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Published in: BMC Primary Care 1/2019

Open Access 01-12-2019 | Care | Research article

Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network

Authors: B. Le Floch, H. Bastiaens, J. Y. Le Reste, H. Lingner, R. Hoffman, S. Czachowski, R. Assenova, T. H. Koskela, Z. Klemenc-Ketis, P. Nabbe, A. Sowinska, T. Montier, L. Peremans

Published in: BMC Primary Care | Issue 1/2019

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Abstract

Background

General Practice (GP) seems to be perceived as less attractive throughout Europe. Most of the policies on the subject focused on negative factors. An EGPRN research team from eight participating countries was created in order to clarify the positive factors involved in appeals and retention in GP throughout Europe. The objective was to explore the positive factors supporting the satisfaction of General Practitioners (GPs) in clinical practice throughout Europe.

Method

Qualitative study, employing face-to-face interviews and focus groups using a phenomenological approach. The setting was primary care in eight European countries: France, Belgium, Germany, Slovenia, Bulgaria, Finland, Poland and Israel. A thematic qualitative analysis was performed following the process described by Braun and Clarke. Codebooks were generated in each country. After translation and back translation of these codebooks, the team clarified and compared the codes and constructed one international codebook used for further coding.

Results

A purposive sample of 183 GPs, providing primary care to patients in their daily clinical practice, was interviewed across eight countries. The international codebook included 31 interpretative codes and six themes. Five positive themes were common among all the countries involved across Europe: the GP as a person, special skills needed in practice, doctor-patient relationship, freedom in the practice and supportive factors for work-life balance. One theme was not found in Poland or Slovenia: teaching and learning.

