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Table 3 Main difficulties or aspects of regular work that generate dissatisfaction for exemplary doctors

From: Medical resilience and morality: a survey study on the opinions and actions of exemplary family physicians

Main category Subcategory Example(s)
1) Healthcare problems (64) 31.6% Excessive number of patient visits
Insufficient time for care
“I have to see more patients a day than I am able to do satisfactorily”;
“The lack of time to analyse patients properly.”
2) The company/healthcare management (32) 15.8% Administrative pressure (re. tasks, objectives)
Management behaviour (arrogance)
Difficult to achieve goals
Interest only in the quantitative at the expense of the qualitative/human
No/little autonomy for the doctor
“Pressure from management to fill out forms and protocols to achieve measurable goals”;
“Managers at the same level as us treat us arrogantly”;
“Unrealistic goals, in many cases not adapted to the patient”;
“Only financial results matter, not qualitative ones, let alone the human ones”;
“Lack of autonomy to manage your own timetable.”
3) Excessive bureaucratic burden (20) 9.9% Administrative tasks
Multiple tasks to be performed at the same time
Management of sick leave
Priority given to protocols and records that are of little use for the patient
“Doing administrative or registration work with little healthcare value”;
“Having to perform multiple tasks simultaneously”;
“I don’t like the paperwork involved in sick leave”;
“The obligation to fill out forms and protocols to achieve measurable goals.”
4) Relationship with colleagues & team (19) 9.4% Poor coordination with nursing
Impossibility of choosing team
Burnt out colleagues
Colleagues at the hospital care level
“Poor collaboration with nursing staff”;
“Not being able to choose your own team, it’s imposed on you”;
“Some colleagues are toxic”;
“The relationship with some fellow specialists is overly depersonalised, bureaucratised and distant.”
5) Relationship with a certain type of patients (17) 8.4% With a culture of immediacy
No health education
With trivial conditions
No appointment
With certain behaviour (demanding, not very empathetic, etc.)
“Patients who have a culture of immediacy”;
“Poor health education of some patients”;
“Visits involving no/trivial conditions”;
“Patients who come in again and again without an appointment”;
“The few welfare patients who fake symptoms so they can get, and stay on, sick leave.”
6) No/little recognition (14) 6.9% In general, towards the specialty
By management regarding the doctor’s work
“Little appreciation of family medicine by healthcare, academic (university) and political institutions”;
“The lack of recognition and compensation for those doctors who work well.”
7) Work organisation (12) 5.9% Slow response to certain problems
Lack of flexibility
Software (ICTS)
Specific organisational aspects
“Sometimes solving a patient’s problem takes forever due to bureaucracy”;
“Difficulty in solving incidents external to our team due to lack of flexibility”;
“Computer-related aspects can become hopeless.”
8) Pay (8) 3.9%   “Inadequate pay especially for being on call.”
9) Scarcity of resources (7) 3.4% Physical spaces
Human resources
“Physical space is very precarious”;
“Lack of personnel, especially for covering things like holidays.”
10) Other (9) 4.4% Research and teaching (scarce)
Routine
Low resolution capacity
Social problems
Call
Pharmaceutical industry relationship
“Research must be done outside working hours”;
“Low priority and resources for other activities (teaching, research)”;
“The routine sometimes exasperates me”;
“I don’t like the relationship with the pharmaceutical industry.”