Does GP income meet expectations? The impact on job satisfaction

Today, we’re speaking to Dr Ben Walker, a post-doctoral associate based at the University of Calgary, who conducted this work while working at the University of Manchester.

Title of paper: Relationships of actual and expected levels of income with GP job satisfaction: repeated cross-sectional study

Available at: https://doi.org/10.3399/BJGP.2025.0683

Recruitment and retention of GPs remains an issue for general practice in England. This work examined the relationship between actual income and income expectations with job satisfaction and intentions to quit. Higher actual income was found to be associated with job satisfaction, but there was little evidence to show that it was associated with intentions to quit. A key and novel finding was that higher income expectations were associated with both lower job satisfaction and higher intentions to quit. The findings suggest that policies that help GPs build accurate income expectations, such as increased transparency for incomes for different GP job roles, may be a means of addressing job dissatisfaction caused by discrepancies between expected and actual income for GPs.

Transcript

This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.

Speaker A

00:00:01.040 - 00:00:58.350

Hello and welcome to BJJP Interviews. I'm Nada Khan and I'm the Senior Research editor at the bjjp. Thanks for taking the time today to listen to this podcast.

In today's episode we're talking to Dr. Ben Walker.

Ben used to be based as a research fellow at the University of Manchester, but is now working as a postdoctoral associate at the University of Calgary in Canada.

We here to talk about the paper he's just published in the BJ GP that's titled Relationships of Actual and Expected Levels of Income with GP Job Satisfaction. A Repeated Cross Sectional Study.

So, hi Ben, it's really nice to meet you and to talk about this work and I guess to start us off, I just wanted to talk a little bit about the background to this paper and it's about GP income and job satisfaction, which is clearly a topic that people have plenty of opinions about. But what made you want to look at this question in a bit more detail?

Speaker B

00:00:58.590 - 00:02:08.930

So, yeah, it's something we had been discussing internally as a team for a while, obviously, I mean, working in a primary care group, a lot of the driving motivation for a lot of our work is the GP recruitment and retention crisis. And we've always had, we've had this data for a while on GP income from us via our surveys.

We've also had this data on GP income expectations and this has been in the survey forever and we've never, we hadn't used anything with it and basically because a lot of us are economists as well as this concept in economics of the Easterland Paradox or the idea that relative income matters more than actual income for happiness.

And so we decided that, well, it would be like, like because we are interested in the GP recruitment and retention crisis, it would be interesting to look at the extent to which relative income matters for GP recruitment and retention. So job satisfaction and intentions to quit being two components of recruitment and retention.

Speaker A

00:02:09.330 - 00:02:14.290

So you mentioned about a survey. So are you talking about the GP Work Life Survey that was done through Manchester?

Speaker B

00:02:14.370 - 00:02:17.130

We are indeed, yeah. So the GP Work Life Survey.

Speaker A

00:02:17.130 - 00:02:28.110

Yeah, yeah. So talk us through that just briefly. So what was that all about? I think, I mean there have been a few publications in the BJGP about it, but what.

Who are you surveying through that?

Speaker B

00:02:28.590 - 00:03:18.400

So the GP Work Life Survey has been going since I believe, 1998.

It's been run by Manchester for I believe, all of its history and it's a government funded survey and when we do it we are attempting to a sample of the general GP population to basically ask about various things to do with their work life, including more sort of like formal things like their income and how many hours they're working, but also just how satisfied they are with their jobs, different aspects of their jobs. Yeah, so we collect lots of data on the GP to respond, and, yeah, we aim to get as general a sample of a population as we can.

Speaker A

00:03:18.800 - 00:03:40.000

And I think one of the really interesting things about this study is that you're not just asking how much GPs actually earn, but how much they think they should earn.

And you mentioned about this paradox that you're interested in in terms of health economics, and I wonder why you think that distinction is important between actual earnings and sort of relative earnings or how much people think they should earn.

Speaker B

00:03:40.990 - 00:04:21.630

So I guess with a lot of things in life, and obviously from this economics paradox, a lot of things are not. It's not necessarily what you have. Absolutely.

A lot of it is driven by things like peer comparison, or if you're seeing that someone else is getting paid more for doing what you believe is like, similar amount of work or similar quality work to you.

So the idea of pure comparison's always just been like, important and there's lots of data out there and lots of studies looking at sort of the effect of absolute income. And this just felt like another relevant dimension to explore, basically.</p