Skip to main content
Top
Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Research article

Are “part-time” general practitioners workforce idlers or committed professionals?

Authors: Kathryn M Dwan, Kirsty A Douglas, Laura E Forrest

Published in: BMC Primary Care | Issue 1/2014

Login to get access

Abstract

Background

The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. Nevertheless, increasing numbers of GPs are choosing to work sessionally, that is, ostensibly “part-time”. There are concerns about the health workforce’s ability to meet demand and also fears that patient care may be compromised. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession?

Methods

Semi-structured interviews were conducted with GPs who worked sessionally, (i.e. six or fewer sessions a week in clinical general practice, where a session comprises four consecutive hours of patient care). These data were analysed qualitatively and saturation was reached.

Results

The majority of participants were in full-time paid employment, while part-time in clinical general practice. They reported that consultations increasingly required the management of patients with complex, chronic conditions who also required psychological management. Coupled with unrealistic patient expectations, these factors led GPs to be concerned about maintaining the quality patient care they considered professionally desirable. Many diversified their work activities to ensure that they retained their professional standards.

Conclusion

“Part-time” general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants’ clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession.
Literature
1.
go back to reference Zurn P, Dal Poz M, Stilwell B, Adams O: Imbalances in the health workforce. WHO Briefing paper. 2002, Geneva: WHO Press Zurn P, Dal Poz M, Stilwell B, Adams O: Imbalances in the health workforce. WHO Briefing paper. 2002, Geneva: WHO Press
2.
go back to reference World Health Organization: The world health report 2006: working together for health. 2006, Geneva: World Health OrganizationCrossRef World Health Organization: The world health report 2006: working together for health. 2006, Geneva: World Health OrganizationCrossRef
3.
go back to reference Commission of the European Communities: Green Paper: On the European Workforce for Health. 2008, Brussels: Commission of the European Communities Commission of the European Communities: Green Paper: On the European Workforce for Health. 2008, Brussels: Commission of the European Communities
4.
go back to reference Davies P: The non-principal phenomenon: a threat to continuity of care and patient enablement?. Br J Gen Pract. 2004, 54 (507): 730-731.PubMedPubMedCentral Davies P: The non-principal phenomenon: a threat to continuity of care and patient enablement?. Br J Gen Pract. 2004, 54 (507): 730-731.PubMedPubMedCentral
5.
go back to reference Elston MA: Women and Medicine: The future. 2009, London: Royal College of Physicians Elston MA: Women and Medicine: The future. 2009, London: Royal College of Physicians
6.
go back to reference Health Policy & Economic Research Unit: BMA cohort study of 1995 medical graduates: Tenth Report. 1995, London: BMA Health Policy & Economic Research Unit: BMA cohort study of 1995 medical graduates: Tenth Report. 1995, London: BMA
7.
go back to reference Australian Medical Workforce Advisory Committee: The general practice workforce in Australia, Supply and Requirements to 2013. AMWAC Report 2005.2. 2005, Sydney: Australian Medical Workforce Advisory Committee Australian Medical Workforce Advisory Committee: The general practice workforce in Australia, Supply and Requirements to 2013. AMWAC Report 2005.2. 2005, Sydney: Australian Medical Workforce Advisory Committee
8.
go back to reference Charles J, Britt H, Harrison C: General practice workforce and workload. General practice in Australia, health priorities and policy 1998 to 2008, Volume No 24. Edited by: Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C, Valenti L, Fahridin S, Pan Y, O’Halloran J. 2009, Canberra: Australian Institute of Health and Welfare, 22-37. Cat. no. GEP 24 Charles J, Britt H, Harrison C: General practice workforce and workload. General practice in Australia, health priorities and policy 1998 to 2008, Volume No 24. Edited by: Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C, Valenti L, Fahridin S, Pan Y, O’Halloran J. 2009, Canberra: Australian Institute of Health and Welfare, 22-37. Cat. no. GEP 24
9.
go back to reference Hopkins Tanne J: US GPs are unhappy, underpaid, deluged by paperwork, and want to retire, study says. BMJ. 2008, 337: a2711-10.1136/bmj.a2711.CrossRefPubMed Hopkins Tanne J: US GPs are unhappy, underpaid, deluged by paperwork, and want to retire, study says. BMJ. 2008, 337: a2711-10.1136/bmj.a2711.CrossRefPubMed
10.
