Values, stress, and coping among practicing family physicians

Objective: To determine the types of values, sources of stress, and methods of coping in a sample of community-based practicing family physicians who were determined as healthy and satisfied with their careers. Design: Qualitative study, combining an interview guide approach with a standardized open-ended interview. Setting: Offices of practicing physicians in Ohio. Participants: A purposeful sample of 10 central Ohio family physicians, ranging in age from their mid-30s to mid-60s; 8 were married; 2 were African American; 3 practiced in a rural environment: 3 worked in a solo practice, 5 in a partnership, and 2 in a group practice. The sample was identified by a knowledgeable informant, using a criterion of success in coping with occupational stress and satisfaction with the practice of medicine. Main Outcome Measure: Patterns and themes common to the interviews. Results: Primary values presented by the sample included caring, diversity, control, family, and spirituality. Sources of stress involved overload, the nature of today's medical environment, and demanding patients. Coping strategies consisted of problem solving, developing a positive perspective, stress monitoring, support, and ''time for self.'' Stress was often produced when a conflict existed between the person and the work environment. Stress was also created when the manifestation of values was unhealthy and unbalanced. Conclusions: Research participants described various learned strategies that enabled them to cope more effectively with stress. These were often developed after personal struggles with work or family. Results suggested that assessing the developmental processes in physician stress and coping is important.