What General Practitioners Find Satisfying in Their Work

Division of Community Health Sciences, University of Edinburgh, 20 West Richmond Street, Edinburgh, UK.
The Annals of Family Medicine (Impact Factor: 5.43). 11/2006; 4(6):500-5. DOI: 10.1370/afm.565
Source: PubMed


We sought to explore general practitioners' satisfaction with their patient visits and the congruity between this satisfaction and new models of practice, such as those implicit in the new general medical services contract in the United Kingdom.
We undertook a qualitative study using audio recordings of patient visits and in-depth interviews with 19 general practitioners in Lothian, Scotland.
Doctors' reports of satisfying and unsatisfying experiences during consultations were primarily concerned with developing and maintaining relationships rather than with the technical aspects of diagnosis and treatment. In their most satisfying consultations, they used the interpersonal aspects of care, in particular their sense of knowing the patient, to effect a successful outcome. Success was seen in holistic terms-not as the prevention, treatment, or cure of a disease, but as restorative of the person. Positive experiences were implicated in maintaining their identity as "good" doctors. Negative experiences sometimes challenged this identity, and doctors resisted this challenge by finding explanations for unsatisfactory experiences that distanced themselves from their source or cause.
The attributes of a satisfying encounter found in this study derive from a model of practice that prioritizes the distress of patients, which cannot be measured, above the technical and quantifiable in diagnosis and treatment. Preoccupation with that which is technical and measurable in health care system reforms risks defining a model of practice with purpose and meaning not congruent with doctors' experiences of their work and may result in further destruction of professional morale.

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Available from: Carl May, Apr 19, 2014
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    • "The two scenarios used in this study would have been familiar to all of the participants and yet mistakes were frequently made. Previous studies with nurses and doctors have emphasised the importance of 'knowing the patient', both as an individual person and in their response to symptoms (Tanner et al., 1993; Fairhurst and May, 2006) in order to plan care appropriately. The lack of history taking by participants in this study suggested that they were not seeking to 'know' the patient, hence they were missing important clues. "
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    • "The variable measuring the compatibility of a physician's goals with those of management of the HCO predicted satisfaction with workgroup and HCO. This finding appears consistent with a recent qualitative study of factors that promote satisfaction and dissatisfaction among general practitioners (Fairburst and May 2006) and may continue to be important as more family physicians become part of large multispecialty groups with large contingents of practice management employees. "
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