‘A sense of self, empowerment and purposefulness’: professional diversification and wellbeing in Australian general practitioners
Jill Benson A B * , Shaun Prentice A C , Penny Need B , Michelle Pitot B and Taryn Elliott BA
B
C
Abstract
Burnout and workforce shortages comprise a vicious cycle in medicine, particularly for Australian general practitioners (GPs). Professional diversification, whereby individuals work multiple roles across their week, may help address this problem, but this strategy is under-studied.
We surveyed 1157 Australian GPs using qualitative and quantitative questions examining professional diversification, values, autonomy, and wellbeing. Quantitative data were analysed using inferential statistics, whilst qualitative data were analysed using inductive thematic analysis. We triangulated the data by using the qualitative findings to inform further quantitative testing.
Approximately 40% of the sample had diversified. Although diversifying was not significantly associated with wellbeing, the qualitative data indicated that diversification supported GPs’ wellbeing by enhancing career sustainability, accomplished through various pathways (e.g. value fulfilment, autonomy, variety). Subsequent quantitative analyses provided evidence that these pathways mediated the relationship between diversification and wellbeing. To diversify, GPs needed particular personal qualities, external supports, flexibility, and serendipity. Barriers to diversifying mirrored these factors, spanning individual (e.g. skillset) and situational levels (e.g. autonomy, location).
Diversification can support GPs’ wellbeing if it meets their needs. Organisations should focus on publicising opportunities and accommodating requests to diversify.
Keywords: diversify, general practice, professional roles, values, wellbeing, workforce.
References
Alarcon GM (2011) A meta-analysis of burnout with job demands, resources, and attitudes. Journal of Vocational Behavior 79, 549-562.
| Crossref | Google Scholar |
Australian Government, Department of Health and Aged Care (2020) Health Workforce Data. GP Medicare billing data – what does it say about current health workforce policy?. Available at https://hwd.health.gov.au/resources/data/gp-statistics-calendar-year-2020-commentary.pdf [Accessed 21 August 2023]
Bentley M, FitzGerald K, Fielding A, Moad D, Tapley A, Davey A, Holliday E, Ball J, Kirby C, Turnock A, Spike N, van Driel M, Magin P (2022) Provision of other medical work by Australian early-career general practitioners: a cross-sectional study. Journal of Primary Health Care 14, 333-337.
| Crossref | Google Scholar |
BMJ Careers (2022) A day in the life of a portfolio GP. Available at https://www.bmj.com/careers/article/a-day-in-the-life-of-a-portfolio-gp [Accessed 21 August 2023]
Brooks J, McCluskey S, Turley E, King N (2015) The utility of template analysis in qualitative psychology research. Qualitative Research in Psychology 12, 202-222.
| Crossref | Google Scholar | PubMed |
Dwan KM, Douglas KA, Forrest LE (2014) Are “part-time” general practitioners workforce idlers or committed professionals? BMC Family Practice 15, 154.
| Crossref | Google Scholar | PubMed |
Eyre HA, Mitchell RD, Milford W, Vaswani N, Moylan S (2014) Portfolio careers for medical graduates: implications for postgraduate training and workforce planning. Australian Health Review 38, 246-251.
| Crossref | Google Scholar | PubMed |
Gates R, Musick D, Greenawald M, Carter K, Bogue R, Penwell-Waines L (2019) Evaluating the Burnout-Thriving Index in a multidisciplinary cohort at a large academic medical center. Southern Medical Journal 112, 199-204.
| Crossref | Google Scholar | PubMed |
Hamidi MS, Bohman B, Sandborg C, Smith-Coggins R, de Vries P, Albert MS, Murphy ML, Welle D, Trockel MT (2018) Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study. BMC Health Services Research 18, 851.