Conclusion

This study identified positive factors which give GPs job satisfaction in their clinical practice. This description focused on the human needs of a GP. They need to have freedom to choose their working environment and to organize their practice to suit themselves. In addition, they need to have access to professional education so they can develop specific skills for General Practice, and also strengthen doctor-patient relationships. Stakeholders should consider these factors when seeking to increase the GP workforce.
Literature
1.
go back to reference Evans T, Van Lerberghe W. The world health report 2008: primary health care : now more than ever. Geneva: World Health Organization; 2008. Evans T, Van Lerberghe W. The world health report 2008: primary health care : now more than ever. Geneva: World Health Organization; 2008.
2.
go back to reference OECD: Health at a Glance 2015. 2015th edition. Paris: OECD Publishing; 2015. [Health at a Glance] OECD: Health at a Glance 2015. 2015th edition. Paris: OECD Publishing; 2015. [Health at a Glance]
3.
go back to reference Evans T, Van Lerberghe W. The World Health Report 2008: Primary Health Care: Now More Than Ever. Geneva: World Health Organization; 2008. Evans T, Van Lerberghe W. The World Health Report 2008: Primary Health Care: Now More Than Ever. Geneva: World Health Organization; 2008.
4.
go back to reference Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European definitions of the key features of the discipline of general practice: the role of the GP and core competencies. Br J Gen Pract. 2002;52:526–7.PubMedPubMedCentral Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European definitions of the key features of the discipline of general practice: the role of the GP and core competencies. Br J Gen Pract. 2002;52:526–7.PubMedPubMedCentral
5.
go back to reference Dusmesnil H, Serre BS, Régi J-C, Leopold Y, Verger P. Professional burn-out of general practitioners in urban areas: prevalence and determinants. Sante Publique. 2009;21:355–64.CrossRef Dusmesnil H, Serre BS, Régi J-C, Leopold Y, Verger P. Professional burn-out of general practitioners in urban areas: prevalence and determinants. Sante Publique. 2009;21:355–64.CrossRef
7.
go back to reference Consortium for the Study of Effective Health, Recruitment W and RS. Recruitment and Retention of the Health Workforce in Europe Report on Evidence of Effective Measures to Recruit and Retain Health Professionals in the EU and EEA/EFTA Countries. Luxembourg; 2015. Consortium for the Study of Effective Health, Recruitment W and RS. Recruitment and Retention of the Health Workforce in Europe Report on Evidence of Effective Measures to Recruit and Retain Health Professionals in the EU and EEA/EFTA Countries. Luxembourg; 2015.
8.
go back to reference Sinclair HK, Ritchie LD, Lee AJ. A future career in general practice? A longitudinal study of medical students and pre-registration house officers. Eur J Gen Pract. 2006;12:120–7.CrossRef Sinclair HK, Ritchie LD, Lee AJ. A future career in general practice? A longitudinal study of medical students and pre-registration house officers. Eur J Gen Pract. 2006;12:120–7.CrossRef
9.
go back to reference Rowsell R, Morgan M, Sarangi J. General practitioner registrars’ views about a career in general practice. Br J Gen Pract. 1995;45:601–4.PubMedPubMedCentral Rowsell R, Morgan M, Sarangi J. General practitioner registrars’ views about a career in general practice. Br J Gen Pract. 1995;45:601–4.PubMedPubMedCentral
10.
go back to reference Czachowski S, Pawlikowska T. “These reforms killed me”: doctors’ perceptions of family medicine during the transition from communism to capitalism. Fam Pract. 2011;28:437–43.CrossRef Czachowski S, Pawlikowska T. “These reforms killed me”: doctors’ perceptions of family medicine during the transition from communism to capitalism. Fam Pract. 2011;28:437–43.CrossRef
11.
go back to reference Huicho L, Dieleman M, Campbell J, Codjia L, Balabanova D, Dussault G, Dolea C. Increasing access to health workers in underserved areas: a conceptual framework for measuring results. Bull World Health Organ. 2010;88:357–63.CrossRef Huicho L, Dieleman M, Campbell J, Codjia L, Balabanova D, Dussault G, Dolea C. Increasing access to health workers in underserved areas: a conceptual framework for measuring results. Bull World Health Organ. 2010;88:357–63.CrossRef
12.
go back to reference Locke EA. The relationship of task success to task liking and satisfaction. J Appl Psychol. 1965;49:379–85.CrossRef Locke EA. The relationship of task success to task liking and satisfaction. J Appl Psychol. 1965;49:379–85.CrossRef
13.
go back to reference Herzberg FI. Work and the nature of man. Oxford: The World Publishing Company, editor; 1966. Herzberg FI. Work and the nature of man. Oxford: The World Publishing Company, editor; 1966.
14.
go back to reference Herzberg F, Mausner B, Snyderman BB. The motivation to work. New York: Wiley; 1959. p. 157. Herzberg F, Mausner B, Snyderman BB. The motivation to work. New York: Wiley; 1959. p. 157.
15.
go back to reference Roos M, Watson J, Wensing M, Peters-Klimm F. Motivation for career choice and job satisfaction of GP trainees and newly qualified GPs across Europe: a seven countries cross-sectional survey. Educ Prim Care. 2014;25:202–10.CrossRef Roos M, Watson J, Wensing M, Peters-Klimm F. Motivation for career choice and job satisfaction of GP trainees and newly qualified GPs across Europe: a seven countries cross-sectional survey. Educ Prim Care. 2014;25:202–10.CrossRef
