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. 2026 Feb 6;26:346. doi: 10.1186/s12913-026-14158-1

Intensified job demands among general practitioners in Finland: associations with work engagement, job satisfaction, and recovery

Outi Öhman 1,2,✉, Taina Hintsa 3, Nina Tusa 1,4, Tiina Ahonen 5, Pekka Mäntyselkä 1,2
PMCID: PMC12973753  PMID: 41652442

Abstract

Background

Working life has become increasingly demanding due to rapid socioeconomic and technological changes. Intensified job demands (IJDs) involve increased work pace, workload, and multitasking, increased requirements for autonomous planning and decision-making regarding daily work and careers, and a continuous need to update one’s knowledge and skills. Depending on their nature, IJDs may represent either positive challenges or strain-inducing stressors for employees. Healthcare professionals face increasing demands from evolving medical practices, an aging society, digitalization, and resource limitations. However, evidence of IJDs and their consequences in primary healthcare is scarce. This study examines the IJDs perceived by general practitioners (GPs) and their associations with well-being at work, operationalized via work engagement, job satisfaction, and recovery from work.

Methods

Data were gathered via an online questionnaire among Finnish GPs in 2023. IJDs were measured with the Intensification of Job Demands Scale. Work engagement was measured with the 9-item Utrecht Work Engagement Scale, and job satisfaction and recovery from work were measured with single-item scales. The Mann-Whitney U test and Kruskall-Wallis test were used for group comparisons. The associations between IJDs and well-being at work were analyzed by calculating correlations and running a hierarchical linear regression.

Results

The study sample consisted of 507 Finnish GPs. The IJDs most experienced by GPs were work intensification and intensified learning demands. Female GPs reported higher levels of work intensification (p < 0.001) and intensified learning demands (p < 0.001) than male GPs. Public sector GPs reported higher levels of work intensification (p < 0.001) and intensified learning demands (p = 0.007) than GPs in other sectors. Work intensification was associated with decreased work engagement (β = -0.19, p < 0.001), job satisfaction (β = -0.36, p < 0.001), and recovery from work (β = -0.32, p < 0.001).

Conclusions

Work intensification and intensified learning demands represent significant challenges in primary healthcare, particularly among female and public sector GPs. Work intensification, characterized by increased time pressure, workload, and multitasking, may lead to decreased well-being at work among GPs. This should be considered when organizing the daily work and allocating resources in primary healthcare. Further research is needed to gain more evidence of the underlying reasons and consequences of IJDs for well-being at work.

Keywords: Intensified job demands, Work intensification, Primary health care, General practitioner, Work engagement, Job satisfaction, Recovery from work, Well-being at work

Introduction

Background and aim

Rapid advancements in medical practices, the growing health needs of an aging society, and digitalization present new challenges for healthcare professionals. In general, work has become more demanding and intense due to the rapid socioeconomic and technological changes in society, aiming at increased efficiency and performance [1–3]. These accelerated societal changes pose expectations for employees to work faster, acquire and update new skills and knowledge, and actively plan their work and careers - a phenomenon known as the intensification of job demands [4, 5].

Although the demanding nature of primary care physicians’ work and high burnout rates among general practitioners (GPs) are well-documented [6–8], opportunities for continuous learning may represent motivating challenges for GPs throughout their careers [9–11], suggesting that intensified job demands (IJDs) can also support the well-being of GPs. Despite this potential, IJDs have received limited attention in primary care research. This study addresses this gap by examining the IJDs among GPs in Finland and their associations with work engagement, job satisfaction, and recovery from work.

