{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:03:21Z","timestamp":1780027401848,"version":"3.53.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical assistants (MAs) are pivotal for access, coordination, and continuity in German primary care, yet workforce shortages and limited attention in research and policy persist. Prior studies quantify dissatisfaction and attrition drivers but offer little insight into how MAs who remain in practice experience job satisfaction. This study explores the social, personal and structural factors shaping MA job satisfaction in everyday work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 14 semi-structured telephone interviews with MAs from German general practices (November\u2013December 2023), recruited via the research networks, the professional association (VMF e.V.) and teaching practice lists. Interviews lasted approximately 60\u00a0min and the interview guide covered practice organisation, communication, working conditions, and job satisfaction. Interview data were analysed using a rapid qualitative analysis approach. Key statements were summarised in a structured matrix aligned with interview topics and compared across cases. Categories were developed iteratively through team-based analysis and consensus meetings, resulting in three overarching domains influencing job satisfaction: social (team dynamics and leadership), personal (identity and motivation), and structural (roles, pay, digital infrastructure, and staffing). Ethics approval: University of Duisburg-Essen, Medical Faculty (23-11354-BO; 14 Nov 2023). Participants provided written consent and received a \u20ac75 expense allowance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three interrelated domains influenced job satisfaction.<\/jats:p>\n                    <jats:p>(1) Social (team dynamics\/leadership): Experiences ranged from respectful, supportive leadership to inattentive or inconsistent supervision; structured feedback and clear communication reduced errors and strain, while gossip\/bullying and informal word-of-mouth channels increased frustration.<\/jats:p>\n                    <jats:p>(2) Personal (identity\/motivation): Satisfaction peaked when responsibilities matched training and skills were recognised and used. Emotional labour, especially in patient communication, was salient. Intrinsic motivation remained important, yet financial pressures increasingly shaped commitment.<\/jats:p>\n                    <jats:p>(3) Structural (roles, pay, digital, staffing): Continuing education (CE) was valued, but many courses were only minimally reflected in pay scales and CE gains were not consistently implemented in contracts or roles. Pay was widely perceived as inadequate relative to responsibility, particularly during the pandemic. Digital infrastructure was often unreliable, especially in rural areas. Understaffing and irregular breaks and overtime contributed to overload. Substitution with non-clinical staff was viewed critically for clinically consequential tasks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>MA job satisfaction is co-produced by social, personal and structural conditions; the most salient burdens were emotional labour in patient contact and a misalignment between responsibility and compensation. Retention improves where leadership and communication routines are supportive, continuing education is translated into role\/grade changes and visible use, and existing collective agreements are implemented consistently. Rather than new pay models, pragmatic fixes are needed, certificate-to-grade mapping, transparent role profiles, inflation-sensitive supplements, alongside dependable digital support. Delegation to non-clinical staff should exclude clinically consequential tasks (e.g. triage or telephone decisions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MA job satisfaction in German primary care emerges from interacting social, personal and structural conditions. Targeted actions across these domains are needed to sustain workforce capacity and patient-centred care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-026-03391-6","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T08:44:38Z","timestamp":1779439478000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Job satisfaction among medical assistants in German general practice: a qualitative study of social, structural and personal factors"],"prefix":"10.1186","volume":"27","author":[{"given":"Susanne","family":"Kersten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Hohmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Piotrowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Kathrin","family":"Lepper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Dehnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pentzek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Weissbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"6","key":"3391_CR1","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1093\/eurpub\/ckw098","volume":"26","author":"CB Maier","year":"2016","unstructured":"Maier CB, Aiken LH. Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study. Eur J Public Health. 2016;26(6):927\u201334.","journal-title":"Eur J Public Health"},{"issue":"1","key":"3391_CR2","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1186\/s12889-024-17798-2","volume":"24","author":"K Schmidt-Stiedenroth","year":"2024","unstructured":"Schmidt-Stiedenroth K, Mambrey V, Dreher A, Loerbroks A. Psychosocial working conditions and mental health among medical assistants in Germany: a scoping review. BMC Public Health. 