GP principals leaving practice in the UK

Abstract

Objectives: To explore gender and career-stage differences in factors affecting GP retention, and to draw out lessons for enhancing the stock of GPs across the UK and Europe.Methods: A postal survey of all 1083 GP principals practising in England and Wales in October 1996 but not 1997.Results: After removing those who had died, emigrated or who could not be traced, the response rate was 63%, with 621 completed questionnaires being returned. Our most striking finding was not the difference, but the similarity in doctors' attitudes. Regardless of gender or career-stage, the most important reasons for leaving a GP principal post were high administrative and clinical workload and high patient expectations. Amongst younger leavers, both men and women also rated lack of flexible hours and GP partnership problems as important. Moreover, whilst women were more likely to say that better opportunities to accommodate family would help them return, a minority of men regarded those factors as relevant too. Another key finding was the general desire for career variety that could not be accommodated as a GP principal. Among older leavers, both genders were likely to have moved to a non-principal post they could combine with other NHS or private medicine. Even amongst young men, the group least likely to combine roles, 13% had a second job. Finally, there was similarity in the importance both genders placed on 11 career structure and job-related factors felt to be discouraging new GP recruits.Conclusions: Whereas “traditional” UK general practice met the full-time, job-for-life needs of earlier male-dominated cohorts of GPs, it no longer seems entirely appropriate either for the increasing number of women GPs or many of their male counterparts. Maximising the stock of GPs across the UK and Europe requires the option of greater flexibility to accommodate doctors' desire for varied lifestyle and employment options at all career stages.