Intensified job demands and their associations with well-being at work

Intensified job demands (IJDs) are conceptualized as a multidimensional construct comprising five dimensions [5]: Work intensification refers to the quantitative increase in work effort, increased working speed and workload, multitasking, and reduced idle time [5, 12, 13]. Intensified job-related planning and decision-making demands are characterized by increasing expectations that employees autonomously plan and evaluate their work tasks and goals [5, 14]. Intensified career-related planning and decision-making demands mean that employees face increasing requirements to prove their worth and autonomously plan their future careers in the job market [5, 14]. The final two dimensions, intensified knowledge-related learning demands and intensified skill-related learning demands, refer to the need to keep up with technological, societal, and organizational changes and constantly update one’s theoretical knowledge and practical skills [5, 15, 16]. In addition to its multidimensional nature, the model of intensified job demands includes a dynamic aspect: an increase in work intensity over time [17].

The impact of job demands on well-being at work is described in several job stress models, arguing that job demands result in various adverse health outcomes, such as mental strain and burnout [18–20], especially when there is a lack of job resources, such as job control, social support, or rewards received from work [19, 21, 22]. However, the challenge-hindrance model of work stress argues that depending on the nature of the stressors, they may represent positive challenges that enhance job satisfaction, motivation, and professional development [23–25].

Based on the challenge-hindrance approach to work stress, IJDs can have both negative and positive consequences for employee well-being [24–27]. There is increasing evidence that the quantitative dimensions of IJDs, such as workload and time pressure, act as hindrance stressors and are associated with strain, burnout, job dissatisfaction, and decreased work engagement, learning, and task performance [5, 13, 28–34]. Furthermore, work intensification is associated with impaired self-assessed psychological health [35], cognitive stress symptoms [36], and psychosomatic and musculoskeletal symptoms [17, 37]. However, the cognitive dimensions of IJDs (intensified decision-making and learning demands) are related to employees’ autonomy, development, and self-actualization. Hence, these demands can function as challenge stressors, thereby enhancing work engagement, job satisfaction, learning, and organizational citizenship behavior [28, 29, 32–34].

Indicators of well-being at work used in this study

Well-being at work is a multifaceted concept that encompasses not only the physical and mental health of the employee, but also positive affect and work-related experiences such as motivation, vigor, meaningfulness, and satisfaction [38, 39]. In this study, well-being at work is operationalized via work engagement, job satisfaction, and recovery from work.

Work engagement is a positive, motivational, and fulfilling state of mind related to work, characterized by vigor, dedication, and absorption [40]. Work engagement is a widely used indicator of occupational well-being that seems to be valid and stable [41] and is associated with employee well-being and performance [42–45]. The associations between work engagement and IJDs seem to differ for the various dimensions of IJDs: work intensification is associated with decreased engagement, whereas moderately intensified learning demands may be related to increased work engagement [33].

Job satisfaction, which can be viewed as positive reactions and attitudes toward one’s job, is strongly related to employee health outcomes: low job satisfaction is associated with impaired mental health, such as burnout, depression, and anxiety, and with physical symptoms [46]. Job satisfaction is negatively related to work intensification [28, 47] and positively related to intensified learning demands [28], although evidence on these associations is scarce. Physicians’ job satisfaction is also important for the quality of health care and is related to the retention of physicians [48].

Recovery refers to both the process of lowering the strain levels elevated by stressors such as job demands and the psychological and physiological state that is reached after a recovery period [49]. Recovery experiences include psychological detachment from work, relaxation, mastery in off-job activities, and control over one’s activities during leisure time [50]. Recovery alleviates the negative effects of work-related stress and job demands on health [49, 51–54]. Job demands, such as time pressure and workload, hinder effective recovery [49], which in turn seems to mediate the effect of job resources on work engagement [53]. In the presence of high IJDs, psychological detachment from work may protect employees from emotional exhaustion [55].

Research questions and hypotheses

This study addresses the following research questions:

  1. What is the level of intensified job demands experienced by general practitioners, and does it vary according to gender, working sector, work experience, and working hours?

