ABSTRACT

Objective—To compare measures of job stress, job satisfaction, and mental health among general practitioners before and after the introduction of the new contract in April 1990.

Design—Cross sectional postal questionnaire survey in July 1990. Comparison of results with those obtained in previous survey in November 1987.

Setting—General practice in United Kingdom

Subjects—1500 general practitioners randomly selected from general medical services lists, 917 of whom (61%) returned questionnaires usable for statistical analysis.

Main outcome measures—Aspects of job causing stress, job satisfaction (Warr, Cook, and Wall scale), and mental health (Crown-Crisp experiential index).

Results—Compared with 1987, in 1990 doctors experienced more stress from night calls (mean score 3·83 in 1990 υ 3·45 in 1987), emergencies during surgery hours (3·72 υ 3·48), and interruption of family life by telephone (3·58 υ 2·73; p<0·001 for all three variables). Scores for somatic anxiety and depression were higher in both men and women in 1990 (men: somatic anxiety 3·12 υ 2·36; depression 3·80 υ 2·94; women: somatic anxiety 3·56 υ 2·65; depression 4·02 υ 3·37; p<0·001). Job satisfaction had also decreased in 1990 (5·23 υ 4·26; p<0·001).

Conclusions—Doctors experienced more stress, less job satisfaction, and poorer mental health in 1990 than in 1987. These changes may have resulted from the introduction of the new contract.