University of Wisconsin–Madison Medical College of Wisconsin

Service Line Director Appraisal: Evaluating Impact on Provider Satisfaction in a Rural-Based Clinic

Adedayo Onitilo, MD, PhD, MSCR; Ya-Huei Li, PhD; Neel Shimpi, BDS, MM, PhD; Ingrid Glurich, PhD; David Putthoff, PhD; Abdul Shour, PhD; Heather Bender; William F. Melms, MD

WMJ. 2025;124(1):47-54.

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ABSTRACT

Introduction: Rural-based health care systems face unique concerns, including the struggle to recruit and retain quality clinicians. We evaluated health care providers’ perceptions of their service line directors (SLDs) in the Marshfield Clinic Health System to understand how these perceptions affect job satisfaction in a rural health care setting.

Methods: Utilizing quantitative and qualitative methods, we reached out to providers within the health system, excluding SLDs to prevent bias. The survey, with a 43% response rate, encompassed 14 questions focusing on 8 domains of engagement. Data analyses included chi-squared tests, t tests, analysis of variance, and correlation matrices. To delve deeper into perceptions, a qualitative approach was employed, analyzing open-ended feedback.

Results: Of the 457 respondents, 70% reported satisfaction with their SLDs. High meeting frequencies with SLDs were positively correlated with satisfaction. The majority acknowledged the positive attributes of SLDs in domains like availability, recognition, and feedback. However, significant variations in perceptions arose between physicians and advanced practice clinicians and between surgeon and non-surgeon SLDs. Qualitative feedback elucidated themes including engagement, communication, and advocacy. Positive attributes, such as competence and proactivity, were mentioned frequently, while negatives highlighted disconnectedness and being uninformed.

Conclusions: The quality of interactions with SLDs significantly influences clinician satisfaction. Regular, meaningful interactions – especially recognizing and providing feedback – enhance satisfaction. However, certain groups like advanced practice clinicians under surgeon SLDs felt less engaged. Our findings underscore the importance of tailored leadership training for SLDs and suggest organizational strategies to boost satisfaction, potentially affecting recruitment and retention in rural health care settings.


Author Affiliations: Department of Oncology, Marshfield Clinic Health System (MCHS), Marshfield, Wisconsin (Onitilo); Cancer Care and Research Center, Marshfield Clinic Research Institute, Marshfield, Wisconsin (Onitilo, Li, Glurich); Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin (Shimpi); Office of Research Support and Services, Marshfield Clinic Research Institute, Marshfield, Wisconsin (Putthoff); Essentia Institute of Rural Health, Essentia, Duluth, Minnesota (Shour); Systems Operations, MCHS, Marshfield, Wisconsin (Bender, Melms); Urgent Care/Emergency Medicine, Marshfield Clinic Health System, Minocqua, Wisconsin (Melms).
Corresponding Author: Adedayo A. Onitilo, MD, PhD, MSCR, FACP, Marshfield Clinic Health System – Weston Center, Department of Oncology/Hematology, 3501 Cranberry Blvd, Weston, WI 54476; phone 715.393.1407; email onitiloa@marshfieldclinic.org; ORCID ID 0000-0001-9185-0606
Funding/Support: None declared.
Financial Disclosures: None declared.
Compliance with Ethical Standards: The Institutional Review Board (IRB) deemed the study did not meet the definition of research and was not subject to IRB oversight.
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