Primary health care struggles with resource constraints and staffing shortages across European and OECD countries [56–58]. Finland faces similar challenges [59, 60], especially characterized by the turnover of experienced GPs [61–64] and increased part-time work [61]. Over the past few years, the Finnish public healthcare system has undergone major organizational and structural reforms, aiming at increasing equality and cost-efficiency, and reducing public expenditure [65]. This, alongside the aging population with increasing health needs, digitalization of health care, and developments in medical practices, gives us a reason to expect that job demands have increased in general practice. Based on these contextual aspects, we hypothesize that GPs experience IJDs, especially the dimensions of work intensification and intensified learning demands (H1).

  • 2.

    How are the different dimensions of intensified job demands associated with (a) work engagement, (b) job satisfaction, and (c) recovery from work experienced by general practitioners?

Based on the challenge-hindrance approach to work stress [23–25] and the evidence regarding the outcomes of IJDs on employee well-being [5, 13, 28–34], we hypothesize that work intensification is a hindrance demand associated with decreased work engagement, job satisfaction, and recovery among GPs (H2a). Furthermore, given the well-established importance of autonomy and continuous learning for GPs [9–11], we hypothesize that intensified learning and decision-making demands represent challenge demands for GPs and are associated with increased work engagement and job satisfaction (H2b).

Methods

Participants and procedure

Data were collected in the fall of 2023 via an online questionnaire targeted at working-age GP specialists and trainees working in Finland. An invitation to participate in the study was sent to the chief physicians of well-being services counties and private primary care service providers, with an inquiry to distribute the invitation to GPs in their organizations. The invitation was also shared in private social media groups accessible exclusively to Finnish physicians and GP trainees.

The dataset was screened for indicators of low-quality responses (e.g., short completion times, straight-lining, highly incomplete or duplicate responses). No invalid responses were identified. Participants not engaged in working life at the time of the study (e.g., in maternal leave), or who had missing data regarding demographics or the measures used in the analyses, were excluded from the final sample. Demographic characteristics of the final sample corresponded well with the target population, indicating that a representative sample was obtained.

Measures

As background variables, gender, work experience in general practice in years, working time percentage (0–49%, 50–79%, 80–99%, 100% of the standard full-time 38.25 h/week), and primary employer were collected. For analyses, variables were categorized as follows: gender (male, female), work experience (< 10 years, 10–20 years, > 20 years), and working hours (full-time corresponding to 38.25 h/week, part-time < 38.25 h/week). According to the primary employer, the employment sector was defined as either public (wellbeing services county, state) or other (private employer, university, foundation, self-employed, other).

IJDs were measured with the Intensification of Job Demands Scale [5, 66], where the participants rated their experiences regarding the changes in their work during the past five years (or during the time they have worked in their current organization, if less than five years). The scale includes 19 items rated on a 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). Work intensification was measured with five items, e.g., “Ever more work has to be completed by fewer and fewer employees”. Intensified job-related planning and decision-making demands were measured with five items, e.g., “One increasingly has to check independently whether the work goals have been reached”. Intensified career-related planning and decision-making demands were measured with three items, e.g., “One increasingly has to plan one’s professional career independently”. Intensified knowledge-related and skill-related learning demands, which are measured with separate subscales in the original scale, were combined into one subscale of intensified learning demands and measured with 6 items, e.g., “One has to acquire new expertise for the job more often”. Intensified knowledge- and skill-related learning demands are conceptually overlapping and strongly correlated, and can therefore be treated as a single dimension [5, 33]. Reliability coefficients for the four subscales were acceptable (α = 0.71–0.91).

Work engagement was measured with the Utrecht Work Engagement Scale UWES-9 [40, 67], where the participants assessed the frequency of their engagement at work on a 7-point frequency scale from 0 (never) to 6 (every day) with nine items, e.g., “My job inspires me” and “I am immersed in my work”. The internal consistency for the engagement scale was high (α = 0,93).

Job satisfaction was measured with a single-item measure rating the level of agreement with the statement “In general, I am very satisfied with my job” with a 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). The single-item job satisfaction measure is shown to be a psychometrically sound overall assessment of job satisfaction [68]. As a measure of recovery from work, a single question assessing the overall state of recovery was used: “During the time after work, how well do you consider yourself to be recovered from the strain caused by work?” [69]. Answers were given on a 5-point Likert scale ranging from 1 (poorly) to 5 (very well). This single-item measure has been used in Finnish studies, and it has demonstrated good criterion validity, correlating, for example, with a high need for recovery after work [69–71].

