Coping with change in public health medicine in the 1990s

Investigates the effect of change, both structural and in process, in the NHS with regard to the capacity of public health doctors and dentists in the South Western Regional Health Authority to cope with the inherent stresses. Sixty-three public health doctors and dentists were asked to fill in a questionnaire. Satisfaction was expressed most with factors intrinsic to the job (41%) followed by the role in the organization (24%), relationships at work (21%), career development (8%), and organizational structure and climate (6%). Dissatisfaction was identified with factors related to organizational structure and climate (32%), factors intrinsic to the job (30%), the role in the organization (18%), career development (14%) and relationships at work (6%). Overall there was much more dissatisfaction than satisfaction with organizational structure and climate and career development than with the other factors. Improvements suggested included more support staff and improved training. Joint problem solving sessions with managers to identify what is required to co-ordinate the work of both, and the use of time management techniques might be helpful.