Abstract
BackgroundStudies conducted to understand how family doctors develop resilience and deal with the challenges posed by work-related stress, usually have focused on identifying the elements that generate resilience from psychological perspectives and their impact on coping strategies. Few have explored the role that personal qualities and values that traditionally motivate family physicians can play as drivers of well-being and resilience.ObjectivesTo explore attributes that exemplary family physicians (EFP) consider important for their work and the elements that, for them, are source of gratification and resources in the face of the adversities they encounter in their practice.MethodsThis is an exploratory study carried out by online survey. Eighty six doctors regarded as exemplary by their colleagues answered 7 close and 4 open-ended questions that explored their job satisfaction, the elements of their work that reward them, the difficulties and problems they usually encounter, the resources they use to cope with those problems, and the personal qualities they consider central to their work. Four researchers conducted a thematic (deductive and inductive) analysis of the free text responses received. Based on the results obtained, and through an iterative discussion process, the researchers proposed an integrated set of qualities at the core of their professionalism.Results88.4% (76) of the doctors said they were satisfied with their work. However, they face problems (202 comments), including demanding patients, insensitive managers with unshared interests/care goals, excessive paperwork, work overload, or time pressures. Sources of gratification point to personal identity; clinical, relational, and collaborative efficiency; a holistic and comprehensive practice (centred on individuals); and a continuous search for excellence (149) and the root of their resources (135). These elements, in turn, corresponded to the attributes considered essential for the practice of family medicine (131).ConclusionsFor EFPs, certain professional values give meaning to their clinical practice and are a source of well-being and resources. This central focus on professional values and qualities can help for better understand the burnout nature and expand the type of action that promotes resilience. Further studies using a less structured qualitative research will be needed to confirm/expand these results.
Highlights
Certain values such as kindness, caring, good communication and interpersonal relationships, availability and accessibility, continuity of care, compassion, honesty, trust, and commitment to people, have been considered the essence of family medicine (FM)
For exemplary family physicians (EFP), certain professional values give meaning to their clinical practice and are a source of wellbeing and resources. This central focus on professional values and qualities can help for better understand the burnout nature and expand the type of action that promotes resilience
The findings clearly show that these physicians are faced with demanding patients, insensitive managers with interests/healthcare goals they do not share, excessive paperwork, work overloading and time pressures, which are the stressors usually described in the literature and which lead to burnout of other doctors in the same setting [30,31,32]
Summary
Certain values such as kindness, caring, good communication and interpersonal relationships, availability and accessibility, continuity of care, compassion, honesty, trust, and commitment to people, have been considered the essence of family medicine (FM) In these lies much of the value that society attaches to this specialty, and their relevance can be seen in the definition that WONCA Europe provides for this profession, where they are included as the cornerstones of clinical practice [1]. There have been cultural changes, doctors in FM have seen an increase in patient demand and experience [9, 13], as well as new technologies for administering and evaluating the care they provide [11] This has meant that family doctors have to cope with very demanding cognitive and emotional environments with high workloads and a great deal of dedication, and a large number of them are not satisfied, in particular with working conditions (remuneration, task management) and with professional acceptance and social recognition [12, 14]. Few have explored the role that personal qualities and values that traditionally motivate family physicians can play as drivers of well-being and resilience
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