“There is never any rest, never enough time and too much to do”: a qualitative study of GP work intensity in an Irish context
摘要
Globally, general practice faces recruitment and retention challenges as many countries struggle to meet the rising demand for primary care. Ireland also faces increased demand for primary care as a result of its ageing population, increased incidence of chronic illness and greater patient complexity. Significantly more GPs will be needed to meet this increased demand. Further challenges facing Ireland’s GP workforce include the fact that one quarter of GPs in Ireland are aged over 60 years old and changing working patterns by GPS which have seen GPs reduce their patient-facing hours. Work intensity is one of the factors driving GPs to change their working patterns. This paper identifies the key sources of work intensity in general practice in Ireland and considers how to improve GPs’ experiences of work with a view to improving GP wellbeing and retention.
MethodsThe study used a qualitative method of remote ethnography, with 20 participant GPs. Each GP participated in two semi-structured interviews and an eight-week instant messaging conversation via Threema. Ethical approval was granted by the institutional ethics committee and data collection took place from October 2024 to July 2025.
ResultsParticipant GPs described a high level of work intensity, describing a “relentless” pace, long hours, and little opportunity for breaks. Sources of work intensity included GPs’ expanded scope of care, increased patient complexity, patient demands and the administrative workload. Participant GPs highlighted practice-level strategies that might reduce work intensity, including protected administrative time, and longer appointment times for complex patients. The results of the study are discussed in the context of the individual, organisational, and system-level solutions that may be deployed to address work intensity in general practice.
ConclusionsGeneral practice in Ireland is under considerable pressure, with increased work intensity driven by multiple sources. In response targeted strategies are necessary to reduce intensity and improve GPs’ experiences of work. In order to protect GP wellbeing, improve GP retention and secure the future sustainability of the GP workforce, the causes of work intensity must be better understood and factored into GP workforce planning.