Measuring morale--does practice area deprivation affect doctors' well-being?
BACKGROUND
Morale is a perennial concern in general practice and, over the years, a variety of tools have been used to examine doctors' mental well-being in a range of psychological and sociological studies. Despite perceived associations between low morale and practice area deprivation, this has not been investigated previously.


OBJECTIVE
To devise and apply a measure of mental well-being in general practitioners, and to use this to investigate the effect of practice area deprivation.


METHODS
A questionnaire was devised and piloted, then used in an anonymous postal survey of a random sample of 500 London general practitioners, with questions on demography, workload, practice characteristics, patient centredness, and practice area deprivation.


RESULTS
A total of 334 (68%) doctors replied to the questionnaire. Of these, 45% often feel exhausted, 46% are often frustrated by trivial consultations, and a third are seriously disenchanted with work. The resulting well-being score had a normal distribution, was reproducible (test-retest reliability = 0.91), and was internally consistent (Cronbach's alpha = 0.76). Comments from respondents suggested good face validity. Low well-being was not associated with practice area deprivation, but was associated with time stress, small practices and primary care teams, and lack of patient centredness.


CONCLUSIONS
The instrument provided a useful tool for examining doctors' well-being and the associations thereof. Well-being was not associated with practice area deprivation. Help for small primary care teams and measures to reduce time stress should help to improve morale.
Grieve
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D002391:Catchment Area, Health; D005194:Family Practice; D006801:Humans; D008131:London; D009013:Morale; D010821:Physicians, Family / Q000523:psychology*; D011204:Poverty Areas; D011569:Psychiatric Status Rating Scales