Salaried contracts in UK general practice: a study of job satisfaction and stress.
OBJECTIVE
To compare job satisfaction and stress levels of general practitioners (GPs) employed on salaried contracts with GPs on a 'standard' performance-related contract paid by fee-for-service and capitation.


METHODS
Job satisfaction and stress levels were assessed using data from two postal surveys of GPs: a national survey of 'standard' contract GPs carried out in 1998; and a survey of salaried GPs and their non-salaried GP employers in 1999. Differences in satisfaction and stress scores were assessed by t-tests; regression analysis was used to control for confounding factors and possible selection bias.


RESULTS
We achieved a response rate of 77% in the 1999 survey of salaried and non-salaried GPs; 48% of 'standard' contract GPs responded in the 1998 survey. We found that salaried GPs were as satisfied overall as both non-salaried GP employers and GPs on the 'standard' contract, even after controlling for confounding factors and selection bias. Salaried GPs were more satisfied with their remuneration, working hours and the recognition they got for their work. They experienced more stress with two factors but less stress with 19 factors compared with the 'standard' contract GPs.


CONCLUSIONS
Overall job satisfaction levels among salaried doctors were similar to those of doctors on contracts paid by mixed fee-for-service and capitation. Future studies of job satisfaction levels under different doctor payment systems need to take account of the extent to which doctors have preferences for different types of contract if they are to derive unbiased results.
Gosden
Toby
T
National Primary Care Research and Development Centre, 5th Floor, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Williams
Jacky
J
Petchey
Roland
R
Leese
Brenda
B
Sibbald
Bonnie
B
D000328:Adult; D002204:Capitation Fee; D003284:Contract Services / Q000191:economics*; D004651:Employment / Q000191:economics*; D018588:Fee-for-Service Plans; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000191:economics / Q000523:psychology*; D012044:Regression Analysis; D012456:Salaries and Fringe Benefits; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data