Well-being at work among general practitioners working in multidisciplinary primary care teams

Context. In many Western countries, transforming primary care (PC) systems involves changes in how work is organised, especially through the development of multidisciplinary teams. This evolution can represent a challenge in terms of occupational well-being.

Objectives. To investigate associations between occupational stress, job satisfaction among general practitioners (GPs) and the professional composition of PC teams.

Study design and analysis. We conducted a secondary analysis of the data of the 2019 Commonwealth Fund International Health Policy Survey of Primary Care Physicians. PC practice types (N=5) were defined in a previous study, based on their composition of healthcare professionals: the Traditional, Multidisciplinary, Nurse-centred, Psychologist-centred and Physiotherapist-centred models. Using ordered logistic regression analysis, we assessed associations between the five practice models and two GP-reported indicators of well-being at work: job satisfaction and occupational stress.

Dataset. 2019 Commonwealth Fund International Health Policy Survey

Population studied. Primary Care Physicians from 11 Western countries(N = 13,200)

Intervention/instrument. Practice composition of healthcare professionals (typology)

Outcome measure. Occupational stress and job satisfaction (likert-scale)

Results. Occupational stress and job satisfaction among GPs varied according to their personal characteristics (sex, age, country of origin) and to PC practices’ organisational characteristics. Working in multidisciplinary teams, rather than traditional (GP-centred) practice models, was associated with higher occupational well-being, both through lower occupational stress (OR = 0.77, 95%CI [0.68–0.87]) and greater job satisfaction (OR = 1.43, 95%CI [1.26–1.62]). This positive association was also observed in psychologist-centred practices (OR = 0.81, 95%CI [0.71–0.93] for occupational stress and OR = 1.24, 95%CI [1.09–1.42] for job satisfaction) when compared to traditional practices. Working in nurse-centred practices was associated with greater satisfaction but only in the smallest practices (OR = 1.59, 95%CI [1.14–2.22]) with < 1.4 full-time equivalent GPs.

Conclusion. Positive associations between multidisciplinary PC teams and occupational well-being are important results for the future of healthcare systems in Western countries, providing interesting avenues for improvements for healthcare professionals and policy-makers.