Statistical analysis

Statistical analysis was conducted via SPSS 29.0 software. The median differences in IJDs and outcome variables by background variable groups were explored using the independent-samples Mann-Whitney U-test and independent-samples Kruskal-Wallis test. Spearman’s correlations were applied to analyze the bivariate correlations between variables.

Hierarchical linear regression was used to test whether the four dimensions of IJDs (independent variables) were associated with work engagement, job satisfaction, and recovery from work (dependent variables). Three regression models were performed, one for each dependent variable. In the first step, the background variables that significantly correlated with the dependent variables (gender, employment sector, and work experience) were controlled for. In the second step, the four dimensions of IJDs were added to the models. Since the residuals of the regression analyses were not ideally distributed, the p-values and confidence intervals of the coefficients were produced using bootstrapping. Collinearity diagnostics raised no concerns.

Results

Background characteristics

Of the total of 526 participants who returned the survey, 507 were included in the final sample (482 in the analysis regarding recovery, due to missing values), representing 12% of working-age GPs and GP trainees in Finland in 2023 (4,292). Most of the participants were female (400, 78.9%) and worked in the public sector (443, 87.4%). Most participants working in other sectors (64, 12.6%) were employed by a private company [37] or were self-employed [16], whereas 5 were employed by a university. In total, 192 participants (37.9%) worked part-time. Of these, 137 (26.9%) held an 80–99% contract, 46 (9.0%) a 50–79% contract, and 9 (1.8%) less than 50% of full-time hours (38.25 h/week). With respect to work experience, 42% (213) had less than 10 years, 34.9% (177) had 10–20 years, and 23.1% (117) had over 20 years of work experience as a GP.

The level of intensified job demands

Table 1 summarizes the medians and interquartile ranges of the study variables and group comparisons by background variables. Of the dimensions of IJDs, GPs most reported work intensification and intensified learning demands, supporting H1. Intensified career-related planning and decision-making demands were least experienced by GPs. Female and public sector GPs reported higher levels of work intensification and intensified learning demands than male GPs and GPs working in other sectors. Recovery from work reported by female and public sector GPs was lower. Public sector GPs reported lower job satisfaction than GPs in other sectors. Participants with the highest level of work experience reported more intensified learning demands than did those with the least amount of work experience. There were no differences in the levels of IJDs between full-time and part-time workers.

Table 1.

Medians and interquartile ranges of the study variables and group comparisons by background variables

n (%) Work intensification (1–5)1
median (IQR)		 Job planning demands (1–5)1
median (IQR)		 Career planning demands (1–5)1
median (IQR)		 Learning demands (1–5)1
median (IQR)		 Work engagement
(0–6)2
median (IQR)		 Job satisfaction (1–5)3
median (IQR)		 Recovery* (1–5)4
median (IQR)
ALL 507 4.10 (1.45) 3.20 (1.40) 3.00 (1.33) 4.00 (0.83) 4.56 (1.11) 4 (1) 3 (1)
Gender5

Female

Male

400 (78.9)

107 (21.1)

4.20 (1.45)

3.70 (1.60)

p < 0.001

3.20 (1.40)

3.20 (1.35)

p = 0.232

3.00 (1.33)

3.00 (1.33)

p = 0.328

4.00 (1.00)

3.67 (1.17)

p < 0.001

4.67 (1.03)

4.44 (1.22)

p = 0.203

4 (1)

4 (1)

p = 0.304

3 (2)

3 (1)

p = 0.005
Work experience6

< 10 yrs

10–20 yrs

> 20 yrs

213 (42.0)

177 (34.9)

117 (23.1)

4.00 (1.60)

4.20 (1.40)

4.00 (1.70)

p = 0.591

3.20 (1.40)

