Optimising professional life: a grounded theory of doctors' careers

Abstract

This thesis presents the Theory of Optimising Professional Life - a new career theory derived from the professional lives of experienced general practitioners (GPs) working in Australia. GP careers involve a portfolio of clinical and non-clinical roles and are most often forged in small, non-hierarchical, private business organisations. This career structure does not conform to the traditional notion of a linear upward progression that underpins many career theories. Furthermore, existing career theories do not reflect the Australian medical context, including the concerns, needs and behaviours of doctors working in Australia. The Theory of Optimising Professional Life was discovered using Glaser’s grounded theory method and a quantitative analysis of survey responses collected for the ‘Medicine in Australia: Balancing Employment and Life (MABEL)’ study. The Theory is compared and contrasted with Dawis and Lofquist’s Theory of Work Adjustment, Super’s career development theory, Patton and McMahon’s Systems Theory Framework and Arthur’s boundaryless career. This thesis found that the main concern GPs have when shaping their professional lives is sustainment - a concept encompassing the aspirational nature of GP career development while also recognising the need for self-care and financial reward. Dynamic tension exists among the three elements of sustainment: the need for self-care to sustain well-being, the need for work interest to sustain motivation and the need for financial reward to sustain lifestyle. This research reveals that GPs satisfy these needs by implementing solutions within four dimensions of professional life: clinical work treating patients, structuring the work day, integrating work-life balance and adapting oneself. The Theory of Optimising Professional Life contributes an occupation specific theory of person-environment fit that includes a dynamic approach to career development where career decisions and events are influenced by previous experiences of vocational adjustment. The Theory can be used by experienced GPs to develop their careers and the way they participate in the clinical workforce. In addition, this Theory provides a new perspective for the design and implementation of GP workforce policy that integrates the structural or organisational dimensions of an issue with the psychological dimensions. Show more