2024;24(1):716.","journal-title":"BMC Public Health"},{"key":"3391_CR3","unstructured":"Deutsches \u00c4rzteblatt. Nachfolgeprobleme und Fachkr\u00e4ftemangel schr\u00e4nken ambulante Versorgung ein: Deutsches \u00c4rzteblatt; 2023 .Available from: URL: https:\/\/www.aerzteblatt.de\/nachrichten\/145243\/Nachfolgeprobleme-und-Fachkraeftemangel-schraenken-ambulante-Versorgung-ein cited 2025 Sep 9."},{"key":"3391_CR4","unstructured":"Dierberger V, Neuabschl\u00fcsse, Ausbildungsberufe. MFA nicht mehr auf Platz 1; 2024. Available from: URL: https:\/\/www.rebmann-research.de\/neuabschluesse-ausbildungsberufe-mfa-nicht-mehr-auf-platz-1.cited 2025 Sep 9."},{"issue":"1","key":"3391_CR5","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1186\/s12913-024-11607-7","volume":"24","author":"V Mambrey","year":"2024","unstructured":"Mambrey V, Dreher A, Loerbroks A. Leaving the profession as a medical assistant: a qualitative study exploring the process, reasons and potential preventive measures. BMC Health Serv Res. 2024;24(1):1111.","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"3391_CR6","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.mnl.2021.08.009","volume":"19","author":"J Donley","year":"2021","unstructured":"Donley J. The impact of work environment on job satisfaction: Pre-COVID research to inform the future. Nurse Lead. 2021;19(6):585\u20139.","journal-title":"Nurse Lead"},{"key":"3391_CR7","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.zefq.2017.06.005","volume":"126","author":"P Vu-Eickmann","year":"2017","unstructured":"Vu-Eickmann P, Loerbroks A. Psychosoziale arbeitsbedingungen medizinischer fachangestellter: ergebnisse einer qualitativen studie zu den berufsspezifischen belastungen, ressourcen, pr\u00e4ventionsm\u00f6glichkeiten und interventionsbed\u00fcrfnissen. Z Evid Fortbild Qual Gesundhwes. 2017;126:43\u201351.","journal-title":"Z Evid Fortbild Qual Gesundhwes"},{"issue":"01","key":"3391_CR8","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1055\/a-2129-3253","volume":"29","author":"P Scheerbaum","year":"2024","unstructured":"Scheerbaum P, Scheerbaum M, Sch\u00f6ffski O. Was will die MFA? Gesundheits\u00f6konomie Qualit\u00e4tsmanagement. 2024;29(01):45\u201350.","journal-title":"Gesundheits\u00f6konomie Qualit\u00e4tsmanagement"},{"key":"3391_CR9","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.zefq.2021.09.006","volume":"167","author":"K Mergenthal","year":"2021","unstructured":"Mergenthal K, G\u00fcthlin C. Einflussgr\u00f6\u00dfen auf die Arbeitszufriedenheit von Medizinischen Fachangestellten. Z Evid Fortbild Qual Gesundhwes. 2021;167:78\u201385.","journal-title":"Z Evid Fortbild Qual Gesundhwes"},{"issue":"9","key":"3391_CR10","doi-asserted-by":"publisher","first-page":"3603","DOI":"10.3390\/su16093603","volume":"16","author":"G Hoxha","year":"2024","unstructured":"Hoxha G, Simeli I, Theocharis D, Vasileiou A, Tsekouropoulos G. Sustainable healthcare quality and job satisfaction through organizational culture: approaches and outcomes. Sustainability. 2024;16(9):3603.","journal-title":"Sustainability"},{"key":"3391_CR11","unstructured":"HAFO.NRW. Haus\u00e4rztliches forschungspraxennetz (NRW.GPRN north-rhine westphalian general practice research)network. Available from: URL: https:\/\/www.hafo.nrw\/ilias.php?baseClass=ilrepositorygui&reloadpublic=1&cmd=&ref_id=1.cited 2025 Sep 9."},{"key":"3391_CR12","unstructured":"DESAM-ForNet. Initiative deutscher forschungspraxennetze. Available from: URL: https:\/\/www.desam-fornet.de\/initiative-deutscher-forschungspraxennetze-desam-fornet\/"},{"key":"3391_CR13","doi-asserted-by":"crossref","unstructured":"Kersten S, Kersting C, Mortsiefer A, Weissbach S, Calis A, Berges N et al. Organisational, hygiene- and team-related changes in german general practices during and after the COVID-19 pandemic: a participatory cross-sectional survey among medical assistants (WiSBAH study). BMC Public Health 2026; 26(1).","DOI":"10.1186\/s12889-026-26523-0"},{"key":"3391_CR14","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.zefq.2020.07.010","volume":"156\u2013157","author":"J Gisbert Miralles","year":"2020","unstructured":"Gisbert Miralles J, Heintze C, Dini L. Haus\u00e4rztliche Delegationskonzepte in Nordrhein-Westfalen Ergebnisse der haus\u00e4rztlichen Befragung zum Einsatz von EVA, VERAH, VERAH Plus zur Delegation definierter T\u00e4tigkeiten. Z Evid Fortbild Qual Gesundhwes. 2020;156\u2013157:50\u20138.","journal-title":"Z Evid Fortbild Qual Gesundhwes"},{"key":"3391_CR15","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","volume":"4","author":"LJ Damschroder","year":"2009","unstructured":"Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.","journal-title":"Implement Sci"},{"issue":"1","key":"3391_CR16","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s13012-022-01245-0","volume":"17","author":"LJ Damschroder","year":"2022","unstructured":"Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.","journal-title":"Implement Sci"},{"key":"3391_CR17","unstructured":"Porst R, Fragebogen. Wiesbaden: Springer Fachmedien Wiesbaden; 2014."},{"issue":"7","key":"3391_CR18","doi-asserted-by":"publisher","first-page":"e076792","DOI":"10.1136\/bmjopen-2023-076792","volume":"14","author":"A Mathieson","year":"2024","unstructured":"Mathieson A, Elvey R, Wilson P. Development and application of a qualitative rapid analysis framework in a hybrid trial within primary care. BMJ Open. 2024;14(7):e076792.","journal-title":"BMJ Open"},{"issue":"1","key":"3391_CR19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s13012-019-0853-y","volume":"14","author":"RC Gale","year":"2019","unstructured":"Gale RC, Wu J, Erhardt T, Bounthavong M, Reardon CM, Damschroder LJ, et al. Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the veterans health administration. Implement Sci. 2019;14(1):11.","journal-title":"Implement Sci"},{"issue":"Suppl 3","key":"3391_CR20","doi-asserted-by":"publisher","first-page":"S242","DOI":"10.1097\/MLR.0000000000001553","volume":"59","author":"AA Lewinski","year":"2021","unstructured":"Lewinski AA, Crowley MJ, Miller C, Bosworth HB, Jackson GL, Steinhauser K, et al. Applied rapid qualitative analysis to develop a contextually appropriate intervention and increase the likelihood of uptake. Med Care. 2021;59(Suppl 3):S242\u201351.","journal-title":"Med Care"},{"issue":"1","key":"3391_CR21","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1177\/160940690600500107","volume":"5","author":"J Fereday","year":"2006","unstructured":"Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qualitative Methods. 2006;5(1):80\u201392.","journal-title":"Int J Qualitative Methods"},{"key":"3391_CR22","doi-asserted-by":"crossref","unstructured":"Swain J. A Hybrid approach to thematic analysis in qualitative research: using a practical example. 1 Oliver\u2019s Yard, 55 City Road, London EC1Y 1SP United Kingdom. SAGE Publications Ltd; 2018.","DOI":"10.4135\/9781526435477"},{"issue":"2","key":"3391_CR23","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1037\/h0076546","volume":"60","author":"JR Hackman","year":"1975","unstructured":"Hackman JR, Oldham GR. Development of the job diagnostic survey. J Appl Psychol. 1975;60(2):159\u201370.","journal-title":"J Appl Psychol"},{"issue":"6","key":"3391_CR24","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1370\/afm.1713","volume":"12","author":"T Bodenheimer","year":"2014","unstructured":"Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573\u20136.","journal-title":"Ann Fam Med"},{"key":"3391_CR25","doi-asserted-by":"crossref","unstructured":"Williams A, Hochschild. (2003) - the managed heart: the recognition of emotional labour in public service work. Nurse Educ Today 2013; 33(1):5\u20137.","DOI":"10.1016\/j.nedt.2012.07.006"},{"key":"3391_CR26","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.zefq.2025.02.002","volume":"195","author":"L K\u00fcmpel","year":"2025","unstructured":"K\u00fcmpel L, Kuschick D, Toutaoui K, Dierks M, Wolf F, Rost L, et al. The aftermath of the COVID-19 pandemic in general practices compared to pre-pandemic times: Longitudinal questionnaire survey among general practitioners and medical practice assistants in Germany on how the pandemic shaped everyday care. Z Evid Fortbild Qual Gesundhwes. 2025;195:51\u20139.","journal-title":"Z Evid Fortbild Qual Gesundhwes"},{"issue":"12","key":"3391_CR27","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1055\/a-2158-8982","volume":"85","author":"F Wolf","year":"2023","unstructured":"Wolf F, Krause M, Mei\u00dfner F, Rost L, Bleidorn J, Dierks MT, et al. Einstellungen von haus\u00e4rzt:innen und medizinischen fachangestellten zur delegation \u00e4rztlicher leistungen \u2013 ergebnisse einer befragung in Berlin, Brandenburg und Th\u00fcringen. Gesundheitswesen. 2023;85(12):1115\u201323.","journal-title":"Gesundheitswesen"},{"issue":"3","key":"3391_CR28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.colegn.2011.04.002","volume":"18","author":"K Yates","year":"2011","unstructured":"Yates K, Usher K, Kelly J. The dual roles of rural midwives: the potential for role conflict and impact on retention. Collegian. 2011;18(3):107\u201313.","journal-title":"Collegian"},{"issue":"4","key":"3391_CR29","doi-asserted-by":"publisher","first-page":"e0320953","DOI":"10.1371\/journal.pone.0320953","volume":"20","author":"A Suslow","year":"2025","unstructured":"Suslow A, Schl\u00f6\u00dfler K, Chikhradze N, Lauer R, Pentzek M, Mortsiefer A, et al. Should i stay or should i go-medical assistants\u00b4 experiences and coping with patient demand and lack of appreciation during the Covid-19 pandemic. PLoS ONE. 2025;20(4):e0320953.","journal-title":"PLoS ONE"},{"issue":"1","key":"3391_CR30","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s12875-022-01880-y","volume":"23","author":"A Dreher","year":"2022","unstructured":"Dreher A, Mambrey V, Loerbroks A. Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study. BMC Prim Care. 2022;23(1):273.","journal-title":"BMC Prim Care"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03391-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03391-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03391-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T03:34:47Z","timestamp":1780025687000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03391-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3391"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03391-6","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"11 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. Ethics approval was obtained from the Ethics Committee of the Medical Faculty of the University of Duisburg-Essen (reference 23-11354-BO; 14 November 2023).All participants provided written informed consent prior to data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent to publish declaration: not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"214"}}