BACKGROUND: Job satisfaction has been associated with intentions to quit and aspects of quality of care. In 2001, GP job satisfaction in England had fallen to its lowest point for over a decade. AIM: To assess GP job satisfaction and stressors immediately prior to implementation of the 2004 contract. DESIGN OF STUDY: National survey of a random sample of GPs. SETTING: England. METHOD: One thousand, nine hundred and fifty principal and salaried GPs surveyed in February 2004 were compared with 1828 principals surveyed in 1998 and 1841 principal and salaried GPs surveyed in 2001. Job satisfaction and stressor scores were adjusted for 2004 age-sex distributions. Determinants of overall satisfaction were examined through ordinary least squares regression. RESULTS: The 2004 response rate was 53%. GPs were most dissatisfied with hours of work, recognition for good work and remuneration, and experienced most pressure from paperwork, increasing workloads and having insufficient time. The majority of doctors were satisfied with their job overall. Satisfaction was higher than in 2001 and approximately the same as in 1998. Overall stress in 2004 was lower than in 2001 but still higher than in 1998. After allowing for personal, practice and job characteristics, higher satisfaction was associated with lower job stress, involvement in decision making, increasing job interest and ability to meet conflicting demands. CONCLUSIONS: Despite recent initiatives to enhance workforce capacity and working lives for GPs, workload, time pressures and job control remain potential areas of concern. Addressing such issues may be key to maintaining morale as the new contract is implemented.
