Research ArticleOriginal Research

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

Karen Fairhurst and Carl May
The Annals of Family Medicine November 2006, 4 (6) 500-505; DOI: https://doi.org/10.1370/afm.565

Article Figures & Data

Tables

  • Table 1.

    Quality and Outcomes Framework

    • Reflects ethos that higher quality care is most likely to be achieved through use of incentives

    • Practices can receive additional funding to reward achievement of range of quality standards

    • Higher standards are rewarded with incrementally higher rewards

    • Four domains in framework

      • Clinical: 10 disease areas

      • Organizational

      • Additional services: cervical screening, child health surveillance, maternity services, contraceptive services

      • Patient experience

    • Quality indicators in each domain are evidence based

  • Table 2.

    Interview Guide

    Section 1: Personal information

    1. Personal details

      1. How long have you been qualified as a doctor?

      2. How long have you been a GP?

      3. Postgraduate training?

      4. Why did you decide to become a GP?

      5. Can you tell me which practices you have worked in as a principal?

    2. Personal interests and motivations

      1. Can you tell me why you decided to become a partner in /work in this particular practice?

      2. What do you find particularly interesting in medicine?

      3. What if any, are your particular interests in general practice?

      4. Can and how do you pursue those interests?

      5. What do you “look for in a patient” to satisfy you?

    Section 2: For each consultation
 I am interviewing GPs about what they find professionally fulfilling/satisfying in the consultation and why it is satisfying/fulfilling. You identified this consultation as either most satisfying or least satisfying, or neither maximally satisfying nor maximally dissatisfying.

    1. Can you describe the content of the consultation to me?

      1. What in particular was rewarding/unrewarding about this consultation?

      2. What do you think was going on here?

      3. Why do you think you as an individual found it rewarding/unrewarding/neither?

    2. Can you identify any personal characteristics that meant you found this consultation satisfying/unsatisfying/neither?

      1. In what circumstances, if any, would this consultation be less/more fulfilling?

    3. Can you recall a time when you wouldn’t have found this consultation less/more fulfilling?

      1. Experience?

      2. What would you need to do /what would need to happen or change to make this consultation more satisfying?

      3. What would the patient need to do?

      4. Are there external factors?

Additional Files

  • 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.
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