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