Work Stress of Primary Care Physicians in the US, UK and German Health Care Systems

Department of Medical Sociology, University of Duesseldorf, Germany.
Social Science [?] Medicine (Impact Factor: 2.89). 07/2010; 71(2):298-304. DOI: 10.1016/j.socscimed.2010.03.043
Source: PubMed


Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions.

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Available from: Rebecca S Piccolo, Jan 27, 2014
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    • "Such three-way interactions have not yet been proposed or empirically investigated, but a few studies have found evidence for a match between job demands and occupational rewards. For instance, a study by Siegrist and colleagues (2010) indicated that physicians who reported higher levels of job insecurity also reported higher levels of cognitive demands, indicating that these cognitive rewards might be more important to employees in a highly cognitively demanding job (cf. Amabile et al., 1996). "
    International Journal of Stress Management 01/2014; 21(4):361-383. DOI:10.1037/a0038149 · 1.28 Impact Factor
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    • "The questionnaire exists in a long (26 items) and a short (16 items) version [32,33]. The short version has been used in many different studies [34,35] and is also listed by the federal institute of work safety and occupational medicine (BAuA) as a screening method with satisfying quality criteria [36]. "
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    ABSTRACT: BackgroundThe students’ perception of working conditions in hospitals hasn’t been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians.Methods/designThe perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey.DiscussionThe iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions.
    Journal of Occupational Medicine and Toxicology 02/2013; 8(1):3. DOI:10.1186/1745-6673-8-3 · 1.62 Impact Factor
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    • "strategies (Institute of Medicine 2001, 2003; Icks et al. 2007) increasingly turning to provider decision making as one potential contributor to observed health disparities. This literature generally seeks to understand well-documented patterns wherein physicians make different diagnostic and treatment decisions based on nonmedical factors, including patient characteristics (such as race, gender, age, socioeconomic status) (Arber et al. 2006), but also providers' individual attributes (gender, level of experience, specialty, place of training) (Shackelton-Piccolo et al. 2011) and the characteristics of the health care settings in which they work, such as practice culture (Kralewski et al. 2005a,b), work stress (Siegrist et al. 2010), presence of health information technology (Ketcham et al. 2009), and country (von dem Knesebeck et al. 2008). "
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    ABSTRACT: To identify styles of physician decision making (as opposed to singular clinical actions) and to analyze their association with variations in the management of a vignette presentation of coronary heart disease (CHD). Primary data were collected from primary care physicians in North and South Carolina. In a balanced factorial experimental design, primary care physicians viewed one of 16 (24) video vignette presentations of CHD and provided detailed information about how they would manage the case. 256 MD primary care physicians were interviewed face-to-face in North and South Carolina. We identify three clusters depicting unique styles of CHD management that are robust to controls for physician (gender and level of experience) and patient characteristics (age, gender, socioeconomic status, and race) as well as key organizational features of physicians' work settings. Physicians in Cluster 1 “Cardiac” (N = 92) were more likely to focus on cardiac issues compared with their counterparts; physicians in Cluster 2 “Talkers” (N = 93) were more likely to give advice and take additional medical history; whereas physicians in Cluster 3 “Minimalists” (N = 71) were less likely than their counterparts to take action on any of the types of management behavior. Variations in styles of decision making, which encompass multiple outcome variables and extend beyond individual-level demographic predictors, may add to our understanding of disparities in health quality and outcomes.
    Health Services Research 10/2012; 48(3). DOI:10.1111/1475-6773.12005 · 2.78 Impact Factor
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