A comparative study on attitudes, towards the provision of out-of-hours care, of the spouses of general practitioners participating, or not, in a rural out-of-hours co-op.

Qualitative research has suggested that the stress of general practice, and that of out-of-hours care in particular, has an impact on general practitioners' (GPs') spouses. The effects on the families of practitioners, of the introduction of out-of-hours co-operatives has not been extensively studied. Our objective was to compare, between the spouses of GPs participating or not in a rural co-op, the effects of out-of-hours commitments on personal and family life. The spouses of all 125 GPs in a rural region in Ireland were sent questionnaires; 59 GPs were members of an out-of-hours co-op, 66 were engaged in traditional on-call rotas. Most questions were in statement form, to which participants were required to respond on a five point Likert rating scale. The response rate was 67%. Non-co-op spouses were significantly older than co-op spouses (48.3 years versus 42.6, t(68)=-3.02, p=0.04). 80% of the co-op group favoured a co-op for on-call cover as compared to 46% of the non-co-op group. The majority of respondents from both groups agreed that they dislike when their spouse is on call and that time spent on-call placed a strain on family life and was detrimental to their spouse's health. Spouses of non-co-op general practitioners were more likely to agree that their home life was interrupted by patients telephoning the house (z=-3.06, p=0.002) and by patients calling to the door without a prior appointment (z=2.9, p=0.004). They were also more likely to worry about the safety of their spouse on call (z=-2.07, p=0.038). The general provision of out-of-hours care has a significant impact on the spouses and families of GPs participating, or not, in a rural co-op. Spouses of participants in co-ops had significantly less interruptions to their home life from patients and worried less about the safety of their spouse. The implications of these findings on the recruitment and retention of rural practitioners merits further discussion.