The authors declare that they have no competing interests.
KAD & KMD conceived the study, participated in its design, oversaw its conduct, analyzed the data, and participated in drafting the manuscript. LF collected data and analyzed the data, and participated in drafting the manuscript. All authors read and approved the final manuscript.
The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. Nevertheless, increasing numbers of GPs are choosing to work sessionally, that is, ostensibly “part-time”. There are concerns about the health workforce’s ability to meet demand and also fears that patient care may be compromised. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession?
Semi-structured interviews were conducted with GPs who worked sessionally, (i.e. six or fewer sessions a week in clinical general practice, where a session comprises four consecutive hours of patient care). These data were analysed qualitatively and saturation was reached.
The majority of participants were in full-time paid employment, while part-time in clinical general practice. They reported that consultations increasingly required the management of patients with complex, chronic conditions who also required psychological management. Coupled with unrealistic patient expectations, these factors led GPs to be concerned about maintaining the quality patient care they considered professionally desirable. Many diversified their work activities to ensure that they retained their professional standards.
“Part-time” general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants’ clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession.
Zurn P, Dal Poz M, Stilwell B, Adams O: Imbalances in the health workforce. WHO Briefing paper. 2002, Geneva: WHO Press
World Health Organization: The world health report 2006: working together for health. 2006, Geneva: World Health Organization CrossRef
Commission of the European Communities: Green Paper: On the European Workforce for Health. 2008, Brussels: Commission of the European Communities
Elston MA: Women and Medicine: The future. 2009, London: Royal College of Physicians
Health Policy & Economic Research Unit: BMA cohort study of 1995 medical graduates: Tenth Report. 1995, London: BMA
Australian Medical Workforce Advisory Committee: The general practice workforce in Australia, Supply and Requirements to 2013. AMWAC Report 2005.2. 2005, Sydney: Australian Medical Workforce Advisory Committee
Charles J, Britt H, Harrison C: General practice workforce and workload. General practice in Australia, health priorities and policy 1998 to 2008, Volume No 24. Edited by: Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C, Valenti L, Fahridin S, Pan Y, O’Halloran J. 2009, Canberra: Australian Institute of Health and Welfare, 22-37. Cat. no. GEP 24
Lewington K: UK Medical Workforce briefing. 2014, London: British Medical Association Health Policy & Economic Research Unit
Health Policy and Economic Research Unit: GPs’ views on The Future of General Practice – Focus Group Findings. 2013, London: British Medical Association
National Health Workforce Taskforce: Health Workforce in Australia and Factors for Current Shortages. 2009, Australia: National Health Workforce Taskforce
Limprecht E: Rising GP numbers undermined by trend to part-time hours. Australian Doctor. 2004, Australia: Reed Business Information, 3-
Pincock S: Generation vexed. Australian Doctor. 2010, Australia: Reed Business Information, 23-24.
Parnell K: Future of general practice is limited only by its own vision. Australian Doctor. 2008, Australia: Reed Business Information, 22-
Linzer M, McMurray JE, Visser MR, Oort FJ, Smets E, de Haes HC: Sex differences in physician burnout in the United States and The Netherlands. J Am Med Womens Assoc. 2002, 57 (4): 191-193. PubMed
Health Policy & Economic Research Unit: BMA cohort study of 2006 medical graduates: First Report. 2007, London: BMA, 32-
Watson DE, Slade S, Buske L, Tepper J: Intergenerational differences in workloads among primary care physicians: a ten-year, population-based study. Health Aff (Millwood). 2006, 25 (6): 1620-1628. 10.1377/hlthaff.25.6.1620. CrossRef
Australian Medical Workforce Advisory Committee: Career decision making by postgraduate doctors: main report. 2005, Sydney, 16-
Jones L, Green J: Shifting discourses of professionalism: a case study of general practitioners in the United Kingdom. Sociol Health Illn. 2006, 28 (7): 927-950. PubMed
French FH, Andrew JE, Awramenko M, Coutts H, Leighton-Beck L, Mollison J, Needham G, Scott A, Walker KA: Consultants in NHS Scotland: a survey of work commitments, remuneration, job satisfaction and retirement plans. Scott Med J. 2004, 49 (2): 47-52. PubMed
Simoens S, Scott A, Sibbald B: Job satisfaction, work-related stress and intentions to quit of Scottish GPs. Scott Med J. 2002, 47 (4): 80-86. PubMed
Australian Government: Primary and community health. Report on Government Services. Edited by: Steering Committee for the Review of Government Service Provision (SCRGSP). 2009, Canberra: Productivity Commission, 153-178. 2009
What is general practice. [ http://www.racgp.org.au/becomingagp/what-is-a-gp/what-is-general-practice/]
Miles MB, Huberman AM: Chapter 2 - Focusing and bounding the collection of data. The substantive start. Qualitative data analysis: An expanded sourcebook. Edited by: Miles MB, Huberman AM. 1994, London: Sage, 16-39.
Thomas W, Thomas D: The child in America: Behavior problems and programs. 1928, New York: Knopf
Crotty M: Chapter 3: Constructionism: the making of meaning. The foundations of social research: Meaning and perspective in the research process. 1998, St Leonards, Australia: Allen & Unwin, 42-65.
Wengraf T: Qualitative research interviewing: biographic narrative and semi-structured methods. 2001, London; Thousand Oaks, Calif: Sage CrossRef
Guest G, Bunce A, Johnson L: How Many Interviews Are Enough?. Field Methods. 2006, 18 (1): 59-82. 10.1177/1525822X05279903. CrossRef
Britt H, Miller G, Charles J, Henderson J, Valenti L, Harrison C, Zhang C, Chamber T, Pollack A, Bayram C, et al: A decade of Australian general practice activity 2002–03 to 2011–12. General practice series no. 32. 2012, Sydney: Sydney University Press
Thomas WI, Znaniecki F: The Polish peasant in Europe and America. 1974, New York: Octagon Books, 2
- Are “part-time” general practitioners workforce idlers or committed professionals?
Kathryn M Dwan
Kirsty A Douglas
Laura E Forrest
- BioMed Central
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