16.
go back to reference Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman RD, Czachowski S, Assenova R, Koskela TH, Klemenc-Ketis Z, Nabbe P, Sowinska A, Montier T, Peremans L. Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review. BMC Fam Pract. 2016;17(1):133.CrossRef Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman RD, Czachowski S, Assenova R, Koskela TH, Klemenc-Ketis Z, Nabbe P, Sowinska A, Montier T, Peremans L. Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review. BMC Fam Pract. 2016;17(1):133.CrossRef
17.
go back to reference Lepnurm R, Dobson R, Backman A, Keegan D. Factors associated with career satisfaction among general practitioners in Canada. Can J Rural Med. 2007;12:217–30.PubMed Lepnurm R, Dobson R, Backman A, Keegan D. Factors associated with career satisfaction among general practitioners in Canada. Can J Rural Med. 2007;12:217–30.PubMed
18.
go back to reference Geneau R, Lehoux P, Pineault R, Lamarche PA. Primary care practice a la carte among GPs: using organizational diversity to increase job satisfaction. Fam Pract. 2007;24:138–44.CrossRef Geneau R, Lehoux P, Pineault R, Lamarche PA. Primary care practice a la carte among GPs: using organizational diversity to increase job satisfaction. Fam Pract. 2007;24:138–44.CrossRef
19.
go back to reference Buono N, Thulesius H, Petrazzuoli F, Van Merode T, Koskela T, Le Reste J-Y, Prick H, Soler JK. 40 years of biannual family medicine research meetings – the European general practice research network (EGPRN). Scand J Prim Health Care. 2013;31:185–7.CrossRef Buono N, Thulesius H, Petrazzuoli F, Van Merode T, Koskela T, Le Reste J-Y, Prick H, Soler JK. 40 years of biannual family medicine research meetings – the European general practice research network (EGPRN). Scand J Prim Health Care. 2013;31:185–7.CrossRef
20.
go back to reference Koskela TH. Building a primary care research network - lessons to learn. Scand J Prim Health Care. 2017;35:229–30.CrossRef Koskela TH. Building a primary care research network - lessons to learn. Scand J Prim Health Care. 2017;35:229–30.CrossRef
21.
go back to reference Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320:114–6.CrossRef Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320:114–6.CrossRef
22.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
23.
go back to reference Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45.CrossRef Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45.CrossRef
24.
go back to reference Campbell R, Pound P, Morgan M, Daker-White G, Britten N, Pill R, Yardley L, Pope C, Donovan J. Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research. Health Technol Assess. 2011;15:1–164.CrossRef Campbell R, Pound P, Morgan M, Daker-White G, Britten N, Pill R, Yardley L, Pope C, Donovan J. Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research. Health Technol Assess. 2011;15:1–164.CrossRef
25.
go back to reference Todd NJ, Jones SH, Lobban FA. “Recovery” in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study. J Ment Health. 2012;21:114–26.CrossRef Todd NJ, Jones SH, Lobban FA. “Recovery” in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study. J Ment Health. 2012;21:114–26.CrossRef
26.
go back to reference Van Ham I, Verhoeven AAH, Groenier KH, Groothoff JW, De Haan J. Job satisfaction among general practitioners: a systematic literature review. Eur J Gen Pract. 2006;12:174–80.CrossRef Van Ham I, Verhoeven AAH, Groenier KH, Groothoff JW, De Haan J. Job satisfaction among general practitioners: a systematic literature review. Eur J Gen Pract. 2006;12:174–80.CrossRef
27.
go back to reference Backer EL, McIlvain HE, Paulman PM, Ramaekers RC. The characteristics of successful family physicians in rural Nebraska: a qualitative study of physician interviews. J Rural Health. 2006;22:189–91.CrossRef Backer EL, McIlvain HE, Paulman PM, Ramaekers RC. The characteristics of successful family physicians in rural Nebraska: a qualitative study of physician interviews. J Rural Health. 2006;22:189–91.CrossRef
28.
go back to reference Walker KA, Pirotta M. What keeps Melbourne GPs satisfied in their jobs? Aust Fam Physician. 2007;36:877–80.PubMed Walker KA, Pirotta M. What keeps Melbourne GPs satisfied in their jobs? Aust Fam Physician. 2007;36:877–80.PubMed
29.
go back to reference Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European Definition of General Practice/Family Medicine. Short version. Eur Acad Teach Gen Pract. 2011;1–11. Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European Definition of General Practice/Family Medicine. Short version. Eur Acad Teach Gen Pract. 2011;1–11.
30.
go back to reference Fairhurst K, May C. What general practitioners find satisfying in their work: implications for health care system reform. Ann Fam Med. 2006;4:500–5.CrossRef Fairhurst K, May C. What general practitioners find satisfying in their work: implications for health care system reform. Ann Fam Med. 2006;4:500–5.CrossRef
31.
