Understanding quit decisions in primary care: a qualitative study of older GPs
- PMID: 26895989
- PMCID: PMC4762139
- DOI: 10.1136/bmjopen-2015-010592
Understanding quit decisions in primary care: a qualitative study of older GPs
Abstract
Objective: To investigate the reasons behind intentions to quit direct patient care among experienced general practitioners (GPs) aged 50-60 years.
Design and setting: Qualitative study based on semistructured interviews with GPs in the South West region of England. Transcribed interviews were analysed thematically.
Participants: 23 GPs aged 50-60 years: 3 who had retired from direct patient care before age 60, and 20 who intended to quit direct patient care within the next 5 years.
Results: The analysis identified four key themes: early retirement is a viable option for many GPs; GPs have employment options other than undertaking direct patient care; GPs report feeling they are doing an (almost) undoable job; and GPs may have other aspirations that pull them away from practice. Findings from this study confirmed those from earlier research, with high workload, ageing and health, family and domestic life, and organisational change all influencing GPs' decisions about when to retire/quit direct patient care. However, in addition, GPs expressed feelings of insecurity and uncertainty regarding the future of general practice, low morale, and issues regarding accountability (appraisal and revalidation) and governance. Suggestions about how to help retain GPs within the active clinical workforce were offered, covering individual, practice and organisational levels.
Conclusions: This research highlights aspects of the current professional climate for GPs that are having an impact on retirement decisions. Any future changes to policy or practice to help retain experienced GPs will benefit from this informed understanding of GPs' views. Key factors to take into account include: making the GP workload more manageable; managing change sympathetically; paying attention to GPs' own health; improving confidence in the future of general practice; and improving GP morale.
Keywords: PRIMARY CARE; QUALITATIVE RESEARCH; retirement; workforce.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Similar articles
-
Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England.BMJ Open. 2018 Jan 10;8(1):e019849. doi: 10.1136/bmjopen-2017-019849. BMJ Open. 2018. PMID: 29326195 Free PMC article.
-
The general practitioner workforce crisis in England: a qualitative study of how appraisal and revalidation are contributing to intentions to leave practice.BMC Fam Pract. 2016 Jul 20;17:84. doi: 10.1186/s12875-016-0489-9. BMC Fam Pract. 2016. PMID: 27439982 Free PMC article.
-
Quitting patient care and career break intentions among general practitioners in South West England: findings of a census survey of general practitioners.BMJ Open. 2017 Apr 11;7(4):e015853. doi: 10.1136/bmjopen-2017-015853. BMJ Open. 2017. PMID: 28446528 Free PMC article.
-
Policies and strategies to retain and support the return of experienced GPs in direct patient care: the ReGROUP mixed-methods study.Southampton (UK): NIHR Journals Library; 2019 Apr. Southampton (UK): NIHR Journals Library; 2019 Apr. PMID: 30973692 Free Books & Documents. Review.
-
Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research.BMJ Open. 2020 May 12;10(5):e029846. doi: 10.1136/bmjopen-2019-029846. BMJ Open. 2020. PMID: 32404383 Free PMC article.
Cited by
-
Psychosocial work environment in Swedish primary healthcare: a cross-sectional survey of physicians' job satisfaction, turnover intention, social support, leadership climate and change fatigue.Hum Resour Health. 2024 Oct 23;22(1):70. doi: 10.1186/s12960-024-00955-4. Hum Resour Health. 2024. PMID: 39443998 Free PMC article.
-
Clinical pharmacists in primary care general practices: evaluation of current workforce and their distribution.J Pharm Policy Pract. 2022 Dec 9;15(1):101. doi: 10.1186/s40545-022-00483-3. J Pharm Policy Pract. 2022. PMID: 36494761 Free PMC article.
-
[One after the other: factors influencing the abandonment of Family and Community Medicine practice in young family physicians. A qualitative study].Rev Esp Salud Publica. 2024 Jul 31;98:e202407044. Rev Esp Salud Publica. 2024. PMID: 39162614 Free PMC article. Spanish.
-
Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England.BMJ Open. 2018 Jan 10;8(1):e019849. doi: 10.1136/bmjopen-2017-019849. BMJ Open. 2018. PMID: 29326195 Free PMC article.
-
Trends in GP incomes in England, 2008-2017: a retrospective analysis of repeated postal surveys.Br J Gen Pract. 2019 Dec 26;70(690):e64-e70. doi: 10.3399/bjgp19X706073. Print 2020 Jan. Br J Gen Pract. 2019. PMID: 31594773 Free PMC article.
References
-
- Hann M, McDonald J, Checkland K et al. . Seventh National GP Worklife Survey 2013.
-
- ICM Unlimited. British Medical Association National Survey of GPs: The future of General Practice 2015. 2015.
-
- Lacobucci G. GMC sees 15% fall in applications for GP training. BMJ 2014;349:g6139. - PubMed
-
- General Medical Council. The state of medical education and practice in the UK. London: General Medical Council, 2014.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources