Working Conditions and Health of General Practitioners in Rhineland-Palatinate, Germany: First Results of a State-Wide Survey

Aim: The present study was designed to assess work stress and strain of German general practitioners as well as their health situation by means of standardised and validated instruments. A further objective was to investigate potential means to systematically prevent stress in the target population. Methods: The Institute of Occupational, Social and Environmental Medicine of the University Medical Centre of Mainz carried out a state-wide anonymous survey between June and July 2009. Altogether, 2 092 practice-based GPs in the federal German state of Rhineland-Palatinate were asked to take part in the cross-sectional study via postal mail. Results: 808 GPs participated (response rate 38.6%), n=790 of these were eligible for the analysis. We found high levels of work strain and perceived stress. The estimated weekly workload was 54.4h, about one quarter of which (13.4h) was dedicated to administrative work. 86.8% of the GPs exceeded the cut-off >1 of the ERI-Q (short version) indicating a high stress level. In the preceding year, participants had kept up their work on an average of 8 days on which they actually felt too sick to work. Measures to prevent stress, as suggested by the general practitioners themselves aim at a reduction of administrative work, an improvement of the financial situation - especially in terms of a higher financial security - and a decrease of the workload. Users of professional supervision and systematic relaxation techniques rated these as helpful regarding stress reduction. Conclusion: The present study is an important first step to systematically assess the working situation and health of GPs in Germany. The results reported here indicate an urgent need for actions to prevent stress.