Work Centrality

Work, like other aspects of life, can have varied meanings to different individuals. At one extreme are individuals who regard work as the centre of their life. For these

individuals work is very important, and may provide meaning and purpose. At the other extreme there are individuals who regard work as important, but other areas of life are also important. Centrality of work to an individual can be placed on a continuum divided into two sub categories, absolute centrality and relative centrality. In absolute centrality

the individual perceives work as the most important aspect of their life. In relative centrality, the individual can adapt the level of involvement in work according to

circumstance or situation, such as during periods of child rearing, or shift in involvement in leisure activity (Harpaz, Claes, Depolo, & Quintello, 1992; MOW International

Research Team, 1987). The findings in the current study indicated that participants could be placed on a continuum between absolute and relative work centrality. Furthermore, as the case study of Jeff that follows in section 8.9 illustrates, it is also possible that the degree of work centrality can shift over time.

When work has a high degree of centrality individuals will tend to immerse

themselves in work, and spend more time in work roles. Work provides an opportunity to perform activities that provide the strongest affective self investment (Dubin & Goldman 1972). Traditionally medicine has been characterised by a high level of work centrality. The doctor was perceived as inseparable from his or her occupational role, and always supposed to be ‘on the job’ (Zerubavel, 1979). Medicine was viewed as a vocation or life calling, which implies a commitment to this life domain above all else. The intrinsic and extrinsic rewards gained from being a doctor, that is social status, financial remuneration, and a personal sense of meaning makes it likely that work will be highly regarded and a central interest in one’s life.

Although some research (e.g., Lupton, 1997) suggests the status of ‘doctor’ in society has declined, a doctor is still generally regarded as having high social status, and is a highly regarded professional, which reinforces the meaning and salience of work to the individual. Several over 40 year old participants mentioned they no longer received the same degree of deference from their patients. For example, in the past, patients would not question the diagnosis and or recommended treatment. Participants commented that with information now being readily available on the internet, patients were less inclined to

accept the GPs’ recommendation without question, and were more inclined to seek a second opinion. One participant also mentioned that patients would accept mobile phone calls during their consultation. This caused her irritation, and she considered this was an example of how in particular ‘educated women’ did not show respect. While some participants noticed a change in how patients related to them, the majority of participants still believed their work was important, and that being a doctor was the best job because you could “make a real difference in people’s lives” and it was the “next best job to being a priest”.

In this study, participants who reported that work occupied a highly central role in their life strongly identified with their work as a GP. They stated their work came first, and put their work before all else, with work taking precedence over other life domains. Conversely, other participants stated that while work was important, other aspects of their lives, such as family and religion, were also important.

Participants whose work was an absolute central life interest spent more time and energy at work, and tended to integrate their work and non-work domains by bringing work into their home. It may be that this tendency for absolute work centrality and bringing work into non-work/family domains is a characteristic of the medical profession that is shifting with the changing work expectations of younger generations of GPs (Tolhurst & Stewart, 2004). In a study of hospital doctors and nurses 23 years ago, Yalof (1988) found that it was not possible for individuals in these job roles to completely leave their patients at work; they always take home in their thoughts, the issues experienced by their patients. In the current study, some participants were successful in their ability to leave work at work because they consciously adopted ways of ‘switching off’ during their non-work time. However, some participants were better able to segment work from non-

work domains, remaining involved in both work and non-work roles, but maintaining a strong boundary between domains.

The degree of work centrality influenced GP preferences for allocating time to

competing roles and life domains, and also appeared to be associated with preferences for integration or segmentation of work. Participants either allowed or restricted work

demands to intrude on non-work/family time and circumstances. Participants with absolute work centrality stated their work was an important aspect of their lives; they were happy to accept calls from patients at home and engage in work related activities outside their usual business hours. They also stated they had no intention of retiring. Participants with relative work centrality commented that there was “life outside medicine” and that “time out (from work) was the key” to dealing with the demands of general practice.