The Effects of Policy Change on Family Doctors: Stress in General Practice under the New Contract

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Abstract
Investigates the effects of policy change‐the Government New Contract (1990) – on the workload and lives of family doctors, using an open‐ended interview approach and numerical research adapted from it. Provides an account of 20 urban general practitioners′ perceptions of their stresses in general practice under the new 1990 contract. Uses an open‐ended, emic, interview approach in order to reflect the perspectives of the participants rather than the assumptions of the researcher. Considers some of the problems and assets of the methodology. Uncovered many stresses during the interviews but focuses on the main ones which involve the effects of the new contract on being “on call”; nightwork; administration and increased paperwork; financial problems; relationships; inherent practice stresses; and job satisfaction. Involves a quantitative component to the survey, which consisted of a postal questionnaire designed from the findings of the preliminary open‐ended interviews; and includes results from the questionnaire findings. Also notes some of the comments given in answer to two open‐ended questions on the form. The preliminary interviews and quantitative findings suggest that it is important to be aware of the effects of the new contract on the general practitioner′s life and work as it is perceived by the doctors themselves, for many feel it has affected their adaptability and may alter the balance between their stresses and their ability to do their job in the most satisfactory spirit for their patients, staff, the administration and their family and personal life.