“Multimorbidity Plus”: a secondary analysis exploring GP work in areas of high socioeconomic deprivation

McCallum, M. and Macdonald, S. (2021) “Multimorbidity Plus”: a secondary analysis exploring GP work in areas of high socioeconomic deprivation. British Journal of General Practice, (doi: 10.3399/BJGPO.2021.0117) (PMID:34465578) (Early Online Publication)

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Background There is a GP workforce crisis, particularly in areas of high socioeconomic deprivation where multimorbidity, and social complexity, is higher. How this impacts GP work, and how they manage workload has not been fully explored. Aim To explore GP work in areas of high socioeconomic deprivation, and the strategies GPs employ using Corbin and Strauss’s ‘Managing Chronic Illness’ model as an analytical lens. Method Secondary analysis of in-depth interviews, with GPs working in areas of high socio-economic deprivation (n=10). Results All three types of work defined by Corbin and Strauss (everyday, illness, biographical) were described, and one additional type: emotional (work managing GPs’ own emotions). The context of socioeconomic deprivation influenced GP work, increased multimorbidity PLUS social complexity (“Multimorbidity plus”). Healthcare systems, and self-management strategies, did not meet patients’ needs; meeting the resulting gap created extra hidden everyday work, often unrecognised (source of frustration). GPs also described taking on “illness work” for patients who were either overwhelmed, or unable to do it. Some GPs described biographical work asserting their professional role against demands from patients, and other professionals. Work aligning with personal values was important in sustaining motivation; strong teams and outside professional appeared to build resilience. Conclusion GPs working in areas of high socioeconomic deprivation experience different types of work; much unrecognised and not resourced. Current strategies to reduce burnout could be more effective if the complexity of different types of work was addressed, personal values supported, practice teams and outside professional interests were supported.

Item Type:Articles
Status:Early Online Publication
Glasgow Author(s) Enlighten ID:McCallum, Dr Marianne and Macdonald, Professor Sara
Authors: McCallum, M., and Macdonald, S.
Journal Name:British Journal of General Practice
Publisher:Royal College of General Practitioners
Published Online:31 August 2021

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