PS 1997; 48:915-920
Copyright © 1997 by American Psychiatric Association
The psychiatrist's role as medical director: task distributions and job satisfaction
J Ranz, J Eilenberg and S Rosenheck
Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. jmr1@columbia.edu
OBJECTIVES: Previous surveys of the alumni of Columbia University's
fellowship in public psychiatry suggest that a large number of alumni fill
positions as program medical directors. In contrast with agency medical
directors, program medical directors work within team structures and
maintain a high degree of clinical involvement. The fellowship faculty
surveyed the alumni to catalog the tasks performed by program medical
directors, agency medical directors, and staff psychiatrists and to
determine the extent to which these tasks contribute to job satisfaction.
METHODS: A survey form was developed using a list of tasks derived from the
American Psychiatric Association's guidelines for psychiatrists working in
organized mental health care delivery systems and from a recent article
that surveyed job descriptions of psychiatrists in community mental health
centers. The survey form was distributed to all current fellows and alumni
in active practice (N = 89). RESULTS AND CONCLUSIONS: Seventy-two forms
were returned, for a response rate of 81 percent. Respondents who were
medical directors performed a greater variety of tasks and reported higher
job satisfaction than those who were staff psychiatrists. Higher job
satisfaction was related to a greater variety of tasks performed,
especially tasks involving clinical collaboration. Most of the respondents
were program medical directors rather than agency medical directors. The
position of program medical director constitutes a relatively small and
attainable step above that of staff psychiatrist. Agencies would do well to
consider creating positions of program medical directors for their staff
psychiatrists whenever feasible, and psychiatrists committed to
public-sector careers should negotiate to have such positions.
