MJA: Schattner & Coman, Box 3

3: Mean and rank order of frequency of general practice stressors

Rank	Stressor	Mean frequency	95% CI
1	Time pressure to see patients	2.41	2.31-2.51
2	Paperwork in general practice	2.27	2.16-2.37
3	Phone interruptions during consultations	2.27	2.16-2.38
4	Too much work to do in a limited time	2.07	1.96-2.18
5	Intrusion of work on family life	1.86	1.74-1.97
6	Patients who are difficult to manage	1.72	1.62-1.81
7	Home visits (in hours)	1.69	1.57-1.80
8	Earning enough money in general practice	1.59	1.46-1.72
9	Intrusion of work on social life	1.53	1.42-1.64
10	Unrealistic community expectations of the medical profession	1.53	1.41-1.64
11	Negative media comments about general practice	1.42	1.31-1.54
12	Having to make too many decisions	1.39	1.28-1.50
13	Excessive clinical responsibility	1.37	1.27-1.48
14	Emergency calls during surgery hours	1.37	1.29-1.45
15	Lack of appreciation by patients	1.34	1.24-1.45
16	Dealing with friends and relatives as patients	1.33	1.23-1.42
17	Keeping current on new advances in treatments and procedures	1.31	1.21-1.42
18	The cost of practice overheads	1.25	1.12-1.38
19	Dealing with death and dying	1.22	1.14-1.29
20	The pressure to bulk bill	1.18	1.04-1.31
21	Administration of practice and staff	1.05	0.93-1.16
22	Competition from "super" clinics or extended-hours practices	0.99	0.87-1.11
23	Continuing medical education points acquisition	0.95	0.85-1.05
24	Competition through oversupply of general practitioners	0.94	0.82-1.05
25	Threat of litigation	0.93	0.85-1.02
26	Not enough input into the way the practice runs	0.80	0.70-0.90
27	Obtaining payments from patients (non-bulk-billed)	0.72	0.62-0.82
28	Conflict with practice partners, associates or assistants	0.59	0.50-0.67

The items were ranked on a Likert-like scale, with 3 representing "frequently, at least weekly"; 2, "occasionally, at least monthly"; 1, "rarely, a few times a year"; and 0, "does not occur". "Super" clinics=extended-hours clinics that universally bulk bill; usually not owned by the GPs who work there. CI=confidence interval. Bulk-bill=charge only the amount rebated by the government.

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