Is general practice stressful?

Objectives: To investigate the prevalence of workrelated mental distress among the workforce in general practice in one region of the UK.

Methods: A two-phase research design was adopted using a mixed methodology. This comprised a postal survey of members of staff (n=1089, response rate=70%) of a random sample of practices (n=81), and follow-up face-to-face interviews with staff from a purposive sample of ten practices (n=87).

Results: Phase 1:23% of respondents were classified as cases of mental distress. The highest rate of cases was found among doctors and practice managers, 30% of whom were classified as cases of psychiatric distress. The lowest rate of cases (17%) was found among receptionists.

Phase 2: Some informants felt that stress was a “good thing”, serving as a stimulus to action and a boost to self-esteem. It was also suggested that individuals had a “threshold” beyond which they would not be able to cope. This threshold varied from person to person, how-ever, it was shaped by social and cultural factors, as well as by personality and work characteristics. Many informants felt that they had stressful jobs, but it was generally not felt that work in general practice was intrinsically harmful to mental or physical health. Several informants viewed their job in general practice as a refuge, either from a previous post, or from stress at home.

Conclusions: The evidence from this study suggests that working conditions in general practice can at least lower morale and make people unhappy in their work, although there was little evidence of more serious psychological or physical health problems.