Job satisfaction among general surgeons and their perception of standards of surgical care provided within the health ministry structure in Sri Lanka

Introduction A surgical career is challenging but provides opportunity for tremendous professional satisfaction. Research has shown that improved surgical infrastructure and human resources to be associated with better clinical outcomes, patient satisfaction and surgeons' job satisfaction. In Sri Lanka, general surgical services are predominantly delivered by surgeons employed by Ministry of Health (MoH). Objectives To assess the job satisfaction, perceptions on available facilities and quality of provided surgical services among general surgeons affiliated to MoH. Method A self-administered questionnaire based cross-sectional study evaluated the surgeons' opinion on adequacy of human resources and infrastructure at working institutions and the quality of provided care on elective general surgery, emergency trauma and emergency non-trauma surgical care. Job satisfaction was assessed using Andrew-Withey scale. Results The response rate was 49.4%(n=78). Majority of general surgeons were 'satisfied' (n=49,62.8%) or 'extremely satisfied' (n=7,9.0%) with their job while 15(19.2%) and 7(9%) were 'neutral' and 'unsatisfied' respectively. Twenty-seven of 29(93.1%) Teaching Hospital(TH)-surgeons, 12/18(66.7%) of Provincial/District General Hospital(PGH/DGH)-surgeons and 17/31(71.8%) Base Hospital(BH)-surgeons were 'extremely satisfied' or 'satisfied' (p-value=0.004). Only 14 of 25(56%) domains assessing the adequacy of infrastructure and manpower had a positive response rate over 50% by participants. Many believed the quality of elective general surgical care (n=67,89.3%) to be satisfactory than emergency non-trauma surgical care (n=55,70.5%) and trauma care (n=48,61.5%). Distribution of surgeons satisfied on trauma care within THs(n=22,75.9%) over PGH/DGHs(n=9, 50%) and BHs(n=17, 54.8%) was significant (p=0.015) in contrast to other service domains. Conclusions Overall majority of general surgeons were satisfied with their job with a significant proportion affiliated to THs. Many believed that available manpower and infrastructure to be suboptimal for ideal surgical care especially at BHs. Surgeons were satisfied on provided elective services than emergency and trauma care.