Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
Med J Aust. 2014 Apr 21;200(7):399-402. doi: 10.5694/mja13.10776.
To explore factors associated with general practitioners' desire to work less and their success in making that change.
DESIGN, PARTICIPANTS AND SETTING: Waves 3 and 4 (conducted in 2010 and 2011) of a national longitudinal survey of Australian doctors in clinical practice (Medicine in Australia: Balancing Employment and Life). Of the broader group of medical practitioners in the survey, there were 3664 and 3436 GP completers in Waves 3 and 4, respectively.
The association between the desire to reduce hours and doctor, job and geographic characteristics; the association between predictors of the capability to reduce hours and these same doctor, job and geographic characteristics.
Over 40% of GPs stated a preference to reduce their working hours. Characteristics that predicted this preference were being middle-aged, being female, working ≥ 40 hours per week (all P < 0.01), and being on call (P = 0.03). Factors associated with not wanting to reduce working hours were being in excellent health, being satisfied or very satisfied with work (both P < 0.01), and not being a partner in a practice (P < 0.01 for a number of alternative options [ie, associates, contractors and locums]). Of those who wanted to reduce working hours, 26.8% successfully managed to do so in the subsequent year (where reduction was defined as reducing hours by at least 5 per week). Predictors of successfully reducing hours were being younger, female and working ≥ 40 hours per week (all P < 0.01).
A number of factors appear to determine both the desire of GPs to reduce hours and their subsequent success in doing so. Declining working hours have contributed to the perceived shortage in GPs. Therefore, designing policies that address not just the absolute number of medical graduates but also their subsequent level of work may alleviate some of the pressures on the Australian primary health care system.
探讨与全科医生减少工作时间的愿望及其实现愿望的成功相关的因素。
设计、参与者和设置:对澳大利亚临床医生(《澳大利亚医学杂志:平衡就业与生活》)进行的全国纵向医生调查的第 3 波和第 4 波(分别于 2010 年和 2011 年进行)。在调查中更广泛的医疗从业者群体中,第 3 波和第 4 波分别有 3664 名和 3436 名全科医生完成了调查。
减少工作时间的愿望与医生、工作和地理位置特征之间的关系;减少工作时间的能力的预测因素与这些相同的医生、工作和地理位置特征之间的关系。
超过 40%的全科医生表示希望减少工作时间。预测这种偏好的特征是中年、女性、每周工作≥40 小时(所有 P<0.01)和轮班(P=0.03)。与不想减少工作时间相关的因素是身体健康状况极佳、对工作感到满意或非常满意(均 P<0.01),并且不是实践中的合作伙伴(对于一些替代选择[即合伙人、承包商和临时工],P<0.01)。在希望减少工作时间的人群中,26.8%的人在随后的一年中成功地做到了这一点(其中减少的定义是每周减少至少 5 小时)。成功减少工作时间的预测因素是年龄较小、女性和每周工作≥40 小时(均 P<0.01)。
有许多因素似乎决定了全科医生减少工作时间的愿望及其随后实现愿望的成功。工作时间的减少导致了全科医生短缺的现象。因此,设计不仅可以解决医学毕业生的绝对数量,还可以解决他们随后的工作水平的政策,可能会减轻澳大利亚初级医疗保健系统的一些压力。