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

<b>Background: </b>Income is known to be a key driver of job satisfaction, especially when compared to expectations. The pertinence of this for General Practitioners (GPs) is not fully understood. <br/><br/><b>Aim: </b>To examine whether GP job satisfaction and intentions to quit are affected by actual and expected levels of income. <br/><br/><b>Design and Setting: </b>We analysed responses to four waves of the GP Worklife Survey, a survey of GPs in England, between 2015 and 2021.<br/><br/><b>Method:</b> We used linear regression models to examine the associations of actual income with 10 domains of job satisfaction and three aspects of intentions to quit, adjusted for potential confounders. We then added respondents’ self-reported expected income to these models. Finally, we repeated these analyses, stratifying by contract status and age. <br/><br/><b>Results: </b>Higher actual income was significantly associated with increased satisfaction across most job satisfaction domains except for amount of variety in your job, satisfaction with colleagues, and physical working conditions. There was little evidence of a relationship between actual income and intentions to quit. Higher expected income, conditional on actual income, was significantly associated with reduced job satisfaction across all domains, and increased intentions to quit. The relationship between expected income and job satisfaction was stronger for GPs under 40, and the relationship between actual income and job satisfaction was stronger for GP partners and for GPs over 50 years old. <br/><br/><b>Conclusion:</b> Income is a determinant of GP job satisfaction. Discrepancy between expected and actual income is an important source of dissatisfaction and intentions to quit.<br/>