Managing Multiple Roles at Work

Each day, people engage in, and move between various roles at work, home, and other places (Ashforth, Kreiner, Fulgate, 2000). Participants in this study acknowledged that they were faced with an increasing number of profession-based roles (clinician, counsellor, social worker, business person, team leader) as well as the familial and social roles outside of work. Kim, a practice partner, identified the multiple roles she engaged in during a working day in general practice. She explained:

I think there are a number of roles. We’re facilitators to help patients through the health system which can often by quite tricky. We’re the gate keepers for Medicare and we are the support person for that person who is sick or in need, apart from the healing and physician aspect.

In a typical work day Kim was transitioning between several in-work roles that were bounded by both physical location and time spent at work in the roles. Moving from one

role to another involved a series of role engagements and role disengagements, but did not cause her significant distress or intra-role conflict. Depending on the requirements of the patient she moved between roles such as counsellor, facilitator, or clinician. Although this combination of roles involved different behavioural components, the roles allowed Kim to maintain her overall GP role identity because they took place within the time and space (location) of her GP work.

6.1.1 Experiencing Role Conflict

Role conflict has been identified as a common occupational stressor, that can occur when there is a sense of incompatibility between demands within a role (intra-role conflict), or between one role and another (inter-role conflict) (Greenhaus & Beutell, 1985). The majority of participants in this study who were business principals or partners experienced intra-role conflict, to varying degrees between their clinical and business activities within the GP role. Robert, a suburban principal explained his experience of intra-role conflict between his clinician activities and his business activities. He did not perceive he had a choice about how business was structured in general practice. Robert resented the additional business demands of his practice, and did not enjoy this aspect of his work. He recounted:

I don’t enjoy the administration part of practice, in fact I hate that, but that’s an important part of the practice. It is by default a small business and I use the word by default because it’s not by choice. I wouldn’t be running a small business by choice; but you can’t practice the sort of general practice that I want to practice without it being in a small business setting. Conversely, Kate, found her clinical and business activities interesting, and did not experience dissonance within her GP role. She enjoyed the business aspects of her practice as well as the clinical aspects. She explained:

It’s important that GP practices do a good job as a well run business so that people will work there. This one’s been hugely successful attracting people because there are proper procedures and contractual arrangements and well organised rosters and all the good HR practices that need to happen in any business. It’s been really good fun putting all of this (business and premises) together; the financial things like the money and choosing the property and all of that, I like all that. There are not very many GPs who are entrepreneurial but there’s a few.

Only one salaried participant identified intra-role conflict within his GP clinical role. Luke, a rural salaried GP, completed his medical training in Europe. He identified a culturally different perspective regarding the clinical GP role in Australia He explained the differences, and the influence on his perceptions of what being a GP entailed:

Work Cover11 patients are not my favourites. I think there is a bit of a cultural difference in the medical system that I was trained in. They (Work Cover doctors) were a separate specialty in Europe who dealt with all work related issues not the GP. You were not involved in making the decision about whether the patient should be working or not working, whereas here you are. I don’t always feel that I’m able to know enough about a particular workplace to make that decision to work it all out. And sometimes if you have to disagree with the patient it can be unpleasant.

Luke disliked the responsibility of deciding whether a patient should return to work or receive Work Cover entitlements. He considered that this type of judgement was outside the scope of his clinical role, and beyond his knowledge and expertise.

Some participants identified another source of role conflict that related to

Government and administrative bureaucracy. Alice, described her frustration and lack of control over having to carry out secondary tasks such as “paperwork” and “red tape” required by the Government. This intruded on the satisfaction she gained from the primary task of face-to-face consultations and patient care. She explained:

We do a lot of paperwork. I feel like a secretary. Clinical decision-making and things like that are much more satisfying.

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In summary, the two sections above have outlined the ways several participants in this study experienced conflict within their GP role. Luke, Robert, Kate and Alice experienced the multiple roles inherent in general practice in different ways. Luke and Robert disliked some aspects of their work roles, and experienced intra-role conflict whereas Kate had a positive attitude to her various GP roles. Alice believed that her job satisfaction was compromised when she was engaged in activities that were “forced” upon her due to Government requirements. She believed these administrative type activities impinged on the time available for the clinical care of her patients.