go back to reference Teljeur C, Thomas S, O’Kelly F, O’Dowd T: General practitioner workforce planning: assessment of four policy directions. BMC Health Serv Res. 2010, 10 (1): 148-10.1186/1472-6963-10-148.CrossRefPubMedPubMedCentral Teljeur C, Thomas S, O’Kelly F, O’Dowd T: General practitioner workforce planning: assessment of four policy directions. BMC Health Serv Res. 2010, 10 (1): 148-10.1186/1472-6963-10-148.CrossRefPubMedPubMedCentral
11.
go back to reference Lewington K: UK Medical Workforce briefing. 2014, London: British Medical Association Health Policy & Economic Research Unit Lewington K: UK Medical Workforce briefing. 2014, London: British Medical Association Health Policy & Economic Research Unit
12.
go back to reference Health Policy and Economic Research Unit: GPs’ views on The Future of General Practice – Focus Group Findings. 2013, London: British Medical Association Health Policy and Economic Research Unit: GPs’ views on The Future of General Practice – Focus Group Findings. 2013, London: British Medical Association
13.
go back to reference National Health Workforce Taskforce: Health Workforce in Australia and Factors for Current Shortages. 2009, Australia: National Health Workforce Taskforce National Health Workforce Taskforce: Health Workforce in Australia and Factors for Current Shortages. 2009, Australia: National Health Workforce Taskforce
14.
go back to reference Limprecht E: Rising GP numbers undermined by trend to part-time hours. Australian Doctor. 2004, Australia: Reed Business Information, 3- Limprecht E: Rising GP numbers undermined by trend to part-time hours. Australian Doctor. 2004, Australia: Reed Business Information, 3-
15.
go back to reference Pincock S: Generation vexed. Australian Doctor. 2010, Australia: Reed Business Information, 23-24. Pincock S: Generation vexed. Australian Doctor. 2010, Australia: Reed Business Information, 23-24.
16.
go back to reference Parnell K: Future of general practice is limited only by its own vision. Australian Doctor. 2008, Australia: Reed Business Information, 22- Parnell K: Future of general practice is limited only by its own vision. Australian Doctor. 2008, Australia: Reed Business Information, 22-
18.
go back to reference Linzer M, McMurray JE, Visser MR, Oort FJ, Smets E, de Haes HC: Sex differences in physician burnout in the United States and The Netherlands. J Am Med Womens Assoc. 2002, 57 (4): 191-193.PubMed Linzer M, McMurray JE, Visser MR, Oort FJ, Smets E, de Haes HC: Sex differences in physician burnout in the United States and The Netherlands. J Am Med Womens Assoc. 2002, 57 (4): 191-193.PubMed
19.
go back to reference McKinstry B, Colthart I, Elliott K, Hunter C: The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners. BMC Health Serv Res. 2006, 6: 56-10.1186/1472-6963-6-56.CrossRefPubMedPubMedCentral McKinstry B, Colthart I, Elliott K, Hunter C: The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners. BMC Health Serv Res. 2006, 6: 56-10.1186/1472-6963-6-56.CrossRefPubMedPubMedCentral
20.
go back to reference Health Policy & Economic Research Unit: BMA cohort study of 2006 medical graduates: First Report. 2007, London: BMA, 32- Health Policy & Economic Research Unit: BMA cohort study of 2006 medical graduates: First Report. 2007, London: BMA, 32-
21.
go back to reference McMurray JE, Heiligers PJ, Shugerman RP, Douglas JA, Gangnon RE, Voss C, Costa ST, Linzer M: Part-time medical practice: where is it headed?. Am J Med. 2005, 118 (1): 87-92. 10.1016/j.amjmed.2004.11.005.CrossRefPubMed McMurray JE, Heiligers PJ, Shugerman RP, Douglas JA, Gangnon RE, Voss C, Costa ST, Linzer M: Part-time medical practice: where is it headed?. Am J Med. 2005, 118 (1): 87-92. 10.1016/j.amjmed.2004.11.005.CrossRefPubMed
22.
go back to reference Watson DE, Slade S, Buske L, Tepper J: Intergenerational differences in workloads among primary care physicians: a ten-year, population-based study. Health Aff (Millwood). 2006, 25 (6): 1620-1628. 10.1377/hlthaff.25.6.1620.CrossRef Watson DE, Slade S, Buske L, Tepper J: Intergenerational differences in workloads among primary care physicians: a ten-year, population-based study. Health Aff (Millwood). 2006, 25 (6): 1620-1628. 10.1377/hlthaff.25.6.1620.CrossRef
23.
go back to reference Australian Medical Workforce Advisory Committee: Career decision making by postgraduate doctors: main report. 2005, Sydney, 16- Australian Medical Workforce Advisory Committee: Career decision making by postgraduate doctors: main report. 2005, Sydney, 16-
24.
go back to reference Heiliger PJ, Hingstman L: Career preferences and the work-family balance in medicine: gender differences among medical specialists. Soc Sci Med. 2000, 50 (9): 1235-1246. 10.1016/S0277-9536(99)00363-9.CrossRefPubMed Heiliger PJ, Hingstman L: Career preferences and the work-family balance in medicine: gender differences among medical specialists. Soc Sci Med. 2000, 50 (9): 1235-1246. 10.1016/S0277-9536(99)00363-9.CrossRefPubMed
25.
