Study On The Relationship Among Job Satisfaction,Career Burnout And Intent To Stay In General Practitioners

BackgroundThe contribution of basic healthcare system is a key matter of medical reform in China. And general practitioners (GPs) as the main providers of general medical services play an important role in the basic medical service. Quality and quantity of the GPs affect the quality and effect of basic medical and health services. However, the GPs group is facing human shortage, staff retention difficulties and other problems, which affect the quality of the basic medical and health services greatly. Existing studies suggested that job satisfaction and career burnout may be important reasons that result in the current predicament. Therefore, stabilize the GPs team, improve the quality of GPs, solve the problems of GPs’recruitment and retention has vital significance to ease the "difficulties and high expense in medical care" problems.Scholars have launched a series of related researches of job satisfaction, career burnout and intent to stay of basic medical and health service staff. But research in the relationship among GPs’job satisfaction, career burnout and intention to stay is very rare. This study from the perspective of GPs’job satisfaction and career burnout explore the measures to improve their intent to stay. This study has a very practical significance in improving the quality of GPs, stabilizing the GPs’team and raising the level of basic medical and health services.ObjectivesAnalyze the current situation of GPs’job satisfaction, career burnout and intent to stay and its influencing factors. Explore the relationship among GPs’job satisfaction, career burnout and intent to stay. Then provide information for policy-making and strategies for improving the quality of basic medical and health services.MethodsData was from field investigation. According to different levels of social economic development,3 sample counties were chosen and 12 towns were extracted from these 3 counties. And each GP from the 12 towns was asked to fill in questionnaires. We mainly used the Job Satisfaction Survey, Maslach Burnout Inventory-Human Service Survey and Intent to stay survey to investigate the GPs’ basic information, job satisfaction, career burnout, and intent to stay, et al. A total of 540 questionnaires were distributed, and 516 were returned validly.The exploratory factor analysis, Cronbach’s alpha and other statistical methods were used to evaluate the reliability and validity of the scales. One way ANOVA, multivariate logistic regression and multiple stepwise linear regression were used to analyze the influencing factors of GPs’job satisfaction, career burnout and intent to stay. The structural equation model was used to explore the relationship among GPs’ job satisfaction, career burnout and intent to stay. Data was mainly analyzed by SPSS 19.0 and AMOS 17.0.Main Results(1) GPs’group needs to be improved. GPs’professional proficiency is overall weak. Most of them have a medium-grade professional title; only 2.88% have a senior vice or above professional title. And a majority of them only received a senior high or technical education, only 21.76% have bachelor degree or above. GPs’management system and pension system is not perfect, only 35.61% have been authorized, more than half of them have no pension insurance. In addition, GPs are also facing lots of problems such as low level of income and heaiver workload.(2) GPs’job satisfaction. GPs’job satisfaction is in a pretty low level, the overall level is in "medium" dimension. As much as 81.40% of them have a "medium" or "not satisfied" feeling on job satisfaction. Age, professional title, education level, employment status, income, training and other factors affect GPs’level of satisfaction.(3) GPs’career burnout. GPs’career burnout is in "medium" level. The detecting rate was 43.22%, mild level burnout accounting for 19.00%, moderate for 24.22%, and no high level burnout. Emotional exhaustion, depersonalization; and self-accomplishment are all at moderate level. The detecting rates of 3 levels are 36.24%,20.35% and 44.57% respectively. Degree, employment, workload and training are the influencing factors of career burnout.(4) GPs’ intent to stay. GPs’intent to stay score is 3.63±0.78 which indicates that GPs’ intent to stay is in moderate level. Employment, workload, training, exhaustion, lack of self-accomplishment and job satisfaction are the influencing factors of intent to stay.(5) The relationship among job satisfaction, career burnout and intent to stay. These 3 factors have a close relationship. Intent to stay is positively related to job satisfaction and negatively related to career burnout. Career burnout has a direct effect on intent to stay, and job satisfaction has an indirect effect on intent to stay through career burnout.Conclusions and SuggestionsThis study found that GPs’ job satisfaction was in a pretty low level, career burnout in medium level and intent to stay in moderate level. Career burnout had a directly negative effect on intent to stay, and job satisfaction has a directly positive influence on intent to stay and also affects intent to stay through job burnout indirectly. Income, employing pattern and workload are the main influencing factors of GPs’job satisfaction and career burnout. Corresponding measures should be taken to improve GPs’job satisfaction, reduce the degree of career burnout in order to promote their intent to stay.Based on the result of this study, we put forward the following suggestions:(1) Confirm GPs’ labor value properly and increase their income. (2)Transform the concept of personnel management and perfect the GPs’recruit patterns. (3) Assign working tasks more reasonably and alleviate GPs’workload. (4) Perfect GP’s training mechanism and improve their working abilities.