COVID-19 Continues to Burden General Practitioners: Impact on Workload, Provision of Care, and Intention to Leave

General practitioners (GPs), already in a profession with a high workload, have been at the frontline of providing COVID-19-related healthcare in addition to routine care. Our study examined the impact of pandemic-related consultations and changes in practice organization on GPs’ current workload and provision of healthcare in summer 2021 (May 2021–July 2021) and early 2022 (January 2022–February 2022). In total, 143 German GPs participated in an online survey in the summer of 2021. Of these, 51 GPs participated in the follow-up survey in 2022. Most GPs perceived an increase in consultation frequency, consultation times, and workload since the pandemic outbreak. Increased consultation times were related to the reduced provision of medical care to other patients with chronic diseases. More SARS-CoV-2 vaccination consultations were associated with reduced home visits, acute consultation times, and cancer screenings. A quarter of GPs considered leaving their job. Pandemic-related bureaucracy, restricted access to therapy and rehabilitation services specialized on COVID-19, unreliable vaccine deliveries, mandatory telematics-infrastructure implementation, and frequent changes in official regulations were the main reasons reported for dissatisfaction. Our results provide insights into how the pandemic continues to burden GPs’ work routines and how better working conditions in times of high demand could be achieved in future pandemics.

[1]  C. Arenson,et al.  Burnout and Commitment After 18 Months of the COVID-19 Pandemic: A Follow-Up Qualitative Study with Primary Care Teams , 2023, The Journal of the American Board of Family Medicine.

[2]  K. Kostev,et al.  The long-term impact of the COVID-19 pandemic on primary and specialized care provision and disease recognition in Germany , 2022, Frontiers in Public Health.

[3]  J. Stephenson Study Highlights Effects of COVID-19 Burnout on Primary Care Physicians in 10 High-Income Countries. , 2022, JAMA health forum.

[4]  R. Batenburg,et al.  Has the COVID-19 Pandemic Led to Changes in the Tasks of the Primary Care Workforce? An International Survey among General Practices in 38 Countries (PRICOV-19) , 2022, International journal of environmental research and public health.

[5]  M. Bleckwenn,et al.  Differences in Demographics of Vaccinees, Access to, and Satisfaction with SARS-CoV-2 Vaccination Procedures between German General Practices and Mass Vaccination Centers , 2022, Vaccines.

[6]  Annett Braesigk,et al.  Management and treatment of long COVID symptoms in general practices: An online-based survey , 2022, Frontiers in Public Health.

[7]  A. Rachas,et al.  Underuse of primary healthcare in France during the COVID-19 epidemic in 2020 according to individual characteristics: a national observational study , 2022, BMC Primary Care.

[8]  S. Fleming,et al.  Primary care practice and cancer suspicion during the first three COVID-19 lockdowns in the UK: a qualitative study , 2022, The British journal of general practice : the journal of the Royal College of General Practitioners.

[9]  U. Merle,et al.  [Long COVID: care and support needs from the perspective of "long-haul" patients and primary care practitioners - a mixed-methods study from Baden-Wuerttemberg]. , 2022, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen.

[10]  T. Fehr,et al.  Impact of the COVID-19 pandemic on emergency outpatient consultations and admissions of non-COVID-19 patients (ECCO)—A cross-sectional study , 2022, PloS one.

[11]  Russell A. Matthews,et al.  Normalizing the Use of Single-Item Measures: Validation of the Single-Item Compendium for Organizational Psychology , 2022, Journal of Business and Psychology.

[12]  C. Wiedermann,et al.  Challenges and experiences of general practitioners during the course of the Covid-19 pandemic: a northern Italian observational study—cross-sectional analysis and comparison of a two-time survey in primary care , 2022, Family practice.

[13]  S. Riedel-Heller,et al.  [Views on Retirement by General Practitioners]. , 2022, Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)).

[14]  Aleksandra J. Borek,et al.  Experiences and concerns of health workers throughout the first year of the COVID-19 pandemic in the UK: A longitudinal qualitative interview study , 2022, PloS one.

[15]  S. Golder,et al.  GP wellbeing during the COVID-19 pandemic: a systematic review , 2022, The British journal of general practice : the journal of the Royal College of General Practitioners.

