| Sub-title | |
| Author | |
| Abstract | Introduction: General practitioners in the public sector provide 60% of Primary Healthcare in Malta. The quality of primary care in our country depends on the performance of these major contributors. However the Department of Primary Health Care has a chronic history of poor retention and high rate of absenteeism. The manpower shortages are constraining the services provided at the health centres. Meanwhile demand is increasing due to demographic trends, ever increasing patients expectations, as well as the shift of secondary care towards more day cases and shorter hospital stays. Literature has shown that strong correlations exist between the presence of occupational stress and the performance of clinicians, the GPs psychological well-being, as well as retention of doctors within organisation setting. Job stress has been identified as a causal antecedent of job satisfaction in GPs. Stress at work is therefore a direct threat to the efficient and effective delivery of primary healthcare. Aim of the study: Recommending Organisation Strategies to Minimise the Effect of Job Stressors among doctors at The Primary Health Clinics. The objectives of the study were to evaluate the level of stress among doctors at the PHC clinics and its effect on the service, identify the occupational stressors present, provide recommendations of organisational strategies to address such stressors and generate information for future research initiatives in this sector Methods: The research was conducted as an evaluation based on an observational case study. Methods of data collection included desk research for a comparative analysis of absenteeism and turn over among doctors in PHC department and another four departments in the healthcare sector. A job stressor questionnaire composed of the statistically established stressor scales from Specter and Jex (1998) and parts of the Job Descriptive Index from Green Bowling University. All eligible doctors were included in the survey and the response rate was 83%. Qualitative research conducted as two sets of interviews, one with 12 doctors (15% of the population) presently working at the PHC centres and another set of 13 doctors (!5% of the population) who had resigned in the last five years. Results: The evaluation established that doctors at the PHC are experiencing an alarming degree of work stress. Occupational stressors are negatively influencing the performance of these GPs, leading to very high levels of absenteeism and triggering most of the resignations in the department. Qualitative and quantitative workloads with the related time pressure are the major stressor. These are closely followed by stress arising from lack of career advancement opportunities. The doctors also reported difficulties to identify the nature of their work within the conventional medical specialities that already exist. They frequently encounter situations where they perceive lack of skills. The clinicians feel constrained by the present organisation structure and management style. The lack of support and the absence of any form of consultation are increasingly stressful for these employees. Recommendations: An Appointments System has been identified as the most effective organisation remedy for stress arising from workload. Such a system can potentially influence the distribution of demand, controlling work overload and leading to a more interesting case mix. Evidently a Job Analysis is fundamentally important to formulate role descriptions, learning and training specifications, as well as career development plans. This job analysis, together with the introduction of a Personal Development Plan will minimise stress from role ambiguities while creating opportunities for career advancements. The incongruence that exists between these professionals and organisation structure, as well as management style can be aligned through a Decentralisation Process driven by People-Centred leadership in the department of PHC. These systems are known to generate a feeling of involvement, participation and support among doctors. Conclusion: The data available by virtue of this study would enable management to implement appropriate measures to minimise occupational stress. Reducing work stressors is intended to improve performance and retention of the health centres doctors, avoid service disruption and loss of valuable resources. This approach may not only resolve the present situation but also ensure that the services of this organisation remain sustainable in the future. |
Published in: | |
| Journal | MSc. Health Services management, University of Malta |
| Volume | |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | Primary health care, health clinics, health services management, job stress |