Effectiveness of cognitive behavioural coaching in improving the well-being and retention of rural general practitioners.

OBJECTIVE: To determine the relationship between cognitive behavioural coaching, the well-being of rural general practitioners (GPs), their intentions to leave and actual leaving of rural general practice. DESIGN: Quasi-experimental study utilising an intervention group of rural GPs and deidentified data for a baseline group and a control group consisting of the remaining population of rural GPs in South Australia. SETTING: Rural general practice. PARTICIPANTS: Rural GPs in South Australia: intervention group (n = 69), baseline group (n = 205) and control group (n = 312). INTERVENTIONS: A 9-hour cognitive behavioural coaching program. MAIN OUTCOME MEASURE(S): Rural doctor distress, intention to leave rural general practice and actual retention rate of rural GPs. RESULTS: GPs who underwent cognitive behavioural coaching had lower rural doctor distress scores (mean = 24.50; confidence interval, 21.71-27.29) than the baseline group (mean = 28.63; confidence interval, 27.08-30.17). Before coaching, 81% of rural GPs in the intervention group had considered leaving general practice, which reduced to 40% after coaching (χ(2) (2) = 16.31, P < .001). Over a 3-year period, 94% of the coaching group remained in general practice compared with 80% of the control group (χ(2) (1) = 4.89, P = 0.027). CONCLUSIONS: Cognitive behavioural coaching reduced the stress levels of rural GPs who self-identified the need for managing stress and reduced their intention to leave rural general practice. Further, despite initially being more stressed compared with the general population of rural GPs, more GPs from the coaching group remained in rural general practice.

Impact of support initiatives on retaining rural general practitioners.

OBJECTIVE: This study aimed to evaluate the impact of the Dr DOC program, a rural doctor workforce support program, which consists of social and psychological support and practical interventions, on the well-being and retention of rural GPs. DESIGN: Rural GPs were assessed on different aspects of well-being and their intentions to leave rural general practice, and these were compared with similar data collected two years prior. SETTING: Rural general practices in South Australia. PARTICIPANTS: Two hundred and twenty-one rural GPs (55% of South Australian rural GP workforce). MAIN OUTCOME MEASURES: GPs completed a questionnaire assessing their levels of support, intention to leave rural practice, use of the dr doc program, and psychological health. RESULTS: Improvements were found in the support networks and in the physical and emotional health of rural GPs from time 1 to time 2. There was also a reduction in the number of GPs wanting to leave rural general practice in the short to medium term (from 30% to 25%). CONCLUSIONS: The initial study in this series suggested that improving psychological well-being might influence rural GPs' intentions to leave rural practice. The current study confirms these suggestions by demonstrating that programs targeted at psychological and physical well-being do indeed impact on rural GPs' intentions to leave. The results of this study highlight the role of psychological well-being in retaining rural GPs and emphasise the value of developing psychologically based programs to not only boost the physical and mental health of GPs, but also to reduce departure from rural areas.