3.40 (1.40)

3.40 (1.00)

p = 0.199

3.00 (1.33)

3.33 (1.33)

3.00 (1.33)

p = 0.079

3.83 (1.00)

4.00 (0.83)

4.00 (0.92)

p = 0.0167

4.56 (1.22)

4.67 (1.33)

4.78 (1.00)

p = 0.263

4 (1)

4 (1)

4 (1)

p = 0.544

3 (1)

3 (1)

3 (1)

p = 0.448
Employment sector5

Public

Other

443 (87.4)

64 (12.6)

4.20 (1.40)

3.30 (2.20)

p < 0.001

3.20 (1.40)

3.40 (1.15)

p = 0.871

3.00 (1.33)

3.33 (1.58)

p = 0.580

4.40 (0.83)

3.75 (0.79)

p = 0.007

4.67 (1.11)

4.56 (1.36)

p = 0.905

4 (1)

4 (1)

p < 0.001

3 (2)

4 (1)

p < 0.001
Working hours5

Full-time

Part-time

315 (62.1)

192 (37.9)

4,20 (1.40)

4,00 (1.50)

p = 0.326

3.20 (1.50)

3.20 (1.40)

p = 0.818

3.00 (1.33)

3.00 (1.33)

p = 0.652

4.00 (0.92)

3.83 (0.83)

p = 0.868

4.67 (1.22)

4.56 (1.11)

p = 0.092

4 (1)

4 (1)

p = 0.141

3 (1)

3 (2)

p = 0.166
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1:Likert scale from 1 (completely disagree) to 5 (completely agree), higher score indicating higher level of IJDs. 2:Frequency scale from 0 (never) to 6 (every day), higher score indicating higher work engagement. 3:Likert scale from 1 (completely disagree) to 5 (completely agree), higher score indicating higher job satisfaction. 4:Likert scale from 1 (poorly) to 5 (very well), higher score indicating better recovery. 5:p-values of the Independent-samples Mann-Whitney U-test. 6:p-values of the Independent-samples Kruskal-Wallis test. 7:the Bonferroni-corrected significance of pairwise comparison < 10 years - > 20 years, others insignificant. *sample size 482 due to missing responses

Associations of intensified job demands with well-being at work

Table 2 presents the bivariate correlations between the study variables. Of the dimensions of IJDs, work intensification was negatively correlated with all indicators of well-being at work. Intensified learning demands and career planning demands showed weak negative correlations with job satisfaction and recovery, and job planning demands with recovery.

Table 2.

Bivariate correlations between study variables

Variable 1 2 3 4 5 6 7 8 9 10 11
1. Work intensification -
2. Job planning demands 0.40*** -
3. Career planning demands 0.31*** 0.65*** -
4. Learning demands 0.40*** 0.43*** 0.33*** -
5. Work engagement -0.14** 0.02 -0.05 0.03 -
6. Job satisfaction -0.35*** -0.07 -0.10* -0.10* 0.55*** -
7. Recovery -0.37*** -0.12** -0.10* -0.20*** 0.31*** 0.34*** -
8. Gender 0.17*** 0.05 0.04 0.18*** 0.06 -0.05 -0.13** -
9. Employment sector 0.21*** -0.01 -0.03 0.12** -0.01 -0.18*** -0.20*** 0.07 -
10. Work experience -0.02 0.08 0.01 0.13** 0.07 0.05 0.05 0.12** -0.08 -
11. Working hours -0.04 0.01 0.02 0.01 -0.08 -0.07 -0.06 0.11* -0.05 -0.03 -
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Gender: 1 = male, 2 = female, Employment sector: 1 = other, 2 = public, work experience: 1 = < 10 years, 2 = 10-20 years, 3 = > 20 years, working hours: 1 = full-time, 2 = part-time

* p < 0,05, ** p < 0,01, *** p < 0,001, two-tailed

Table 3 summarizes the results of the regression analysis. Of the background variables, working in the public sector was associated with lower job satisfaction and lower recovery, and female gender was associated with lower recovery (Step 1 model). Supporting H2a, work intensification was associated with lower work engagement, lower job satisfaction, and lower recovery after controlling for the effects of the background variables. The other three dimensions of IJDs were not associated with any of the background variables. Therefore, H2b was not supported.

