Emotionally-demanding work and confrontational patients are among the key stressors for GPs in England, reveals an analysis of feedback from GPs published in BMJ Open.
The qualitative study used in-depth interviews with 47 GPs participants who self-identified as currently living with mental distress, returning to work following treatment, off sick or retired early as a result of mental distress, or without experience of mental distress. Analyses revealed that key sources of stress/distress were:
Emotion work - managing and responding to psychosocial issues, and dealing with abusive or confrontational patients
Practice culture - collegial conflict, bullying, isolation and lack of support
Work role and demands - fear of making mistakes, complaints and inquests, revalidation, appraisal, inspections and financial worries
The findings show that rising workload and long working hours are only part of the high levels of workplace stress and burnout experienced by GPs, say the study authors. “In addition to addressing escalating workloads through the provision of increased resources, addressing unhealthy practice cultures is paramount,” they say.
“Collegial support, a willingness to talk about vulnerability and illness, and having open channels of communication enable GPs to feel less isolated and better able to cope with the emotional and clinical demands of their work.
“Doctors, including GPs, are not invulnerable to the clinical and emotional demands of their work nor the effects of divisive work cultures. Culture change and access to informal and formal support is therefore crucial in enabling GPs to do their job effectively and to stay well,” the authors conclude.