Enhancing the Motivation for Rural Career: The Collaboration between the Local Government and Medical School

Seguchi, Masaru; Furuta, Noriko; Kobayashi, Seiji; Kato, Kazuhiro; Sasaki, Kouji; Hori, Hiroki; Okuno, Masataka

doi:10.1620/tjem.236.169

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Presupposing this quantitative study will reproduce our findings, the positive aspects of being a GP, especially in rural regions, need to be transported to those recipients who are in the running for becoming GPs. This could be achieved by university lectures given by experienced GPs from rural regions ( 8 ), campaigns transporting the positive view of working as a GP [in rural regions], promotion of work placements in rural general practices ( 31 ) or incentives for working as a GP especially in rural regions ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

General practitioners’ perception of being a doctor in urban vs. rural regions in Germany - A focus group study

2017

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BackgroundInadequate recruitment numbers for GPs in rural regions give cause for concern. Working in rural regions is less attractive among medical students because of strong associations concerning a higher workload, restriction of privacy and demands exceeding their competences. We aimed to explore perceptions of GPs working in urban versus rural regions to contrast these prejudices.MethodsWe conducted nine focus groups with GPs [female = 21, male = 44] from urban and rural regions, using a semi-structured guideline. Transcripts were content analyzed using deductive and inductive categories.ResultsUrban GPs perceived themselves as a provider of medical services and rural GPs as being a medical companion. Compared to urban GPs, GPs from non-urban regions portray themselves more strongly as a family physician that accompanies patients ‘from the cradle to the grave’ and is responsible for the treatment of any medical issue. They emphasized their close relationship with their patients. Rural GPs establish a close relationship with their patients and considered this as beneficial for the treatment relationship. This aspect seems to play a subordinate role for urban GPs.ConclusionsGPs enjoy their work and the role they play in their patients’ lives. Being a rural GP was described very positively. Greater emphasis should be made on positive aspects of being a GP in rural regions, e.g. by university lectures given by rural GPs, campaigns emphasizing the positive aspects of working as a GP [in rural regions], promotion of work placements or incentives for working in rural general practices.

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Section: Discussionmentioning

confidence: 99%

General practitioners’ perception of being a doctor in urban vs. rural regions in Germany - A focus group study

2017

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“…This study broaches the idea that stent implantation to an SVC may be performed in a small, rural hospital. In general, medical resources, including human resources and medical equipment, are sparser in small rural hospitals 4 , 5 ) . While it is unrealistic to purchase expensive medical equipment, like a radiation therapy apparatus, to use on a few patients in rural hospitals, the option of inviting specialists for a short period of time would cost much less provided that the procedures can be performed with the usual, non-specialized equipment found in rural hospitals.…”

Section: Discussionmentioning

confidence: 99%

Successful stent implantation in a rural area on a patient with superior vena cava syndrome through specialist intervention: a case report

et al. 2019

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Superior vena cava syndrome (SVCS), which is characterized by facial edema and congestion of the head, upper extremities, and neck, is a life-threatening oncologic emergency. Although a combination of chemotherapy and radiation therapy has been considered as the standard treatment for SVCS, stent implantation to the superior vena cava (SVC) has been recently developed to alleviate edema or dyspnea caused by SVCS. On the other hand, stent implantation to the SVC requires skilled interventional cardiologists or radiologists. In general, those specialists reside in university hospitals or large hospitals in an urban area. In this case report, an 86-year-old man underwent stent implantation to a stenosed SVC in a rural area. Because the patient refused the transfer to the core, urban hospital, we invited a skilled interventional cardiologist from the core hospital and performed stent implantation to the SVC in a small, rural hospital. It is generally difficult to perform stent implantation for SVCS in a small hospital, because skilled operators in the field of interventional cardiology or radiology do not usually perform operations in smaller facilities. Our case indicates the importance of cooperation between rural generalists and urban specialists.

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“…These distribution phenomena do not exist in Germany exclusively but also poses a growing problem in e.g. England [9], the U.S. [10–12], Japan [13] and Australia [14]. …”

Section: Introductionmentioning

confidence: 99%

Regional variations of perceived problems in ambulatory care from the perspective of general practitioners and their patients - an exploratory focus group study in urban and rural regions of northern Germany

et al. 2017

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BackgroundPatients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients.MethodsWe conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany. Discussions were facilitated by two researchers using a semi-structured guideline. The transcripts were content analyzed using deductive and inductive categories.ResultsGeneral practitioners and patients reported problems due to demographic change and patient behaviour, through structural inequalities and the ambulatory reimbursement system as well as with specialist care and inpatient care. A high physician density, associated with high competition between general practitioners, a high fluctuation of patients and a low status of general practitioners were the main problems reported in urban areas. In contrast, participants from rural areas reported an insufficient physician density, a lack of young recruits in primary care and a resulting increased workload as problematic. All regions are concerned with subjectively inadequate general practitioners’ budgets, insufficiently compensated consultations and problems in the cooperation with specialists and inpatient care institutions. Most problems were mentioned by GPs and patients alike, but some (e.g. high competition rates in urban regions and problems with inpatient care) were only mentioned by GPs.ConclusionsWhile many problems arise in urban regions as well as in rural regions, our results support the notion that there is an urgent need for action in rural areas. Possible measures include the support of telemedicine, delegation of medical services and reoccupation of vacant practices. The attractiveness of working in rural areas for general practitioners, specialists and clinicians must be increased by consolidating and expanding rural infrastructure (e.g. child care and cultural life). The above mentioned results also indicate that the ambulatory reimbursement system should be examined regarding the reported inequalities. Measures to further enhance the cooperation between general practitioners, specialists and inpatient care should be taken to solve supra-regionally reported problems. Problems showing regional variations indicate the need for measures to balance these variations between the regions.This is the first German study to analyze subjective views of the stakeholders concerned on regionally variating problems in ambulatory care. Further studies are needed to quantify the extent of the identified problems and differences. A corresponding survey is currently under way.

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Enhancing the Motivation for Rural Career: The Collaboration between the Local Government and Medical School

Cited by 5 publications

References 23 publications

General practitioners’ perception of being a doctor in urban vs. rural regions in Germany - A focus group study

General practitioners’ perception of being a doctor in urban vs. rural regions in Germany - A focus group study

Successful stent implantation in a rural area on a patient with superior vena cava syndrome through specialist intervention: a case report

Regional variations of perceived problems in ambulatory care from the perspective of general practitioners and their patients - an exploratory focus group study in urban and rural regions of northern Germany

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