Murfett, Amanda (2011) Time out for respite and recovery : a qualitative study of influences on general practitioners’ adaptation to general practice. PhD thesis, Victoria University.

Abstract

Previous research has highlighted general practitioners (GPs) maladaptive coping efforts, but little is known about GPs who appear to adapt positively to their inherently demanding work. This study aimed to address this knowledge gap by identifying factors that optimise GPs adaptation to working in general practice. A qualitative methodology underpinned by a constructionist epistemological stance was used. Twenty-six semistructured individual interviews with suburban and rural GPs in the State of Victoria aged between 24 and 77 years were conducted. GPs identified work demands consistent with previous research: time pressure, long hours of work, heavy workload, and pace of work; work interfering with non-work/family, threat of malpractice litigation, and bureaucratic interference. However, the degree of concern and coping responses was varied; some GPs appraised the work demands as a threat while others considered them an opportunity. GPs adopted a range of adaptive behaviours to manage and resolve work demands that were influenced by six key elements. These were: (1) the degree of work centrality to GPs, (2) the inclination of GPs towards integration or segmentation of work and non-work/family domains, (3) situational factors in the general practice and non-work/family domains, (4) ability to psychologically detach from GP role (5) choice of respite activity, and (6) adequate recovery from work demands. An heuristic schema that brings together these six elements and their implications for GP adaptation was presented. Understanding and self-knowledge about work orientation, and preference for integrating and segmenting life domains, point to the need for tailored respite strategies that facilitate psychological detachment, recovery of resources, and successful adaptation to working in general practice and life as a GP. This knowledge may also assist medical students to prepare for meeting the challenges of their future medical careers.

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