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Work stress and health in primary health care physicians and hospital physicians

¹ Tampere School of Public Health, University of Tampere, Tampere, Finland
² Finnish Institute of Occupational Health, Turku, Finland
³ University College London, London, UK
⁴ Finnish Institute of Occupational Health, Helsinki, Finland
⁵ Finnish Institute of Occupational Health, Turku, Finland

Correspondence to:
Pekka Virtanen, Tampere School of Public Health, 33014 University of Tampere, Tampere, Finland; pekka.j.virtanen{at}uta.fi

Objective: In order to understand the reasons for the low priority given to work in primary health care among physicians, we studied differences in work stress, health and health related lifestyles between general practitioners (GPs) and hospital physicians.

Method: A cohort of 226 GPs and 523 consultants from Finland responded to a questionnaire survey. The responses were linked to data on registered sickness absence.

Results: Compared with consultants, GPs reported higher job strain (OR 1.76, 95% CI 1.23 to 2.53) and perceived work overload (OR 2.29, 95% CI 1.65 to 3.16) but were less likely to report poor team climate (OR 0.65, 95% CI 0.46 to 0.91), procedural injustice (OR 0.49, 95% CI 0.34 to 0.72) and interactional injustice (OR 0.62, 95% CI 0.44 to 0.88). There were only small differences in lifestyle, perceived health, psychological distress and long sick leaves between GPs and consultants. Short sick leaves were more common among GPs, but this difference disappeared after controlling for work characteristics.

Conclusion: In relation to the current recruitment crisis in primary health care and the studied working conditions, job strain and heavy workload outweigh the attractiveness of a good working climate and low organisational injustice. The non-significant differences in health may indicate that there are no differences in total work stress between GPs and consultants. In tackling the recruitment problems in the field of health care, it is of particular importance to be aware of the sector specific difficulties in working conditions.

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