Influences on GP coping and resilience: a qualitative study in primary care

Abstract

Background‘Neoliberal’ work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs.AimTo explore GPs’ experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change.Design and settingStudy design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews.MethodFocus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis.ResultsThere were 22 GP participants recruited: focus groups (n = 15) and interviews (n = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for ‘good’ doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work–life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced.ConclusionGPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues.

Resilience: a nationwide study of medical educators

“…Others have noted similar factors in UK healthcare professionals (Platt et al, 2015;Matheson et al, 2016), and more specifically in medical educators from a U.S. context (DeCastro et al, 2013). Our findings are also consistent with recent arguments that supportive external factors can synergistically work with individual factors to foster resilience (Balme, Gerada and Page, 2015;Matheson et al, 2016;Cheshire et al, 2017;Shanafelt and Noseworthy, 2017). Importantly, respondents mainly considered internal resources as being resilience promoting, while external factors were undermining.…”

“…Examples include work-intensification, challenging patients, preparation for practice, work-life balance, support from family and friends, connection with colleagues, personal characteristics (e.g. self-reflection, help seeking), and spirituality (McCann et al, 2013;Zwack and Schweitzer, 2013;Goodyear, 2014;Matheson et al, 2016;Robertson et al, 2016;Cheshire et al, 2017). However, there is a dearth of research exploring factors that medical educators identify as being related to their resilience.…”

Mental healthcare staff well‐being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions

“…Despite this cap, many doctors in the UK are continuing to choose locum work over substantive positions as it provides more control and is less stressful (Cheshire et al . ). This further adds to the shortage of healthcare staff and exacerbates current staffing level issues.…”

Family Physician Perceptions of Their Role in Managing the Opioid Crisis

“…At a time when physicians are already experiencing unprecedented rates of work-related stress and burnout, feelings of being "caught in the middle" without adequate system supports may compromise the objectives of the Quadruple Aim (specifically clinician and patient experience). Physicians are under unprecedented pressure, and work-related stress and increased anxiety can erode physician resilience, 32 placing providers at risk of burnout. Time pressures, lack of resources, and challenging patients are further threats to resilience, 32 underscoring the need for interventions to include strategies for navigating challenging conversations as part of a multifaceted strategy.…”

“…Physicians are under unprecedented pressure, and work-related stress and increased anxiety can erode physician resilience, 32 placing providers at risk of burnout. Time pressures, lack of resources, and challenging patients are further threats to resilience, 32 underscoring the need for interventions to include strategies for navigating challenging conversations as part of a multifaceted strategy. Family physicians continue to feel unsupported in their management, 33,34 which interferes with the ability to provide guidelineconcordant care.…”