Table 3.

Associations between intensified job demands and work engagement, job satisfaction, and recovery from work

Variable Work engagement (n = 507) Job satisfaction (n = 507) Recovery (n = 482)
β B β B β B
Step 1:
 Gender 0.04 0.09 -0.03 -0.07 -0.13** -0.29**c
 Employment sector -0.02 -0.06 -0.17*** -0.50***b -0.19*** -0.52***c
 Work experience
 <10 years Ref. Ref. Ref. Ref. Ref. Ref.
 10-20 years 0.05 0.10 0.02 0.04 0.04 0.08
 >20 years 0.06 0.14 0.04 0.09 0.04 0.08
Step 1 R2adj = -0.002 Step 1 R2adj= 0.03 Step 1 R2adj= 0.05
Step 2:
 Work intensification -0.19*** -0.19***a -0.36*** -0.34***b -0.32*** -0.29***c
 Job planning demands 0.09 0.10 0.08 0.09 0.06 0.06
 Career planning demands -0.04 -0.05 -0.06 -0.06 -0.01 -0.01
 Learning demands 0.08 0.11 0.08 0.10 -0.06 -0.07
Step 2 R2adj = 0.02 Step 2 R2adj= 0.12 Step 2 R2adj= 0.14
∆R2for Step 2 0.03** 0.10*** 0.10***
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β =standardized beta coefficient. B = unstandardized beta coefficient based on bootstrapping (1000 samples).  Gender: 0 = male, 1 = female, Employment sector: 0 = other, 1 = public. * p < 0.05, ** p < 0.01, *** p < 0.001. a = based on bootstrapping (960 samples), b = based on bootstrapping (967 samples), c = based on bootstrapping (953 samples)

IJDs explained 2% of the variance in work engagement, 10% of the variance in job satisfaction, and 10% of the variance in recovery from work when adjusted for gender, employment sector, and work experience (Step 2 model). P-values less than 0.05 were regarded as significant.

Discussion

This study explored intensified job demands among Finnish general practitioners and their association with work engagement, job satisfaction, and recovery from work. Within the theoretical framework of the challenge-hindrance model of work stress, our special interest was to explore whether the various dimensions of IJDs act as challenge or hindrance demands for GPs. Supporting our hypothesis, GPs experienced work intensification and intensified learning demands, which were particularly faced by female and public sector GPs. Also supporting our hypothesis, work intensification appeared as a hindrance demand, showing negative associations with all well-being indicators. Contrary to our hypothesis, the other three dimensions of IJDs did not act as challenge demands, as intensified learning and decision-making demands were not associated with GP well-being.

Compared with a large Finnish dataset comprising several occupations [66], it seems that GPs experience higher levels of work intensification and intensified learning demands than most other professionals. Feasible explanations include evolving medical practices, an aging population, and resource constraints in primary care. Additionally, the increasing use of information and communication technology (ICT) appears to predict higher levels of IJDs [72, 73]. In Finnish primary care, direct patient contacts have decreased due to digitalization, remote consultations, and consultative roles of GPs in multidisciplinary teams [74], resulting in increased ICT use. The implementation of electronic medical record systems has increased the administrative load on physicians [75], contributing to time pressure and multitasking.

Conversely, GPs reported lower levels of intensified career-related planning and decision-making demands than most other professionals did. Likely due to the good employment situation of physicians and the shortage of GPs in Finland, GPs are not faced with requirements to constantly plan their future careers and prove their worth in the job market.

