Psychosocial demands and resources for working time organization in GP practices. Results from a team-based ethnographic study in Germany

Abstract

Background General practitioners (GPs) are challenged, e.g. by long working hours, and as employers they are responsible for the creation of working conditions that prevent work-related psychosocial risks. Leadership behaviour plays an important role within the working conditions of employees, thus we focused on two research questions: To what extent and how do GPs fulfil their role as entrepreneurs and leaders responsible for occupational safety and health of the team members in the organization of working time of the employees? What psychosocial factors result from the way of organization of working time for the practice team? Methods Data was collected by participant observations, individual interviews with six GPs, and five focus group discussions with 19 members of the practice staff in total. We gained access to five general practices through a teaching network associated with the Institute for General Medicine, University Hospital Essen (Germany). The analysis was carried out according to the Grounded Theory approach. Results GPs have several roles and related tasks to fulfil in the organization of working time. This can lead to perceived psychological stress. With regard to the organization of predictable working hours, vacations and sickness absence, the GPs determined the scope of action of the practice assistants. The delegation of these tasks took place to varying degrees and resulted in different work-related resources and stressors. Conclusion We described transactional and transformational leadership behaviours which are all related to specific psychosocial demands and resources and may overlap on site. Leadership training seems recommendable as part of the training of GPs and other future leaders of micro-enterprises to promote self-reflection by the entrepreneurs and leaders and strengthen occupational health of leaders and staff.

Psychosocial working conditions and mental health among medical assistants in Germany: a scoping review

“…Help or translation is often requested by patients or physicians. The interviewed MA felt integrated into the family practice setting and reported no additional stress or resources emerging from the additional tasks they were assigned due to their migration background Communication and interaction with patients Language connection [ 55 ] Preiser et al 2021 19 w Qualitative, cross-sectional; participant observation, semi-structured interviews and focus group discussions To answer how GP fulfill their role as entrepreneurs and leaders responsible for the occupational safety of their employees regarding the organization of working time, and what psychosocial demands and resources result from the way how working time for practice teams is organized Work content and task “Unplannable” events considered part of the daily routine during consultation hours and lead to perceived psychological stress for GP and the practice team. MA expressed satisfaction with the flexibility of different working time models and the GP’s overall willingness to adjust working time models and hours to their needs.…”

Impacts of Symptom Checkers for Laypersons’ Self-diagnosis on Physicians in Primary Care: Scoping Review

“…The potential for primary care transformation and better health system performance remains unresearched and focuses mainly on operational benefits and 24-hour patient access [ 13 ]. Our previous work showed that work-related demands in general practice are already high [ 60 , 61 ], indicating that new technologies need to fit the needs and routines of HCPs to find acceptance [ 62 ]. Real-life implications of SCs, especially with regard to the changes in the daily working routines of GPs and more generally HCPs in primary care, are not well understood [ 47 , 57 ].…”

Work-related psychosocial demands related to work organization in small sized companies (SMEs) providing health-oriented services in Germany – a qualitative analysis

“…We planned semi-structured interviews with company owners and executive managers as well as focus group discussions with employees from different enterprises in the health and service sector to identify work-related psychosocial demands relevant from the company owner/manager as well as the employee perspective. Initially, we planned to conduct a participatory observation of team meetings to triangulate different methods to continue our recent study addressing psychosocial demands in general practices [ 25 , 26 ]. During the recruitment process, it became evident that none of the included companies conducted regular team meetings.…”

“…Since we wanted to encourage discussion on these topics, the questions of the interview guide were put in a narrative-generating way and we avoided yes/no questions. The interview guide was previously tested and large parts of it were successfully applied in a study among managers and employees in general practices as another SME setting [ 24 – 26 ].…”

“…Current research recently identified various work-related psychosocial demands, stressors and resources of general practitioners (GP) and their primary care teams [ 24 – 26 ], including, for example, frequent interruptions, high work intensity, and high noise levels in practice rooms [ 25 ]. Based on the findings, a complex intervention for the improvement of job satisfaction and the prevention of work-related stress of GPs and their primary care teams as a model for SMEs was developed and evaluated in Germany [ 27 ].…”