Surgeons are the least satisfied of all specialty physicians, "which is troubling because they are high revenue producers," according to a new Press Ganey Associates report. The firm surveyed 27,671 physicians practicing at 302 hospitals/facilities nationwide between Jan. 1 and Dec. 31, 2007 to compile Hospital Check-Up Report 2008: Physician Perspectives on American Hospitals.

In the OR specifically, physicians are least satisfied with the ease of inpatient surgery (a satisfaction score of 72.3), but outpatient surgery isn't far behind at 72.4. With regard to whether the facility provides up-to-date medical equipment, physicians gave a 75.5 rating; and overall anesthesiology received an 80.4.

"The ability for physicians to schedule patients for times conducive to their schedules and the availability of OR suites during prime surgery times are an area of concern for many hospitals," the report says. "Managing block time and add-on scheduling continues to challenge OR managers nationwide."

Of the 14 surgical specialties listed, 12 reported satisfaction levels below the mean satisfaction score, and four of the five least-satisfied specialties were surgical: thoracic, vascular, cardiovascular and general surgery. Oral surgery was the only surgical specialty to make the top five. Read the surgical specialty rankings.

"Physician referrals and admission rates drive hospital business; thus, physicians and their referrals are integral components of a successful hospital strategy," says the report. "However, the quality of the relationship between administrators and physicians can significantly affect the likelihood that a physician will refer patients to, or choose to care for patients at, a particular facility. Furthermore, hospitals are no longer the only place where physicians can practice surgical or other complex procedures; a growing number of physicians are striking out on their own and establishing physician-owned clinics and hospitals that rival traditional hospital operations.

"For most organizations, improving relationships is critical to maintaining robust patient volumes and healthy revenue, and discouraging competition from physician-owned hospitals."

It is interesting to note that physicians employed by their hospitals/facilities (20 percent of those surveyed) reported higher overall satisfaction (75.2 satisfaction score) compared with those who are not (72.4 satisfaction score). In particular, surgical specialties not employed by hospitals reported lower satisfaction with their practice at the hospitals. Read the employed and independent surgical specialty rankings.

"Administrators regularly cite physician-administrator relations and physician retention as two of their top concerns, and they know that alienating physicians can lead to physician attrition and lower patient volumes," says the report. Further, "Press Ganey research also shows that the most satisfied physicians refer the greatest number of patients. Hospital administrators who acknowledge the demands on their medical staff and take steps to partner with physicians can see not only increased physician retention. but increased patient volumes and healthier bottom lines.

"The healthcare landscape is changing, but there is still incredible potential for growth ? and, more important, improved patient care ? for hospitals that choose to partner with their physicians."

Read more about physician priorities for hospital administrators, which focus heavily on physician/administration relations.