Workload in Norwegian general practice 2018 \u2013 an observational study

Tone Morken,Ingrid Keilegavlen Rebnord,Steinar Hunskaar,Kjell Maartmann-Moe

doi:10.1186/s12913-019-4283-y

Abstract

BackgroundRising workload in general practice has been a recent cause for concern in several countries; this is also the case in Norway. Long working hours and heavy workload seem to affect recruitment and retention of regular general practitioners (RGPs). We investigated Norwegian RGPs’ workload in terms of time used on patient-related office work, administrative work, municipality tasks and other professional activities in relation to RGPs, and gender, age, employment status and size of municipality.MethodsIn early 2018, an electronic survey was sent to all 4716 RGPs in Norway. In addition to demographic background, the RGP reported minutes per day used on various tasks in the RGP practice prospectively during 1 week. Working time also included additional tasks in the municipality, other professional work and on out-of-hours primary health care. Differences were analysed by chi square test, independent t-tests, and one-way ANOVA.ResultsAmong 1876 RGPs (39.8%), the mean total working hours per week was 55.6, while the mean for regular number of working hours was 49.0 h weekly. Men worked 1.5 h more than women (49.7 vs. 48.2 h, p = 0.010). Self-employed RGPs work more than salaried RGPs (49.3 vs. 42.5 h, p < 0.001), and RGPs age 55–64 years worked more than RGPs at age 30–39 (51.1 vs. 47.3 h, p < 0.001). 54.1% of the regular working hours was used on face-to-face patient work.ConclusionsNorwegian RGPs have long working hours compared to recommended regular working hours in Norway, with small gender differences. Only half of the working time is used on face-to-face consultations. There seems to be a trend of increasing workload among Norwegian GPs, at the cost of direct patient contact. Further research should address identifying factors that can reduce long working hours.

Highlights

Rising workload in general practice has been a recent cause for concern in several countries; this is the case in Norway
We excluded 79 persons as they reported that they did not work as regular general practitioner (RGP) or were on sick leave at the time of the study. 1876 RGPs (39.8%) were included in the final analyses
This study shows that the RGPs in Norway have a high number of regular working hours, with small age and gender differences

Summary

Introduction

Rising workload in general practice has been a recent cause for concern in several countries; this is the case in Norway. Long working hours and heavy workload seem to affect recruitment and retention of regular general practitioners (RGPs). In recent years there have been increasing concerns in several countries about the rising workload in general practice. Several changes that affect the workload of general practitioners (GPs) include more multimorbidity, an ageing population, increased patient demand, pressure to reduce access to secondary care, growing number of responsibilities, escalating administrative tasks, and more documentation requirements [1,2,3,4,5]. In addition to the Morken et al BMC Health Services Research (2019) 19:434 regular working hours, the RGPs are responsible for participating in out-of-hours (OOH) primary health care

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Conclusion