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GP non-principals in north-east Scotland--a valuable pool of medical labour or second-class citizens? Results of a questionnaire survey.

OBJECTIVES
(1) To identify all general practitioner [GP] non-principals in the Grampian Health Board area (north-east Scotland), (2) To seek their views via a questionnaire survey, (3) to offer them the opportunity to meet individually with an Associate Adviser [GP Tutor].


DESIGN
All GP practices were contacted, requesting the names of non-principals. A questionnaire was sent, where possible, to all non-principals so identified.


SETTING
The Grampian Health Board area in north-east Scotland.


SUBJECTS
One hundred and nine names were obtained, 90 questionnaires were mailed and a final response rate of 67 per cent was achieved.


RESULTS
Eighty-seven per cent of respondents were female (median age--35 years); 92 per cent were vocationally trained; 89 per cent had at least one postgraduate qualification; 32 per cent had been a principal; 68 per cent agreed to meet with an Associate Adviser. There was considerable confusion regarding entitlement to funding for continuing medical education [CME]. Advantages of working as a non-principal included the flexibility of working part-time and limited involvement in practice administration and out-of-hours work. However, many disliked their inferior conditions of employment, their inability to follow up patients and the negative attitudes displayed by some principals. Feelings of professional isolation, lack of involvement in practice decision-making and employment insecurity were also cited as disadvantages. Short-term career plans included maintaining the status quo (45 per cent); increasing work commitment (26 per cent) or becoming a principal (11 per cent), while in the longer term, 67 per cent of those intending to remain in general practice wished to do so on a part-time basis. The main factors determining career plans were family commitments and/or availability of suitable posts.


CONCLUSIONS
Demand for part-time principal posts will undoubtedly increase. Regional databases of non-principals must be established and all GPs must have equal access to CME particularly in the light of the General Medical Council's [GMC] pronouncements on revalidation of all doctors.