Permanent psychological wellbeing being in Australian general practitioners: exploring and applying principles of positive psychology

Abstract

The wellbeing of Australian general practitioners was explored. This complements research on burnout and mental ill health in doctors by contributing to the emerging focus on promoting ‘the positive’ towards achieving wellbeing. We addressed the improvement of provider wellbeing. GPs find themselves at the core of improving patient outcomes, population health, and reducing health care costs, and thus their wellbeing deserves particular focus. I applied a mixed methods approach: a systematic literature review on interventions to improve the wellbeing of GPs; qualitative interviews with Australian GPs; and a quantitative analysis of Australian longitudinal data on GPs. The systematic review identified very few interventions for GPs that promoted, and measured the positive, as opposed to mitigating burnout and mental ill health. Mindfulness interventions were the most common with medium to high effect sizes. The qualitative interviews included 20 GPs working across Australia. Both determinants and strategies contributing to the wellbeing of Australian GPs were organised across the individual level, the organisation, the profession, the system, and finances. I also investigated how COVID-19 impacted GPs’ wellbeing. Funding models and finances were identified as an important potentially modifiable determinant of wellbeing. Lastly, I analysed a large doctors cohort dataset collected from 2009 – 2018. I found a robust and statistically significant negative correlation between the current billing system (bulk billing) in Australia and GPs’ job satisfaction, irrespective of model and confounding factors known to impact job satisfaction. This PhD thesis has contributed towards understanding wellbeing and satisfaction in Australian GPs, and how to improve it. This may help inform future research, interventions, and policy to bolster the GP profession.