Abstract
BackgroundThe traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. Nevertheless, increasing numbers of GPs are choosing to work sessionally, that is, ostensibly “part-time”. There are concerns about the health workforce’s ability to meet demand and also fears that patient care may be compromised. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession?MethodsSemi-structured interviews were conducted with GPs who worked sessionally, (i.e. six or fewer sessions a week in clinical general practice, where a session comprises four consecutive hours of patient care). These data were analysed qualitatively and saturation was reached.ResultsThe majority of participants were in full-time paid employment, while part-time in clinical general practice. They reported that consultations increasingly required the management of patients with complex, chronic conditions who also required psychological management. Coupled with unrealistic patient expectations, these factors led GPs to be concerned about maintaining the quality patient care they considered professionally desirable. Many diversified their work activities to ensure that they retained their professional standards.Conclusion“Part-time” general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants’ clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession.
Highlights
The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care
According to the Australian Capital Territory (ACT) Medical Registration Board data, our sample was skewed towards women and those trained in Australia
Ethics Ethical clearance was granted by both the ACT Health and the Australian National University (ANU) Human
Summary
The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession?. Women are more likely to choose general practice and to work sessionally (i.e. less than a full-time clinical load) because of caring commitments [17,18,19,20,21]. Some British research suggests that “the new general practice” distinguishes itself from “traditional” general practice in the way that quality of work and life has replaced commitment to patients and the profession [25], but there is no evidence that explicitly links Generation Y with workforce shortages [13]
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