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). "
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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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    • "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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