Job stress, satisfaction, and mental health among general practitioners before and after introduction of new contract

Abstract

Objective - To compare measures of job stress, job satisfaction, and mental health among general practitioners before and after the introduction of the new contract in April 1990. Design - Cross sectional postal questionnaire survey in July 1990. Comparison of results with those obtained in previous survey in November 1987. Setting - General practice in United Kingdom. Subjects - 1500 general practitioners randomly selected from general medical services lists, 917 of whom (61%) returned questionnaires usable for statistical analysis. Main outcome measures - Aspects of job causing stress, job satisfaction (Warr, Cook, and Wall scale), and mental health (Crown-Crisp experiential index). Results - Compared with 1987, in 1990 doctors experienced more stress from night calls (mean score 3.83 in 1990 υ 3.45 in 1987), emergencies during surgery hours (3.72 υ 3.48), and interruption of family life by telephone (3.58 υ 2.73; p<0.001 for all three variables). Scores for somatic anxiety and depression were higher in both men and women in 1990 (men: somatic anxiety 3.12 υ 2.36; depression 3.80 υ 2.94; women: somatic anxiety 3.56 υ 2.65; depression 4.02 υ 3.37; p<0.001). Job satisfaction had also decreased in 1990 (5.23 υ 4.26; p<0.001). Conclusions - Doctors experienced more stress, less job satisfaction, and poorer mental health in 1990 than in 1987. These changes may have resulted from the introduction of the new contract.