). Among respondents, 28.5% (n=639) reported experiencing some degree of burnout. Compared with physicians who reported no burnout symptoms, those who were completely burned out had lower odds of finding their work rewarding (odds ratio [OR], 0.05; 95% CI, 0.02-0.10; P<.001), seeing their work as one of the most important things in their lives (OR, 0.38; 95% CI, 0...
Supplemental material, sj-pdf-1-mcr-10.1177_10775587211007748 for Motivational Mechanisms Underly... more Supplemental material, sj-pdf-1-mcr-10.1177_10775587211007748 for Motivational Mechanisms Underlying Physicians' Occupational Health: A Self-Determination Theory Perspective by Arlen C. Moller, Anja H. Olafsen, Andrew J. Jager, Audiey C. Kao and Geoffrey C. Williams in Medical Care Research and Review
Journal of Health Communication, 2012
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients ’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites ’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17 % reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting non-allowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing ...
The Annals of Family Medicine, 2018
With the US health care system facing a primary care physician shortage, we evaluated whether med... more With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the “practice of medicine is a calling.” Students who strongly agreed that medicine was a calling had higher odds (P=.003) of selecting a primary care-related residency. Identifying with medicine as a calling may increase the likelihood of pursuing a primary care career.
Journal of health disparities research and practice, 2013
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting nonallowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing pati...
Variable success with quality improvement (QI) efforts in ambulatory care is often attributed to ... more Variable success with quality improvement (QI) efforts in ambulatory care is often attributed to differences in local contexts. Identifying and addressing patient-, practice-, or community-level contextual factors might improve implementation of QI projects. The authors developed and validated a framework for a Practice Context Assessment (PCA), and then created the PCA instrument to glean insights from staff on contextual factors and distributed it at 10 ambulatory practice sites. The PCA framework showed acceptable expert-assessed content validity, with content validity index scores ranging from 0.74 (community engagement) to 0.97 (leadership). The PCA instrument comprised several scales grouped into 7 domains with Cronbach α scores from 0.83 (leadership) to 0.95 (patient and family engagement). The PCA framework provides a valid construct to help ambulatory practices understand contextual issues that might influence QI projects. A revised version of the PCA instrument is now read...
Medical Care Research and Review
Numerous studies have documented deteriorating occupational health among practicing physicians. T... more Numerous studies have documented deteriorating occupational health among practicing physicians. This trend poses a serious risk not only for physicians but also for the many patients under their care. Past research finds that one protective factor involves the quality of physicians’ motivation. When physicians are more autonomously motivated, they tend to experience better occupational health. However, few studies have identified antecedent factors that support physicians’ autonomous work motivation. To identify and model potential root causes of physicians’ autonomous work motivation and occupational health, the current study assessed physicians’ intrinsic aspirations and need satisfaction at work. Hypotheses were tested in a sample of 2,116 U.S. practicing physicians. Structural equation modeling showed that physicians who endorsed intrinsic aspirations more strongly reported better occupational health, and that this association was mediated by physicians’ need satisfaction and au...
Journal of Health Disparities Research and Practice, 2013
Regulatory and accreditation organizations have advocated open visitation policies and allowance ... more Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients' choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites' policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had 2.4 times greater odds of reporting non-allowance of support than their white counterparts, while speakers of a language other than English or Spanish had 3.9 times greater odds. There were no significant differences noted between sites with a policy allowing patient support persons and those with no policy or one in development. Most patients report being allowed a support person, but African Americans and those speaking a language other than English or Spanish have greater odds of reporting not being allowed a support person. Reliable methods of informing all patients of this right are needed.
Journal of general internal medicine, Jan 29, 2018
Primary care physicians generally earn less than specialists. Studies of other occupations have i... more Primary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health. Three thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions. Total compensation was self-reported, and we used validated measures of work satisfaction, likelihood of leaving current practice, and health status. Hierarchical logistic regressions were used to assess the associations between pay fairness perceptions and work/life-related outcomes. A total of 2263 physicians completed surveys. Fifty-seven percent believed their compensation was fair; there was no difference between physicians in internal medicine and non-primary care specialties (P = 0.5...
Mayo Clinic proceedings, 2017
To evaluate the association between degree of professional burnout and physicians' sense of c... more To evaluate the association between degree of professional burnout and physicians' sense of calling. US physicians across all specialties were surveyed between October 24, 2014, and May 29, 2015. Professional burnout was assessed using a validated single-item measure. Sense of calling, defined as committing one's life to personally meaningful work that serves a prosocial purpose, was assessed using 6 validated true-false items. Associations between burnout and identification with calling items were assessed using multivariable logistic regressions. A total of 2263 physicians completed surveys (63.1% response rate). Among respondents, 28.5% (n=639) reported experiencing some degree of burnout. Compared with physicians who reported no burnout symptoms, those who were completely burned out had lower odds of finding their work rewarding (odds ratio [OR], 0.05; 95% CI, 0.02-0.10; P<.001), seeing their work as one of the most important things in their lives (OR, 0.38; 95% CI, 0...