Preferences for general practice jobs: a survey of principals and sessional GPs

Background. Many countries are experiencing recruitment and retention problems in general practice, particularly in rural areas. In the United Kingdom (UK), recent contractual changes aim to address general practitioner (GP) recruitment and retention difficulties However the evidence base for their impact is limited, and preference differences between principals and sessional GPs (previously called non-principals) are insufficiently explored.

Aim: To elicit GP principals' and sessional GPS' preferences or alternative jobs in general practice, and to identify the most important work attributes.

Design of study: A discrete choice experiment.

Setting. National Health Service (NHS) general practices throughout Scotland.

Method. A postal questionnaire was sent to 1862 principals and 712 sessional GPs. The questionnaire contained a discrete choice experiment to quantify GPs' preferences for different job attributes.

Results. A response rate of 49% (904/1862) was achieved for principals and 54961 (388/712) for sessional GPs. Of responders, most principals were male (60%), and sessional GPs female (75%), with the average age being 42 years. All GTs preferred a job with longer consultations, no increase in working hours, but an increase in earnings. A job with outside commitments (for example, a health board or hospital) was preferable, one with additional out-of-hours work was less preferable. Sessional GTs placed a lower value on consultation length, were less worried about hours of work, and a job offering sufficient continuing professional development was less important.

Conclusion: The differences in preferences between principals and sessional GPs, and also between different personal characteristics, suggests that a general contract could fail to cater for all GPs Recruitment and retention of GTs may improve if the least preferred their jobs are changed However the long-term success of contractual reform will require enhancement of the positive aspects of working, such as patient contact.