Intended for healthcare professionals


What do hospital consultants value about their jobs? A discrete choice experiment

BMJ 2003; 326 doi: (Published 26 June 2003) Cite this as: BMJ 2003;326:1432
  1. Cristina Ubach, research assistant1,
  2. Anthony Scott (a.scott{at}, reader in health economics1,
  3. Fiona French, research and development officer2,
  4. Morag Awramenko, research fellow2,
  5. Gillian Needham, postgraduate dean2
  1. 1 Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD
  2. 2 NHS Education for Scotland, Forest Grove House, Aberdeen AB25 2ZP
  1. Correspondence to: A Scott
  • Accepted 12 June 2003


Objective To examine the strength of hospital consultants' preferences for various aspects of their work.

Design Questionnaire survey including a discrete choice experiment.

Setting NHS Scotland.

Participants 2923 hospital consultants in Scotland.

Main outcome measures Monetary valuations or prices for each job characteristic, based on consultants' willingness to pay and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients.

Results The response rate was 61% (1793 resspondents). Being on call was the most important attribute, as consultants would need to be compensated up to £18 000 (30% of their average net income) (P < 0.001) for a high on-call workload. Compensation of up to £9700 (16% of their net income) (P < 0.001) would be required for consultants to forgo opportunities to undertake non-NHS work. Consultants would be willing to accept £7000 (12% of net income) (P < 0.001) in compensation for fair rather than good working relationships with staff, and £6500 (11% of net income) (P < 0.001) to compensate them for a shortage of staff. The least important characteristic was hours of work, with £562 per year (0.9% of their net income) (P < 0.001) required to induce consultants to work one extra hour per week. These preferences also varied among specific subgroups of consultants.

Conclusions Important information on consultants' strength of preferences for characteristics of their job should be used to help to address recruitment and retention problems. Consultants would require increased payment to cover more intensive on-call commitments. Other aspects of working conditions would require smaller increases.


  • Embedded Image Contributors All authors contributed to the design of the questionnaire and interpretation of results. FF and MA undertook piloting and focus group work. CU designed and analysed the discrete choice experiment under the supervision of AS. CU and AS drafted the paper. GN, FF, AS, Linda Leighton-Beck, and Jill Mollison were involved in the design of the project. Helen Coutts assisted with piloting. Kim Walker and Linda Leighton-Beck provided overall project management for the flexible workforce study. Jill Mollison provided statistical advice and Jane Andrew assisted with data analysis. AS, FF, GN, LLB and JM were grantholders. AS is the guarantor.

  • Funding Scottish Council for Postgraduate Medical and Dental Education (now NHS Education for Scotland). The Health Economics Research Unit is funded by the Chief Scientist Office of the Scottish Executive Health Department. The views in this paper are those of the authors. The guarantor accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

  • Competing interests None declared.

  • Accepted 12 June 2003
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