Job satisfaction of general practitioners: an international comparison
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Résumé
Purpose \nJob satisfaction of general practitioners (GPs) is an important issue, because of widespread dissatisfaction in several countries. GPs often feel overburdened by administrative detail that keeps them from direct patientrelated work. Workload of GPs is increasing as a result of demographic and epidemiological changes. The complexity of healthcare systems and managerial pressure may have affected job satisfaction as well. The aim of this study is to analyse job satisfaction in an international comparative framework. \nTheory \nA general theory of how people ‘produce’ their own wellbeing is described and applied to the job satisfaction of GPs. It is expected that job satisfaction is influenced by the stimulation that GPs experience from the variety and challenges of their tasks, from comfortable working \nconditions, such as hours and pay, from their social status, and from behavioural confirmation from colleagues and patients. Based on these general insights more specific hypotheses are developed. \nMethods \nData from the QUALICOPC study is used, conducted among approximately 7,000 GPs in 34 (mainly European) countries. Job satisfaction was measured in the GP survey through six items (combined into a scale) about job experience. Independent variables are taken from the GP survey and from existing data on country and healthcare system level. Data were analysed using linear multilevel regression analysis, with countries and GPs as levels. \nResults \nGPs vary in job satisfaction with the lowest levels in Spain, Hungary, Slovakia, Estonia and Lithuania and the highest levels in Sweden, Norway, Canada, Cyprus and Denmark. Findings show that around 33% of the total variance is situated on the country level and that in countries with a higher GDP per capita, GPs are more satisfied. At the GP- and practice level, practicing technical procedures and preventive care, vacation, feedback from colleagues, patient satisfaction, and age are positively related to GP job satisfaction and working hours is negatively related to GP job satisfaction. \nDiscussion \nDespite the finding that a substantial portion of the variation in GP job satisfaction is accounted for by country level characteristics, this study has not been able to identify relevant country level characteristics, other than GDP per capita, that explain the variation in GP job satisfaction between countries. Therefore, based on the \nGP- and practice level results, recommendations on how to organise GP-friendly primary care practices are formulated regarding nurse substitution of GP tasks, the work-life balance and peer feedback.
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