Abstract:
The research presented in this thesis sought to identify the key issues underlying the
current recruitment and retention problems in general practice. Previous studies have
tended to focus on medical careers in isolation, neglecting the wider context of
professional careers in the non-medical workplace. In an attempt to untangle the
effects of being in general practice from the effects of being in professional practice per
se, medical professionals were compared with those in a parallel profession -
law.
Therefore the present research focused on identifying, and comparing, the career
aspirations of doctors and lawyers.
The work comprised two qualitative studies. Study 1 compared the values, beliefs and
work perceptions of experienced doctors and lawyers, to establish similarities and
differences between the two groups. Study 2 focused on the career expectations of
both general and hospital trainees to allow comparisons between trainee groups, and
between trainees and experienced practitioners. Participants totalled fifty nine for both
studies. Data pertaining to the first study were analysed within the framework of the
Job Characteristics Model (JCM). These findings subsequently determined the
direction and shape of the second study.
Problems in general practice related to a combination of organisational change, and
doctors' reasons for their career choice. Whilst both lawyers and doctors have
experienced aggressive government intervention, doctors seemed to have interpreted
this as a violation of their relational psychological contract with the State. Moreover,
many doctors appear to have chosen general practice for less than positive reasons.
Findings according to the JCM showed general practice to be low in motivating
potential, with experienced practitioners strongly resenting their diminishing
professional autonomy.
Trainee GPs appeared very similar to their predecessors, in terms of reasons for
choosing general practice. Furthermore, they were overly optimistic regarding both
the job's characteristics, and their ability to cope with potential difficulties. They were
also less committed than their experienced counterparts.
The data could offer few assurances of retention problems being eased by this new
generation of GPs.