Public sector GPs reported higher levels of work intensification and intensified learning demands, along with lower job satisfaction and recovery, compared with those in other sectors. This finding aligns with previous research in other occupational groups, where working in the public sector has been associated with higher work intensification and intensified knowledge-related learning demands [72]. This may reflect heavier workloads and more complex patient cases in the public sector, which also hamper recovery opportunities. Although previous research has linked private sector employment with intensified job-related and career-related planning demands [72], our study found no significant differences in the levels of job and career-related planning demands between the employment sectors. In addition, the more experienced GPs reported a higher level of intensified learning demands than their younger colleagues did, likely reflecting the need to keep up with constant advances in technology and updates in treatment guidelines.

One potential consequence of IJDs is GPs’ shift toward part-time work, which is adopted mainly to reduce workload and improve work-life balance [61]. However, this study found no significant differences between full-time and part-time GPs in IJDs, work engagement, job satisfaction, or recovery. This suggests that IJDs alone may not drive to part-time work. Moreover, reduced working hours were not associated with better well-being, although it remains unclear whether part-time work improves or merely maintains well-being.

With respect to gender differences, female GPs reported higher levels of work intensification and intensified learning demands than male GPs did. Additionally, recovery from work reported by female GPs was lower. The findings are in line with previous evidence suggesting that female GPs face different demands both in their workplaces and non-work time: female GPs bear more responsibility for women’s and children’s health concerns and supporting teams [76], and due to their more patient-centered and empathetic approach, may be expected to take on tasks that demand more emotional labor [77, 78]. Work-family conflict and care responsibilities are also a major concern for female GPs and other physicians alike [76, 79], contributing to higher burnout rates in female physicians [79]. This is a critical issue to address in primary care organizations.

Work intensification was associated with reduced well-being with all three indicators, supporting H2a and previous evidence that quantitative demands, such as increased workload and multitasking, act as hindrance demands that are related to several adverse well-being outcomes [5, 13, 28–31, 33, 34]. As knowledge work poses high cognitive demands on employees [80, 81], increased time pressure and workload place additional strain on them, reducing work engagement. Moreover, as ICT and electronic medical record systems have substantially increased physicians’ workload [75], GPs have less time for their core task of providing direct patient care, weakening their absorption and dedication at work.

It is noteworthy that work intensification explained only 3% of the total variance in work engagement. The low variance in work engagement may contribute to the low explanatory power of the regression model. However, it is also likely that the work engagement of GPs is explained by other factors, and it may be robust in an occupation that can be considered meaningful and intrinsically motivating regardless of external factors.

The associations of work intensification with lower job satisfaction and lower recovery were stronger, with work intensification explaining 10% of the variance in each outcome variable. It is well documented in the literature that heavy workload and time pressure are substantial contributors to GP job dissatisfaction [82, 83] and, conversely, manageable workload and autonomy in time management are important resources in GPs’ work [9–11]. Our findings suggest that GPs may experience growing job dissatisfaction, likely contributing to adverse health outcomes such as burnout and anxiety, turnover intentions [46, 48], and even the decreased quality of primary health care services [31, 48].

Consistent with previous research [49, 54], high workload and work pace appear to mitigate GPs’ recovery during nonwork time. Work intensification may generate pressure to work overtime and compromise work-life balance, and hamper recovery activities, which play a crucial role in employee well-being [49]. Technology, as a contributor to work intensification, may also impede detachment from work during free time. As recovery is essential for alleviating the negative effects of job demands [49, 51, 52] and for mediating the benefits of job resources [53], there is a risk of a negative cycle where poor recovery and work intensification reinforce each other.

