Abstract:Background
A shortage of general practitioners (GPs) is common to many European countries. To counteract this, it is essential to understand the factors that encourage or discourage medical students from choosing to become a GP
Objective
To evaluate medical students’ attitudes towards general practice and to identify factors that discourage them from considering a career as a GP.
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“…As found in other studies, the low status of GPs demotivates quali ed GPs working in primary care (2,14,49). Espinosa-Gonzalez and Normand (37) con rm that the expansion of acquired competences during the specialty training for family medicine and the increase of training quality attracts medical students, contributes to public recognition as a scienti c discipline, and improves professional status within this population and in general.…”
Section: Discussionmentioning
confidence: 59%
“…In line with international and national study results, entrepreneurship and management competencies are essential, but rare among GPs (3,49). Adequate basic education and vocational training seems to play a crucial role in getting GPs ready for entering primary care.…”
Section: Discussionmentioning
confidence: 89%
“…Until now, most studies on facilitators and barriers in Austria have focused on trainees or already established GPs in relation to working in the public primary care system and founding PCUs, but lack the perspective of non-contracted GPs (16,20,49). Considering the increasing demand for GPs within the public primary care system, it is necessary to plan and establish successful policy measures and attract this target group to work in PCUs.…”
Background
General practitioner (GP) workforce shortages are a global threat to primary health care systems. In Austria, nearly 75 % of qualified GPs are not working as contracted GPs within the social health insurance system. This study aims to explore the facilitators and barriers for non-contracted GPs to work in a primary care unit (PCU).
Methods
We conducted twelve semi-structured, problem-focused interviews among purposively sampled non-contracted GPs. To extract categories of facilitators and barriers for working in a PCU, transcribed interviews were inductively coded using qualitative content analysis. These subcategories were then grouped into categories of thematic criteria and mapped on the macro-, meso-, micro-, and individual levels.
Results
We identified 36 factors, including 18 facilitators and 18 barriers. Most facilitators were located on the micro-level, while most barriers were located on the macro-level. Teamwork, which allows focus on professional medical work, shared responsibilities, flexibility in working time and work-life balance, mainly make PCUs attractive as workplaces and correspond with individual demands. By contrast, the absence of a clear vision for reform and insufficient implementation produce general ignorance and resistance. The conditions of contracts with social health insurance providers, including the remuneration system, requirements for PCUs and high workload with little time for individual patient care, are seen as inflexible and discouraging. Combined with insufficient vocational training and the low perceived status of GPs and PHC generally, GPs voiced concerns about being an entrepreneur and businessperson.
Conclusions
Targeted and proactive measures are necessary to attract non-contracted GPs to leave their current individual work-life arrangement and consider working in a PCU, especially considering the higher perceived risks. Multi-faceted efforts are needed to approach factors on all levels. Addressing system barriers should include a reform strategy with a clearly stated mission, defined PHC role, and tangible stakeholder commitment, as well as a modernized remuneration system and supportive measures to equip GPs with essential competences and skills. Proactive communication and exchange could promote the already existing attractive working conditions in PCUs and attract non-contracted GPs into the public sector.
“…As found in other studies, the low status of GPs demotivates quali ed GPs working in primary care (2,14,49). Espinosa-Gonzalez and Normand (37) con rm that the expansion of acquired competences during the specialty training for family medicine and the increase of training quality attracts medical students, contributes to public recognition as a scienti c discipline, and improves professional status within this population and in general.…”
Section: Discussionmentioning
confidence: 59%
“…In line with international and national study results, entrepreneurship and management competencies are essential, but rare among GPs (3,49). Adequate basic education and vocational training seems to play a crucial role in getting GPs ready for entering primary care.…”
Section: Discussionmentioning
confidence: 89%
“…Until now, most studies on facilitators and barriers in Austria have focused on trainees or already established GPs in relation to working in the public primary care system and founding PCUs, but lack the perspective of non-contracted GPs (16,20,49). Considering the increasing demand for GPs within the public primary care system, it is necessary to plan and establish successful policy measures and attract this target group to work in PCUs.…”
Background
General practitioner (GP) workforce shortages are a global threat to primary health care systems. In Austria, nearly 75 % of qualified GPs are not working as contracted GPs within the social health insurance system. This study aims to explore the facilitators and barriers for non-contracted GPs to work in a primary care unit (PCU).