go back to reference Behmann M, Schmiemann G, Lingner H, Kühne F, Hummers-Pradier E, Schneider N. Job satisfaction among primary care physicians: results of a survey. Dtsch Arztebl Int. 2012;109:193–200.PubMedPubMedCentral Behmann M, Schmiemann G, Lingner H, Kühne F, Hummers-Pradier E, Schneider N. Job satisfaction among primary care physicians: results of a survey. Dtsch Arztebl Int. 2012;109:193–200.PubMedPubMedCentral
32.
go back to reference Makivić I, Janko K, Klemenc-Ketiš Z. The role of the psychosocial dimension in the improvement of quality of care: a systematic review. Slov J Public Heal. 2016;55:86–95.CrossRef Makivić I, Janko K, Klemenc-Ketiš Z. The role of the psychosocial dimension in the improvement of quality of care: a systematic review. Slov J Public Heal. 2016;55:86–95.CrossRef
33.
go back to reference Shrestha D, Joyce CM. Aspects of work-life balance of Australian general practitioners: determinants and possible consequences. Aust J Prim Health. 2011;17:40–7.CrossRef Shrestha D, Joyce CM. Aspects of work-life balance of Australian general practitioners: determinants and possible consequences. Aust J Prim Health. 2011;17:40–7.CrossRef
34.
go back to reference Goetz K, Musselmann B, Szecsenyi J, Joos S. The influence of workload and health behavior on job satisfaction of general practitioners. Fam Med. 2013;45:95–101.PubMed Goetz K, Musselmann B, Szecsenyi J, Joos S. The influence of workload and health behavior on job satisfaction of general practitioners. Fam Med. 2013;45:95–101.PubMed
35.
go back to reference McGrail MR, Humphreys JS, Scott A, Joyce CM, Kalb G. Professional satisfaction in general practice: does it vary by size of community? Med J Aust. 2010;193:94–8.PubMed McGrail MR, Humphreys JS, Scott A, Joyce CM, Kalb G. Professional satisfaction in general practice: does it vary by size of community? Med J Aust. 2010;193:94–8.PubMed
36.
go back to reference Rivet C, Ryan B, Stewart M. Hands on: is there an association between doing procedures and job satisfaction? Can Fam Physician. 2007;53(93):93–5, 92.PubMed Rivet C, Ryan B, Stewart M. Hands on: is there an association between doing procedures and job satisfaction? Can Fam Physician. 2007;53(93):93–5, 92.PubMed
37.
go back to reference Eliason BC, Guse C, Gottlieb MS. Personal values of family physicians, practice satisfaction, and service to the underserved. Arch Fam Med. 2000;9:228–32.CrossRef Eliason BC, Guse C, Gottlieb MS. Personal values of family physicians, practice satisfaction, and service to the underserved. Arch Fam Med. 2000;9:228–32.CrossRef
38.
go back to reference Meli DN, Ng A, Singer S, Frey P, Schaufelberger M. General practitioner teachers’ job satisfaction and their medical students’ wish to join the field - a correlational study. BMC Fam Pract. 2014;15:50.CrossRef Meli DN, Ng A, Singer S, Frey P, Schaufelberger M. General practitioner teachers’ job satisfaction and their medical students’ wish to join the field - a correlational study. BMC Fam Pract. 2014;15:50.CrossRef
39.
go back to reference Shanley BC, Schulte KM, Chant D, Jasper A, Wellard R. Factors influencing career development of Australian general practitioners. Aust Fam Physician. 2002;31:49–54.PubMed Shanley BC, Schulte KM, Chant D, Jasper A, Wellard R. Factors influencing career development of Australian general practitioners. Aust Fam Physician. 2002;31:49–54.PubMed
40.
go back to reference Scott I, Wright B, Brenneis F, Brett-Maclean P, McCaffrey L. Why would I choose a career in family medicine?: reflections of medical students at 3 universities. Can Fam Physician. 2007;53:1956–7.PubMedPubMedCentral Scott I, Wright B, Brenneis F, Brett-Maclean P, McCaffrey L. Why would I choose a career in family medicine?: reflections of medical students at 3 universities. Can Fam Physician. 2007;53:1956–7.PubMedPubMedCentral
41.
go back to reference Stagg P, Prideaux D, Greenhill J, Sweet L. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health. 2012;12:1832.CrossRef Stagg P, Prideaux D, Greenhill J, Sweet L. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health. 2012;12:1832.CrossRef
42.
go back to reference Rourke JTB, Incitti F, Rourke LL, Kennard M. Relationship between practice location of Ontario family physicians and their rural background or amount of rural medical education experience. Can J Rural Med. 2005;10:231–40.PubMed Rourke JTB, Incitti F, Rourke LL, Kennard M. Relationship between practice location of Ontario family physicians and their rural background or amount of rural medical education experience. Can J Rural Med. 2005;10:231–40.PubMed
43.
go back to reference Noonan T, Arroll B, Thomas D, Janes R, Elley R. When should I do rural general practice? A qualitative study of job/life satisfaction of male rural GPs of differing ages in New Zealand. N Z Med J. 2008;121:59–67.PubMed Noonan T, Arroll B, Thomas D, Janes R, Elley R. When should I do rural general practice? A qualitative study of job/life satisfaction of male rural GPs of differing ages in New Zealand. N Z Med J. 2008;121:59–67.PubMed
Metadata
Title
Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network
Authors
B. Le Floch
H. Bastiaens
J. Y. Le Reste
H. Lingner
R. Hoffman
S. Czachowski
R. Assenova
T. H. Koskela
Z. Klemenc-Ketis
P. Nabbe
A. Sowinska
T. Montier
L. Peremans
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2019
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-019-0985-9

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