Job stress among GPs: associations with practice organisation in 11 high-income countries

Abstract

BackgroundJob stress among GPs is an issue of growing concern.AimTo investigate whether the structural and organisational features of GPs’ practices were associated with job stress in 11 countries.Design and settingSecondary analysis of the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, an international cross-sectional study. A total of 11 Western countries participated in the 2015 edition.MethodRandom samples of practising GPs were drawn from government or private lists in each country (N = 12 049). Job stress was measured by the question: ‘How stressful is your job as a GP?’ (5-point Likert scale). Numerous practices’ organisation and functioning characteristics were considered. Multilevel mixed-effects ordered logistic regression was performed.ResultsThe prevalence of job stress varied from 18% to 59% according to country. Job stress was higher among GPs aged 45–54 years (middle age) (odds ratio [OR] 1.35, 95% confidence interval [CI] = 1.07 to 1.70) and those practising in an urban area (OR 1.23, 95% CI = 1.15 to 1.31). It was also associated with a high weekly workload (OR 2.88, 95% CI = 2.38 to 3.50) if >50 hours/week workload, large administrative burden (OR 1.65, 95% CI = 1.44 to 1.89), long delays in receiving hospital discharge, poor possibilities in offering same-day appointments (OR 1.74, 95% CI = 1.18 to 2.56), and performance assessment (OR 1.15, 95% CI = 1.05 to 1.24).Finally, long consultations (OR 0.64, 95% CI = 0.53 to 0.76) and working with a case manager attached to the practice were associated with a lower job stress. The vast majority of results were consistent across the countries.ConclusionHeavy workloads and time pressure are clearly associated with GP job stress. However, organisational changes such as employing case managers and allowing longer consultations could potentially reduce this burden.

Exploring whether teaching activity is a way to improve GPs' satisfaction and wellbeing: a cross-sectional study

“…Regarding the other predictors of loss of meaning in work, the harmful impact of administrative overload on GPs has been pointed out several times in terms of dissatisfaction and burnout. 2,3,10,11,14 To the authors' knowledge, this is the first time that administrative overload is demonstrated to be associated with a loss of meaning for GPs in their work. In a UK study conducted at the national level, 80% of the 3000 GPs surveyed felt that they were required to do unimportant administrative tasks, preventing their completion of more important ones.…”

“…[5][6][7] The origins of dissatisfaction and stress at work in GPs have also been investigated; for example, heavy workload, especially administrative tasks; fragmentation of activities and time pressure; regulation and control of practices; and increases in patient demands have been pointed out. [8][9][10][11] Exposure to all of these occupational pressures, but in particular administrative overload, could lead to a loss of meaning at work (or brownout in some occupational sectors, 12 which occurs when there is a discrepancy between the expected job and the reality of it). Although there is much research into the causes and consequences of GPs' dissatisfaction at work, studies considering positive predictors of GPs' satisfaction and wellbeing at work are fewer.…”

Feasibility, acceptability and effect of the Mindful Practice curriculum in postgraduate training of general practitioners

“…There is an urgent need to promote wellbeing and resilience strategies within vocational training in order to prepare doctors for a career in general practice and lower the risk of emotional exhaustion and burnout in trainee and early career GPs [ 32 ]. This is important to retaining a healthy GP workforce, particularly given that relatively large numbers of trainees are currently intending to take career breaks, part-time work or leave the profession altogether [ 1 , 2 ].…”

“…General practitioners (GPs) at all stages of their career are at high risk of suffering from emotional stress, depression and burnout [ 1 , 2 ], and this is contributing to increasing levels of sickness absence, and difficulties in retaining the GP workforce [ 3 ]. This is an international issue, with risk of burnout reflecting numerous factors including personal attributes, workload pressures, and difficult encounters with patients and colleagues [ 3 , 4 ].…”

What if something happens tonight? A qualitative study of primary care physicians’ perspectives on an alternative to hospital admittance

“…The Vanguard study in England indicated that collaboration is difficult because there are barriers between the different health care levels [ 42 ], which is supported by our findings. A lack of communication and collaboration between healthcare providers is one of the main factors for stress among PCPs in high-income countries [ 43 ]; hence, this situation demands action. A focus on better collaboration between primary healthcare services and hospitals is essential to ensure the exchange of knowledge and experiences related to various diseases and how they are handled [ 44 , 45 ].…”