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

Abstract

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.