[16]  P. Nilsen,et al.  Working conditions in primary healthcare during the COVID-19 pandemic: an interview study with physicians in Sweden , 2022, BMJ Open.

[17]  O. Senn,et al.  The impact of the COVID-19 pandemic on the continuity of care for at-risk patients in Swiss primary care settings: A mixed-methods study , 2022, Social Science & Medicine.

[18]  K. Bloor,et al.  General practitioner well-being during the COVID-19 pandemic: a qualitative interview study , 2022, BMJ Open.

[19]  U. Merle,et al.  Stressors faced by healthcare professionals and coping strategies during the early stage of the COVID-19 pandemic in Germany , 2022, PloS one.

[20]  L. Jacob,et al.  Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany , 2022, Journal of Cancer Research and Clinical Oncology.

[21]  E. Baum,et al.  Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review , 2021, Frontiers in Public Health.

[22]  A. Schrimpf,et al.  The Impact of the COVID-19 Pandemic on Avoidance of Health Care, Symptom Severity, and Mental Well-Being in Patients With Coronary Artery Disease , 2021, Frontiers in Medicine.

[23]  Roger L. Brown,et al.  COVID-Related Stress and Work Intentions in a Sample of US Health Care Workers , 2021, Mayo Clinic Proceedings: Innovations, Quality & Outcomes.

[24]  James F Fitzgerald,et al.  Minimizing COVID-19 disruption: Ensuring the supply of essential health products for health emergencies and routine health services , 2021, The Lancet Regional Health - Americas.

[25]  R. Braun-Dullaeus,et al.  Healthcare professionals’ perceptions of impacts of the Covid-19-pandemic on outpatient care in rural areas: a qualitative study , 2021, BMC Health Services Research.

[26]  L. Harst,et al.  [The role of university hospitals in regional health care management for coping with the COVID-19 pandemic]. , 2021, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen.

[27]  L. Kroll,et al.  COVID-19 Vaccination in Medical Practices in Germany. , 2021, Deutsches Arzteblatt international.

[28]  J. Desborough,et al.  Ensuring the continuation of routine primary care during the COVID-19 pandemic: a review of the international literature , 2021, Family practice.

[29]  E. Cvejic,et al.  COVID-19 challenges faced by general practitioners in Australia: a survey study conducted in March 2021. , 2021, Australian journal of primary health.

[30]  M. Bismark,et al.  “Covid Just Amplified the Cracks of the System”: Working as a Frontline Health Worker during the COVID-19 Pandemic , 2021, International journal of environmental research and public health.

[31]  H. Goossens,et al.  Supporting Primary Care Professionals to Stay in Work During the COVID-19 Pandemic: Views on Personal Risk and Access to Testing During the First Wave of Pandemic in Europe , 2021, Frontiers in Medicine.

[32]  K. Goetz,et al.  Facilitators and barriers for the implementation of telemedicine from a local government point of view - a cross-sectional survey in Germany , 2021, BMC Health Services Research.

[33]  E. van Ginneken,et al.  Transformations in the landscape of primary health care during COVID-19: Themes from the European region , 2021, Health Policy.

[34]  Elisabeth Mahase General practice needs rescue package to prevent burnout and preserve care, warns RCGP , 2021, BMJ.

[35]  S. Meister,et al.  The Role of Physicians in Digitalizing Health Care Provision: Web-Based Survey Study , 2021, JMIR medical informatics.

[36]  I. Schäfer,et al.  The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study , 2021, BMC Family Practice.

[37]  F. Walter,et al.  Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views , 2021, BJGP open.

[38]  H. Goossens,et al.  Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries , 2021, The British journal of general practice : the journal of the Royal College of General Practitioners.

[39]  M. Theodoridou,et al.  Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals , 2021, Archives of Medical Research.

[40]  Gemma A. Williams,et al.  Providing health services effectively during the first wave of COVID-19: A cross-country comparison on planning services, managing cases, and maintaining essential services , 2021, Health Policy.

[41]  M. Rutter,et al.  Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618 161 people in primary care , 2021, BMJ Quality & Safety.

[42]  C. Collins,et al.  How COVID-19 has affected general practice consultations and income: general practitioner cross-sectional population survey evidence from Ireland , 2021, BMJ Open.