go back to reference Jones L, Green J: Shifting discourses of professionalism: a case study of general practitioners in the United Kingdom. Sociol Health Illn. 2006, 28 (7): 927-950.PubMed Jones L, Green J: Shifting discourses of professionalism: a case study of general practitioners in the United Kingdom. Sociol Health Illn. 2006, 28 (7): 927-950.PubMed
26.
go back to reference French FH, Andrew JE, Awramenko M, Coutts H, Leighton-Beck L, Mollison J, Needham G, Scott A, Walker KA: Consultants in NHS Scotland: a survey of work commitments, remuneration, job satisfaction and retirement plans. Scott Med J. 2004, 49 (2): 47-52.PubMed French FH, Andrew JE, Awramenko M, Coutts H, Leighton-Beck L, Mollison J, Needham G, Scott A, Walker KA: Consultants in NHS Scotland: a survey of work commitments, remuneration, job satisfaction and retirement plans. Scott Med J. 2004, 49 (2): 47-52.PubMed
27.
go back to reference Simoens S, Scott A, Sibbald B: Job satisfaction, work-related stress and intentions to quit of Scottish GPs. Scott Med J. 2002, 47 (4): 80-86.PubMed Simoens S, Scott A, Sibbald B: Job satisfaction, work-related stress and intentions to quit of Scottish GPs. Scott Med J. 2002, 47 (4): 80-86.PubMed
28.
go back to reference Mechaber HF, Levine RB, Manwell LB, Mundt MP, Linzer M, Schwartz M, Dowell D, An P, Felix K, McMurray J, et al: Part-time physicians…prevalent, connected, and satisfied. J Gen Intern Med. 2008, 23 (3): 300-303. 10.1007/s11606-008-0514-3.CrossRefPubMedPubMedCentral Mechaber HF, Levine RB, Manwell LB, Mundt MP, Linzer M, Schwartz M, Dowell D, An P, Felix K, McMurray J, et al: Part-time physicians…prevalent, connected, and satisfied. J Gen Intern Med. 2008, 23 (3): 300-303. 10.1007/s11606-008-0514-3.CrossRefPubMedPubMedCentral
29.
go back to reference Australian Government: Primary and community health. Report on Government Services. Edited by: Steering Committee for the Review of Government Service Provision (SCRGSP). 2009, Canberra: Productivity Commission, 153-178. 2009 Australian Government: Primary and community health. Report on Government Services. Edited by: Steering Committee for the Review of Government Service Provision (SCRGSP). 2009, Canberra: Productivity Commission, 153-178. 2009
31.
go back to reference Miles MB, Huberman AM: Chapter 2 - Focusing and bounding the collection of data. The substantive start. Qualitative data analysis: An expanded sourcebook. Edited by: Miles MB, Huberman AM. 1994, London: Sage, 16-39. Miles MB, Huberman AM: Chapter 2 - Focusing and bounding the collection of data. The substantive start. Qualitative data analysis: An expanded sourcebook. Edited by: Miles MB, Huberman AM. 1994, London: Sage, 16-39.
32.
go back to reference Thomas W, Thomas D: The child in America: Behavior problems and programs. 1928, New York: Knopf Thomas W, Thomas D: The child in America: Behavior problems and programs. 1928, New York: Knopf
33.
go back to reference Crotty M: Chapter 3: Constructionism: the making of meaning. The foundations of social research: Meaning and perspective in the research process. 1998, St Leonards, Australia: Allen & Unwin, 42-65. Crotty M: Chapter 3: Constructionism: the making of meaning. The foundations of social research: Meaning and perspective in the research process. 1998, St Leonards, Australia: Allen & Unwin, 42-65.
34.
go back to reference Wengraf T: Qualitative research interviewing: biographic narrative and semi-structured methods. 2001, London; Thousand Oaks, Calif: SageCrossRef Wengraf T: Qualitative research interviewing: biographic narrative and semi-structured methods. 2001, London; Thousand Oaks, Calif: SageCrossRef
35.
go back to reference Guest G, Bunce A, Johnson L: How Many Interviews Are Enough?. Field Methods. 2006, 18 (1): 59-82. 10.1177/1525822X05279903.CrossRef Guest G, Bunce A, Johnson L: How Many Interviews Are Enough?. Field Methods. 2006, 18 (1): 59-82. 10.1177/1525822X05279903.CrossRef
36.
go back to reference Britt H, Miller G, Charles J, Henderson J, Valenti L, Harrison C, Zhang C, Chamber T, Pollack A, Bayram C, et al: A decade of Australian general practice activity 2002–03 to 2011–12. General practice series no. 32. 2012, Sydney: Sydney University Press Britt H, Miller G, Charles J, Henderson J, Valenti L, Harrison C, Zhang C, Chamber T, Pollack A, Bayram C, et al: A decade of Australian general practice activity 2002–03 to 2011–12. General practice series no. 32. 2012, Sydney: Sydney University Press
37.
go back to reference Thomas WI, Znaniecki F: The Polish peasant in Europe and America. 1974, New York: Octagon Books, 2 Thomas WI, Znaniecki F: The Polish peasant in Europe and America. 1974, New York: Octagon Books, 2
Metadata
Title
Are “part-time” general practitioners workforce idlers or committed professionals?
Authors
Kathryn M Dwan
Kirsty A Douglas
Laura E Forrest
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-154

Other articles of this Issue 1/2014

BMC Primary Care 1/2014 Go to the issue