According to the challenge-hindrance framework, learning and decision-making demands represent a motivational, autonomy-enhancing challenge, resulting in positive well-being outcomes such as increased work engagement [28, 29, 33, 34]. Our findings challenge this approach, as intensified learning and decision-making demands were not associated with work engagement or job satisfaction, suggesting that they are not positive challenge stressors for GPs. This indicates that occupational context may shape the motivational outcomes of challenge demands, as noted in previous literature [33]. The absence of support for H2b may be explained by the lack of job resources available to GPs in their work, such as restricted autonomy in time management, heavy workload, and insufficient supervisor support, which can mitigate the positive effect of planning and decision-making demands on GPs’ engagement and satisfaction. Because the motivational potential of intensified learning demands is limited by employees’ available resources [33], our findings suggest that GPs may be confronted with learning and decision-making demands that exceed their capacity. Learning demands may simply exceed the time GPs have available for learning. In the context of recent health care reforms, ongoing organizational changes, and increasing digitalization, many of these demands relate less to professional development and more to organizational requirements. As a result, learning demands may appear irrelevant or meaningless to GPs and may not contribute to their engagement or satisfaction.

Practical implications

This study highlights that increased time pressure, workload, and multitasking in primary care are potentially harmful for GPs, contributing to reduced well-being, job dissatisfaction, and a risk of turnover, rather than improved efficiency. These effects may also compromise healthcare quality, patient safety, and patient satisfaction [31, 48, 84, 85]. Such risks should be carefully considered when organizing work and allocating resources in primary care, particularly in the public sector, where excessive workloads may accelerate movement to the private sector. Maintaining a moderate level of learning demands, supported by adequate resources, would be beneficial, although optimal levels likely vary between individuals and over time. Gender differences in IJDs underscore the need for equitable workload and responsibility distribution. Evidence that older GPs may suffer more from IJDs [30] highlights the importance of support for continuous professional development throughout careers. Finally, increased ICT use should be critically evaluated: ICT is a helpful tool in many aspects and may contribute to motivation-enhancing learning demands, but it may also be a source of secondary tasks, time pressure, task fragmentation, and stress [81].

Limitations and future research

This study has certain limitations that should be considered when interpreting the findings. First, the cross-sectional self-report design prevents conclusions about causality and does not account for potential mediating or moderating factors. The sample consisted predominantly of female GPs working in the public sector in Finland, during a period of major healthcare reform. This may limit the generalizability to other populations and contexts. Online data collection may have been prone to sampling bias, although the large and representative sample supports the relevance of the findings for similar settings.

Another limitation concerns the use of single-item measures for job satisfaction and recovery, which, despite acceptable validity, may not fully capture the multidimensional nature of these constructs. Future studies should apply more comprehensive measures and employ longitudinal and intervention designs to further examine the relationships between IJDs and GP well-being, particularly when introducing new technologies and work practices. Finally, the observed sectoral and gender differences warrant further investigation to promote equity and identify best practices across sectors.

Conclusions

Work intensification and intensified learning demands are considerable challenges in contemporary working life for general practitioners, particularly among female and public sector employees. The results of this study indicate that work intensification, characterized by increased time pressure, workload, and multitasking, is potentially harmful and may lead to decreased well-being at work. This in turn may increase the risk of turnover of GPs. These risks should be considered when organizing the daily work of GPs and allocating resources in primary healthcare. The underlying reasons behind the intensification of job demands in primary healthcare should be examined, and longitudinal and intervention designs are needed to gain more evidence on the relationships between IJDs and the well-being at work of GPs.

Acknowledgements

The authors would like to thank Ari Voutilainen, Research Manager at the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, for invaluable statistical support.

Abbreviations

GP

General practitioner

IJDs

Intensified job demands

OECD

Organisation for Economic Co-operation and Development

UWES-9

Utrecht Work Engagement Scale

ICT

Information and communication technology

IQR

Interquartile range

Author contributions

All the authors contributed to the design of the study. OÖ collected the data and conducted the statistical analysis, and PM was a major contributor to the data analysis. All the authors interpreted and discussed the results and critically reviewed the manuscript.

Funding

The research was supported by the Finnish Medical Association and GPF ry.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

Participation in this study was voluntary, and informed consent was obtained from all participants. The research did not pose any risk to the safety or health of the participants. The survey did not collect any personal data that could enable participants to be identified. According to the guidelines of the Finnish National Board on Research Integrity (TENK), an ethical review was not required. All procedures complied with the ethical principles of the WMA Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

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Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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