“If I could do anything but vote with my feet…” Understanding why GPs are leaving direct patient care and what might help to retain them: a qualitative study.
Problem
In the context of the current GP workforce crisis, this study aimed to identify factors influencing GPs’ decisions about whether to remain in direct patient care, and what might help to retain them in that role.
Approach
Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in, and returning to direct patient care. Forty-one GPs from South West England were interviewed: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 who had left or were intending to leave direct patient care; and 6 who were not intending to leave or to take a career break. In addition, 19 stakeholders were interviewed from a range of primary care related organisations and roles.
Findings
Reasons for leaving patient care were complex and based on a range of job-related and individual factors. Three key themes underpinned GPs’ thinking and rationale: issues relating to personal and professional identity and the perceived value of general practice within the healthcare system; concerns regarding fear and risk, for example in respect of medical litigation and managing administrative challenges within the context of increasingly complex care pathways and environments; and issues around choice and volition in respect of personal social, financial, domestic, and professional considerations. These themes provide increased understanding of the lived experience of being a GP in today’s NHS.
Consequences
Future policies and strategies aimed at retaining GPs in direct patient care should clarify GPs’ role and identity; demonstrate to GPs that they are valued and listened to in planning delivery of UK healthcare; target GPs’ concerns regarding fear and risk, seeking to reduce these to manageable levels; and give GPs viable options to support them to remain in direct patient care.