The Article in Brief

What General Practitioners Find Satisfying in Their Work: Implications for Health Care System Reform

By Karen Fairhurst, PhD, MRCGP, and colleague

Background It is increasingly common to evaluate medical practice according to patients' views of quality and clinicians' ability to meet standards of clinical and organizational quality established by a variety of groups. This kind of approach does not usually consider doctors' values, beliefs, and expectations about patient care or the context in which a visit to the doctor takes place. This study of general practitioners in Scotland explores what is meaningful to them in their work.

What This Study Found General practitioners' satisfaction with patient visits is related to developing and maintaining relationships, rather than to technical aspects of diagnosis and treatment. In their most satisfying visits, they achieve successful results by using interpersonal aspects of care, especially knowing the patient. They view success in terms of restoring the person, not in terms of prevention, treatment, or cure of a disease. Doctors' satisfaction with their work is also influenced by their sense of self as a doctor and the way in which they relate to and accept discussions about what determines good medical practice.

Implications

• Health care systems tend to focus on technical and measurable aspects of care. This may result in a model of medical practice in which purpose and meaning are not consistent with doctors' experiences of their work, and could harm professional morale.
• Health care reform should ensure that work conditions do not prevent the development of meaningful relationships between doctors and patients.