Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research
dc.contributor.author | Long, H | |
dc.contributor.author | Moore, D | |
dc.contributor.author | Robinson, S | |
dc.contributor.author | Sansom, A | |
dc.contributor.author | Aylward, A | |
dc.contributor.author | Fletcher, E | |
dc.contributor.author | Welsman, J | |
dc.contributor.author | Dean, SG | |
dc.contributor.author | Campbell, JL | |
dc.contributor.author | Anderson, R | |
dc.date.accessioned | 2020-05-28T09:09:21Z | |
dc.date.issued | 2020-05-12 | |
dc.description.abstract | Background UK general practitioners (GPs) are leaving direct patient care in significant numbers. We undertook a systematic review of qualitative research to identify factors affecting GPs’ leaving behaviour in the workforce as part of a wider mixed methods study (ReGROUP). Objective To identify factors that affect GPs’ decisions to leave direct patient care. Methods Qualitative interview-based studies were identified and their quality was assessed. A thematic analysis was performed and an explanatory model was constructed providing an overview of factors affecting UK GPs. Non-UK studies were considered separately. Results Six UK interview-based studies and one Australian interview-based study were identified. Three central dynamics that are key to understanding UK GP leaving behaviour were identified: factors associated with low job satisfaction, high job satisfaction and those linked to the doctor–patient relationship. The importance of contextual influence on job satisfaction emerged. GPs with high job satisfaction described feeling supported by good practice relationships, while GPs with poor job satisfaction described feeling overworked and unsupported with negatively impacted doctor–patient relationships. Conclusions Many GPs report that job satisfaction directly relates to the quality of the doctor–patient relationship. Combined with changing relationships with patients and interfaces with secondary care, and the gradual sense of loss of autonomy within the workplace, many GPs report a reduction in job satisfaction. Once job satisfaction has become negatively impacted, the combined pressure of increased patient demand and workload, together with other stress factors, has left many feeling unsupported and vulnerable to burn-out and ill health, and ultimately to the decision to leave general practice. | en_GB |
dc.identifier.citation | Vol. 10, article e029846 | en_GB |
dc.identifier.doi | 10.1136/bmjopen-2019-029846 | |
dc.identifier.uri | http://hdl.handle.net/10871/121189 | |
dc.language.iso | en | en_GB |
dc.publisher | BMJ Publishing Group | en_GB |
dc.rights | Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. | en_GB |
dc.title | Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2020-05-28T09:09:21Z | |
dc.identifier.issn | 2044-6055 | |
dc.description | This is the final version. Available on open access from BMJ Publishing Group via the DOI in this record | en_GB |
dc.description | Data availability statement: All data relevant to the study are included in the article or uploaded as supplementary information. No additional data available. | en_GB |
dc.identifier.journal | BMJ Open | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2020-01-31 | |
exeter.funder | ::SW Academic Health Science Network Ltd | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2020-01-31 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2020-02-11T10:02:31Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2020-05-28T09:09:29Z | |
refterms.panel | A | en_GB |
refterms.depositException | publishedGoldOA |
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Except where otherwise noted, this item's licence is described as Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.