| Crossref | Google Scholar | PubMed |
Harris R (2021) Forty common values: a checklist. Available at https://drive.google.com/file/d/1xfWe8pCkDWeJ7rNcIFIukOMarra-HAZ8/view?fbclid=IwAR0BK511eOzEPdYWmZ5pevz1S6Z_62eEpZ4eC9x8s690RFEQx6r23bttQrQ [Accessed 9 May 2021]
Johnson RB, Onwuegbuzie AJ, Turner LA (2007) Toward a definition of mixed methods research. Journal of Mixed Methods Research 1, 112-133.
| Crossref | Google Scholar |
Ko SS, Guck A, Williamson M, Buck K, Young R, Residency Research Network of Texas Investigators (2020) Family medicine faculty time allocation and burnout: a residency research network of Texas study. Journal of Graduate Medical Education 12, 620-623.
| Crossref | Google Scholar | PubMed |
Lundgren T, Luoma JB, Dahl JA, Strosahl K, Melin L (2012) The Bull’s-Eye Values Survey: a psychometric evaluation. Cognitive and Behavioral Practice 19, 518-526.
| Crossref | Google Scholar |
Maslach C, Schaufeli WB, Leiter MP (2001) Job burnout. Annual Review of Psychology 52, 397-422.
| Crossref | Google Scholar | PubMed |
Murray M, Murray L, Donnelly M (2016) Systematic review of interventions to improve the psychological well-being of general practitioners. BMC Family Practice 17, 36.
| Crossref | Google Scholar |
O’Connor AB, Halvorsen AJ, Cmar JM, Finn KM, Fletcher KE, Kearns L, McDonald FS, Swenson SL, Wahi-Gururaj S, West CP, Willett LL (2019) Internal medicine residency program director burnout and program director turnover: results of a national survey. The American Journal of Medicine 132, 252-261.
| Google Scholar | PubMed |
Penwell-Waines L, Greenawald M, Musick D (2018) A professional well-being continuum: broadening the burnout conversation. Southern Medical Journal 111, 634-635.
| Crossref | Google Scholar | PubMed |
Prentice S, Dorstyn D, Benson J, Elliott T (2020) Burnout levels and patterns in postgraduate medical trainees – a systematic review and meta-analysis. Academic Medicine 95, 1444-1454.
| Crossref | Google Scholar | PubMed |
Prentice S, Elliott T, Dorstyn D, Benson J (2023a) Burnout, wellbeing and how they relate: a qualitative study in general practice trainees. Medical Education 57, 243-255.
| Crossref | Google Scholar | PubMed |
Prentice S, Benson J, Need P, Pitot M, Elliott T (2023b) Personal value fulfillment predicts burnout and wellbeing amongst Australian General Practitioners. Journal of Workplace Behavioral Health 30, 1-17.
| Crossref | Google Scholar |
Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA (2018) Prevalence of burnout among physicians: a systematic review. JAMA 320, 1131-1150.
| Crossref | Google Scholar | PubMed |
Royal Australian College of General Practitioners (2022) General practice: health of the nation 2022. Available at https://www.racgp.org.au/general-practice-health-of-the-nation-2022 [Accessed 31 July 2023]
Salvatore D, Numerato D, Fattore G (2018) Physicians’ professional autonomy and their organizational identification with their hospital. BMC Health Services Research 18, 775.
| Crossref | Google Scholar | PubMed |
Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, Rummans TA, Dyrbye LN (2009) Career fit and burnout among academic faculty. Archives of Internal Medicine 169, 990-995.
| Crossref | Google Scholar | PubMed |
Stevenson AD, Phillips CB, Anderson KJ (2011) Resilience among doctors who work in challenging areas: a qualitative study. British Journal of General Practice 61, e404-e410.
| Crossref | Google Scholar |
Zhou AY, Panagioti M, Esmail A, Agius R, Van Tongeren M, Bower P (2020) Factors associated with burnout and stress in trainee physicians: a systematic review and meta-analysis. JAMA Network Open 3, e2013761.
| Crossref | Google Scholar | PubMed |
Özkan AH (2022) The effect of burnout and its dimensions on turnover intention among nurses: a meta-analytic review. Journal of Nursing Management 30, 660-669.
| Crossref | Google Scholar | PubMed |