Retirement, job satisfaction and attitudes towards mandatory accreditation: a Danish survey study in general practice

OBJECTIVES: This study aims to analyse the associations between general practitioner (GP) retirement, job satisfaction and attitudes towards a mandatory accreditation scheme. External interventions such as mandatory accreditation schemes may be perceived negatively by GPs, causing early retirement from practice. In Denmark, almost half of the GPs had negative attitudes prior to the implementation of a mandatory accreditation scheme, constituting a possible risk of early practice retirement. SETTING: In January 2015 all 3,404 Danish GPs were invited to participate in a survey on attitudes towards a forthcoming mandatory accreditation programme. PARTICIPANTS: 1,906 GPs (56%) answered the questionnaire. In total, 391 (11%) retired from practice in the following period from 1 January 2015 to 31 January 2017. Of these, 193 GPs (49%) answered the questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was GP retirement. Labour union data on practice retirement were linked with data from the questionnaire survey on job satisfaction and attitudes prior to implementation of mandatory accreditation. Logistic regression analyses were used to determine the associations between practice retirement and job satisfaction and attitudes towards accreditation. RESULTS: Practice retirement was associated with job dissatisfaction (OR: 2.5, 95% CI 1.6 to 3.7). Retirement was not associated with any of the other surveyed attitudinal variables. Retirement rate was relatively high in the accreditation start-up period. CONCLUSION: Practice retirement was associated with job dissatisfaction but not to a priori attitudes towards an upcoming mandatory accreditation programme. However, the retirement rate was relatively high in the start-up period of the accreditation programme. Future research should evaluate the effects of external interventions on preterm retirement from general practice. TRIAL REGISTRATION NUMBER: NCT02762240.