[43]  S. Mache,et al.  Job Demands, Resources and Strains of Outpatient Caregivers during the COVID-19 Pandemic in Germany: A Qualitative Study , 2021, International journal of environmental research and public health.

[44]  Sabine Kuhlmann,et al.  Multi-level responses to COVID-19: crisis coordination in Germany from an intergovernmental perspective , 2021, Local Government Studies.

[45]  T. Hendel,et al.  Nurses' occupational satisfaction during Covid-19 pandemic , 2021, Applied Nursing Research.

[46]  David A. Drew,et al.  Attributes and predictors of long COVID , 2021, Nature Medicine.

[47]  J. Verster,et al.  The Use of Single-Item Ratings Versus Traditional Multiple-Item Questionnaires to Assess Mood and Health , 2021, European journal of investigation in health, psychology and education.

[48]  L. Kalabay,et al.  To prevent being stressed-out: Allostatic overload and resilience of general practitioners in the era of COVID-19. A cross-sectional observational study , 2021, The European journal of general practice.

[49]  M. Sivan,et al.  A Multidisciplinary NHS COVID-19 Service to Manage Post-COVID-19 Syndrome in the Community , 2021, Journal of primary care & community health.

[50]  N. Bragazzi,et al.  COVID-19 pandemic-related anxiety, distress and burnout: prevalence and associated factors in healthcare workers of North-West Italy , 2021, BJPsych Open.

[51]  Hamzeh Mohammad Alrawashdeh,et al.  Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study , 2020, BMC Public Health.

[52]  H. Chevalier,et al.  Family medicine practitioners’ stress during the COVID-19 pandemic: a cross-sectional survey , 2020, BMC Family Practice.

[53]  C. Heidemann,et al.  Care for the chronically ill in Germany – The challenges during the COVID-19 pandemic , 2020, Journal of health monitoring.

[54]  M. Wensing,et al.  Beliefs and practices among primary care physicians during the first wave of the COVID-19 pandemic in Baden-Wuerttemberg (Germany): an observational study , 2020, BMC Family Practice.

[55]  C. Vindrola‐Padros,et al.  Frontline healthcare workers’ experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal , 2020, BMJ Open.

[56]  M. Schuers,et al.  How GPs adapted their practices and organisations at the beginning of COVID-19 outbreak: a French national observational survey , 2020, BMJ Open.

[57]  N. Peek,et al.  Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study , 2020, The Lancet Public Health.

[58]  T. Greenhalgh,et al.  Management of post-acute covid-19 in primary care , 2020, BMJ.

[59]  E. Halcomb,et al.  The Experiences of Primary Healthcare Nurses During the COVID‐19 Pandemic in Australia , 2020, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[60]  G. Riva,et al.  The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study , 2020, Frontiers in Psychology.

[61]  K. Khunti,et al.  Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[62]  P. Van Royen,et al.  Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs , 2020, BMJ Open.

[63]  T. Shanafelt,et al.  Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. , 2020, JAMA.

[64]  Pascal Wild,et al.  Practice Organization Characteristics Related to Job Satisfaction Among General Practitioners in 11 Countries , 2019, The Annals of Family Medicine.

[65]  T. Green,et al.  Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study. , 2017, The British journal of general practice : the journal of the Royal College of General Practitioners.

[66]  K. Rodham,et al.  Lost to the NHS: a mixed methods study of why GPs leave practice early in England , 2016, The British journal of general practice : the journal of the Royal College of General Practitioners.

[67]  Aaron George,et al.  Stressed and overworked? A cross-sectional study of the working situation of urban and rural general practitioners in Austria in the framework of the QUALICOPC project , 2015, Croatian medical journal.

[68]  Anna Selva Olid,et al.  Medical students’ perceptions and attitudes about family practice: a qualitative research synthesis , 2012, BMC medical education.

[69]  David Reeves,et al.  Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. , 2011, European journal of public health.

[70]  M. Clarke,et al.  Methods to increase response to postal and electronic questionnaires , 2023, The Cochrane database of systematic reviews.

[71]  J. Drennan,et al.  Cognitive interviewing: verbal data in the design and pretesting of questionnaires. , 2003, Journal of advanced nursing.

[72]  D. G. Gardner,et al.  Single-Item Versus Multiple-Item Measurement Scales: An Empirical Comparison , 1998 .