SynthesisBMJ open2020
Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Understanding why health professionals are leaving the UK national health service (NHS) - A systematic review and narrative synthesis.Journal of health services research & policy · 2026Pooled it
- Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support.BMJ open quality · 2022Trial
- Physiotherapist or physician as primary assessor for patients with suspected knee osteoarthritis in primary care - a cost-effectiveness analysis of a pragmatic trial.BMC musculoskeletal disorders · 2022Trial
- Continuity in a fragmented healthcare system: - organizational and individual determinants.Scandinavian journal of primary health care · 2026Article
- Sustaining a career in general practice: a qualitative study of experienced GPs in South West England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- What primary care physicians in Germany consider meaningful and meaningless work: a qualitative interview study using reflexive thematic analysis.BMC primary care · 2026Article
- GP workforce sustainability to maximise effective and equitable patient care: a realist review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Review
- Counting general practitioners: a comparative repeat cross-sectional analysis of GPs in NHS general practice in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Evaluating the Validity of the GM@W Survey: A Psychometric Study Across Gender and Industry.Journal of occupational rehabilitation · 2026Article
- Physicians shortage in primary care: a protocol for updating a systematic review of recruitment and retention strategies.F1000Research · 2026Article
- Addressing systemic workforce challenges in general practice-a qualitative study of general practitioners in Ireland.Family practice · 2025Article
- Mapping the ideal job: insights into job resources of general practitioner trainees.Scandinavian journal of primary health care · 2025Article
- Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study.BMJ (Clinical research ed.) · 2025Article
- Retaining family physicians in comprehensive primary care: Scoping review.Canadian family physician Medecin de famille canadien · 2025Article
- Hard road to climb: blunted academic and professional trajectories and effort-reward imbalance for people with narcolepsy type 1.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Retaining doctors in organisations in socioeconomically deprived areas in England: a qualitative study.BMJ open · 2025Article
- Factors influencing medical disputes among village doctors from seven provinces in China: a cross-sectional study.Human resources for health · 2025Article
- Factors affecting cancer care delivery in primary care: a qualitative study.Family practice · 2025Article
- Medical students' perceptions of improving physician satisfaction and patient care: a text network analysis approach.BMC medical education · 2024Article
- Healthcare professionals as domestic abuse survivors: workplace impact and support-seeking.Occupational medicine (Oxford, England) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUK general practitioners (GPs) are leaving direct patient care in significant numbers. We undertook a systematic review of qualitative research to identify factors affecting GPs' leaving behaviour in the workforce as part of a wider mixed methods study (ReGROUP).
objectiveTo identify factors that affect GPs' decisions to leave direct patient care.
methodsQualitative interview-based studies were identified and their quality was assessed. A thematic analysis was performed and an explanatory model was constructed providing an overview of factors affecting UK GPs. Non-UK studies were considered separately.
resultsSix UK interview-based studies and one Australian interview-based study were identified. Three central dynamics that are key to understanding UK GP leaving behaviour were identified: factors associated with low job satisfaction, high job satisfaction and those linked to the doctor-patient relationship. The importance of contextual influence on job satisfaction emerged. GPs with high job satisfaction described feeling supported by good practice relationships, while GPs with poor job satisfaction described feeling overworked and unsupported with negatively impacted doctor-patient relationships.
conclusionsMany GPs report that job satisfaction directly relates to the quality of the doctor-patient relationship. Combined with changing relationships with patients and interfaces with secondary care, and the gradual sense of loss of autonomy within the workplace, many GPs report a reduction in job satisfaction. Once job satisfaction has become negatively impacted, the combined pressure of increased patient demand and workload, together with other stress factors, has left many feeling unsupported and vulnerable to burn-out and ill health, and ultimately to the decision to leave general practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.