Methods
We conducted twelve semi-structured, problem-focused interviews among purposively sampled non-contracted GPs. To extract categories of facilitators and barriers for working in a PCU, transcribed interviews were inductively coded using qualitative content analysis. These subcategories were then grouped into categories of thematic criteria and mapped on the macro-, meso-, micro-, and individual levels.
Results
We identified 36 factors, including 18 facilitators and 18 barriers. Most facilitators were located on the micro-level, while most barriers were located on the macro-level. Teamwork, which allows focus on professional medical work, shared responsibilities, flexibility in working time and work-life balance, mainly make PCUs attractive as workplaces and correspond with individual demands. By contrast, the absence of a clear vision for reform and insufficient implementation produce general ignorance and resistance. The conditions of contracts with social health insurance providers, including the remuneration system, requirements for PCUs and high workload with little time for individual patient care, are seen as inflexible and discouraging. Combined with insufficient vocational training and the low perceived status of GPs and PHC generally, GPs voiced concerns about being an entrepreneur and businessperson.
Conclusions
Targeted and proactive measures are necessary to attract non-contracted GPs to leave their current individual work-life arrangement and consider working in a PCU, especially considering the higher perceived risks. Multi-faceted efforts are needed to approach factors on all levels. Addressing system barriers should include a reform strategy with a clearly stated mission, defined PHC role, and tangible stakeholder commitment, as well as a modernized remuneration system and supportive measures to equip GPs with essential competences and skills. Proactive communication and exchange could promote the already existing attractive working conditions in PCUs and attract non-contracted GPs into the public sector.
“… 8 High-quality practical experience not only enhance the professional skills of medical students, but also increase their interest in becoming GPs. 17 The second is to strengthen the professional confidence of GPs and encourage more medical students to engage in general practice. According to a survey, 18 Chinese GPs generally hold a negative attitude towards their professional status, which was mainly reflected in income level, occupational risk, and social respect, but they were optimistic about the development expectations in the next 3 years.…”
Section: Suggestions On Strengthening the Training Of Gpsmentioning
confidence: 99%
“…The government should take measures to improve the professional attraction of GPs, such as raising their salaries and social status. 4 With the efforts of the German government, 17 the salary gap between specialists and GPs is narrowing, and the attractiveness of GPs is also increasing. As mentioned in this study, 1 GPs expected to be rewarded, not necessarily financially, but through respect and consideration.…”
Section: Suggestions On Strengthening the Training Of Gpsmentioning
Background
The
ongoing COVID-19 pandemic has revealed gender-specific differences between general practitioners in adapting to the posed challenges. As primary care workforce is becoming increasingly female, in many countries, it is essential to take a closer look at gender-specific influences when the global health care system is confronted with a crisis.
Objective
To explore gender-specific differences in the perceived working conditions and gender-specific differences in challenges facing GPs at the beginning of the COVID-19 pandemic in 2020.
Design
Online survey in seven countries.
Participants
2,602 GPs from seven countries (Austria, Australia, Switzerland, Germany, Hungary, Italy, Slovenia). Of the respondents, 44.4% (n = 1,155) were women.
Main Measures
Online survey. We focused on gender-specific differences in general practitioners’ perceptions of working conditions at the beginning of the COVID-19 pandemic in 2020.
Key Results
Female GPs rated their skills and self-confidence significantly lower than male GPs (f: 7.1, 95%CI: 6.9–7.3 vs. m: 7.6, 95%CI 7.4–7.8; p < .001), and their perceived risk (concerned about becoming infected or infecting others) higher than men (f: 5.7, 95%CI: 5.4–6.0 vs. m: 5.1, 95%CI: 4.8–5.5; p = .011). Among female GPs, low self-confidence in the treatment of COVID-19 patients appear to be common. Results were similar in all of the participating countries.
Conclusions
Female and male GPs differed in terms of their self-confidence when dealing with COVID-19-related issues and their perceptions of the risks arising from the pandemic. To ensure optimal medical care, it is important that GPs realistically assess their own abilities and overall risk.
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