New research published in BMJ Open has shed light on the reasons driving doctors out of General Practice, following earlier findings that around two out of every five GPs in the South West are planning to leave direct patient care in the next five years.
The research, led by Professor John Campbell of the University of Exeter Medical School and funded by the National Institute for Health Research (NIHR), aimed to identify factors influencing General Practitioners’ (GPs) decisions about whether or not to remain in direct patient care, and what might help to retain them in the role.
Professor Campbell, who is a practising GP, said the new research is a significant study of what is driving the exodus of GPs from direct patient care. Policymakers need to take this on-board and address these issues to retain GPs and encourage medical students to take up a career in general practice.
Despite recent government plans to address the problem, numbers are continuing to fall. If we do not act now, many areas will face a severe shortfall in the number of GPs providing care for patients their area. Researchers interviewed 41 GPs for the study and identified three main themes underpinning the GPs' thinking and rationale.
Three reasons emerged: a sense that general practice-based primary care was under-valued within the healthcare system; concerns regarding professional risk encountered in delivering care in an increasingly complex health environment; and finally, considerations about leaving or remaining in direct patient care and the options and choices that GPs felt were available to them.
It comes following a large-scale survey led by Professor Campbell, which showed that two in every five GPs in the South West intended to quit within the next five years. The research adds to the picture of a crisis developing around the national GP workforce in the last five years. The number of unfilled GP posts quadrupled between 2012 and 2014, while the numbers of GPs fell substantially.
The national situation has prompted political action, with the Government announcing measures to train 5,000 new GPs in 2015 and to increase the proportion of medical students who choose general practice as a career. Despite this, government data showed that over 1000 GPs left full-time practice between 2016 and 2017.
There is a need for sustained, strategic, and stable planning of health services – not a series of short-term fixes which only destabilise clinical care further. Innovation is essential but needs to be based on firm evidence.