Merging Rural Family Practices into the SCHAAZ – Effects on Work Satisfaction and Risk of Burnout
DOI: 10.3238/zfa.2012.0303-0312german translation / full article
Introduction: Unfavourable working conditions such as a high workload, little time for leisure activities, and a lack of infrastructure for spouse and children contribute to the rising shortage of young family doctors in rural areas in Germany. In its 2009 report, the Federal Advisory Council proposed ‚Primary Care Practices‘ as a future organizational model for primary care. In July 2009, six family practitioners (FPs) in rural Schaafheim (Hesse) founded a health center with several elements of a primary care practice. We evaluated the impact of the model on work-life balance and risk of burnout of FPs; on working conditions and work satisfaction of health care assistants (HCA); and on patient acceptance.
Methods: FPs, HCAs, and a 10% sample of patients were asked to answer self-administered questionnaires before (T0) and 12 months after the primary care model was founded (T1). We also used the Maslach Burnout Inventory (MBI-D) for FPs, the Copenhagen Psychosocial Questionnaire (COPSOQ) for HCAs, and the EUROPEP for patients as standardized instruments.
Results: 6/6 FPs, 14/15 HCAs, and 301/439 patients answered the questionnaires at T0 and T1. FPs reported a decreased workload and more leisure time. The MBI-D showed significantly higher scores for personal fulfilment through work at 12 months. The COPSOQ results showed more responsibility for HCAs and better leadership by FPs, which resulted in higher work satisfaction. The results of the EUROPEP showed that patients generally accepted the practice changes.
Conclusions: The Primary Care Practice model seems to improve some of the unfavorable working conditions in rural areas.