A new analysis has found that many overloaded Australian GPs have such poor work-life balances they no longer feel in control of their own lives.
The study from Flinders University, published 29 September 2022 in the Journal of Psychiatric Research, showed that working long hours, having inadequate mentoring or supervision, running a stressful practice, and overall job dissatisfaction were all factors contributing to many GPs low ‘locus of control’ (LoC) – the sense that they themselves, and not external forces, were in control over the outcome of events in their lives.
Alongside inadequate support and unrealistic patient expectations, the study highlighted the growing number of issues faced by GPs, including the pressures of an increasing costs and a shrinking workforce, especially in regional and remote communities.
Senior author Dr Vivian Isaac, from Flinders University Rural and Remote Health SA, explained that GPs often work very long hours, some as much as 70 hours per week, with regional doctors likely to work even longer if they service a small community.
“These long hours contribute to fatigue, reduced well-being, and poor mental health, which alongside maintaining patient and colleague relationships and workforce shortages is increasingly leading to burnout and depression,” Dr Isaac said.
“Studies have shown that individuals with a high locus of control (LoC) are more resilient, cope better under stressful conditions, have higher job satisfaction and in the case of healthcare workers, cope better with shift work.
“On the other hand, having a low LoC is associated with depression, anxiety, and stress. But this had yet to be investigated in relation to Australian doctors.”
Using data from a survey of more than 3,600 GPs, the team discovered that other issues which contributed to lower LoC included being overseas trained, not having a spouse and self-reporting poor health. And while gender had no impact on LoC, GPs aged between 40 and 60 years reported a lower internal LoC than those below 40 or older than 60 years.
“Another key factor that reduced GPs internal LoC was unrealistic expectations from their patients,” Dr Isaac explained.
“This indicates more formal training of doctors in improving communication skills is necessary, which could lead to an improved sense of control and overall wellbeing.”
Socially, work life balance was key, with low LoC linked to limited opportunities for social interaction and an imbalance of personal and professional commitments.
“We found over half of all GPs surveyed were dissatisfied with their social network, which was then negatively affecting their sense of control,” Dr Isaac said.
“This clearly highlights that the work-life imbalance has tended to become normalised for GPs and they struggle with work overload, which has a negative impact on their ability to do their job.”
Even though the data for the study was collected in 2010, Dr Isaac stressed that the issues identified had not gone away, with the immense changes that have since occurred in the sector potentially exacerbating the issue.
For example, a perspective piece investigating the phenomenon in GPs, published 5 November 2018 in the Medical Journal of Australia, reported that female doctors took their own lives at 227% the rate of the general population, with male doctors committing suicide at 141% the rate of other Australians.
And on 15 December 2020 the ABC reported that in QLD, after one year of dealing with the fallout of the pandemic, “the rate of calls to Doctor’s Health — an anonymous helpline for medical practitioners — increased by 25%, raising fears they are not seeking the full extent of help they may need.”
The authors concluded that their study highlights the importance of fostering work-life balance, building social support systems, and providing adequate training to manage patient expectation among Australian GPs – to improve their LoC and thereby their wellbeing.