Morale in general practice: crisis and solutions.
OBJECTIVE
To place the causes and level of psychological stress among general practitioners (GPs) within the context of the overall morale in the profession and to describe solutions suggested or achieved in response.


METHODS
Postal survey of a random sample of GPs in New Zealand. Levels of morale and psychological distress (GHQ-12) were assessed. Respondents scored categories of workload stress and generated solutions to perceived stressors.


RESULTS
The response rate was 448/ 658 (68%). Potent causes of work stress were excessive paperwork, bureaucracy, multiple problem consultations, time pressures and combining work with family life. Overall mean 5 point Likert scale ratings for perceived stress and morale were 3.47 (SD 0.98) for morale, and 4.15 (SD 0.85) for stress. GHQ scores: of 448 respondents 143 (33%) scored 4-8, and 43 (10%) scored >8. The most commonly suggested solutions were simplifying paperwork, increasing the General Medical Subsidy, increasing locum provision and providing united professional representation.


CONCLUSIONS
Potent sources of stress and low morale continue to affect New Zealand general practice, with significant numbers of GPs recording high levels of psychological distress. Morale was higher than in the UK, but lower than in Ireland. GPs have developed a range of potential solutions they would like implemented.
D003625:Data Collection; D006801:Humans; D007588:Job Satisfaction; D009013:Morale; D009520:New Zealand / Q000453:epidemiology; D010821:Physicians, Family / Q000523:psychology*; D011216:Practice Management, Medical / Q000458:organization & administration; D013315:Stress, Psychological / Q000453:epidemiology*