How can primary care be secured in the long term? – a qualitative study from the perspective of general practitioners in Germany

Abstract

Background Securing primary care is an important issue for health policy. Given a threatened shortage of GPs in Germany, there are discussions about what actions to take to guarantee primary care. Objectives The aim was to obtain opinions of German GPs towards (a) the status quo and development of primary care, (b) favoured actions to secure it and (c) assessment of the actions taken. Methods In 2021 and 2022, 96 semi-structured interviews (criterion sampling) amongst GPs were conducted in all German federal states (41 face-to-face, 32 by telephone, 23 via telecommunication application). The data was analysed according to qualitative content analysis. Additionally, a short questionnaire recorded the problem of GP shortage. Results Many interviewees fear a veritable shortage of GPs in the future. They identify structural problems linked to the health care system. The interviewees suggested creating a primary care physician system or upgrading the GP position. They proposed greater support of interests about general practice in education and training, a restructuring of curricula and admissions criteria in higher medical education and reforming GP training. Building up multi-professional outpatient care centres and strengthening task shifting are valuable. The interviewees have observed progress in ensuring primary care but see a need for further action. Conclusion The study has shown that GPs, from their perspective and experience, make specific suggestions to ensure primary care in the long term. Consequently, it is advisable to consider their points of view when planning, implementing and adjusting steps to strengthen primary care.

Associations between COVID-19 Pandemic-Related Overtime, Perceived Chronic Stress and Burnout Symptoms in German General Practitioners and Practice Personnel—A Prospective Study

“…Overall, our findings are worrisome considering the already existing and further worsening staff shortage in European and other healthcare systems [74][75][76]. A nationwide longitudinal study in Hungary observed a decrease in GP practices by 7.7% between 2007 and 2016 [74].…”

“…While family medicine is still a rewarding career for young residents, as it offers high autonomy in diverse work settings and long-term doctor-patient relationships, the design of workplaces and working conditions needs to respect the described associations to psychological well-being [78,79]. A recent qualitative study with semi-structured interviews of 96 German GPs suggested actions such as upgrading the GP position, creating interdisciplinary outpatient care centers and reforming GP training to secure future primary care [76].…”

Hypertension doctors’ awareness and practice of medication adherence in hypertensive patients: a questionnaire-based survey

“…As for which level of hospital physicians are mainly responsible for the medication adherence of hypertensive patients, 67.4% of the respondents believed that they were general practitioners. Considering the different medical services and responsibilities of specialist cardiologists and general practitioners in the health care system ( Wangler & Jansky, 2023 ), and the strong support of national policies for primary health care facilities, general practitioners are indeed suitable to assume the main responsibility for medication adherence. For general practitioners, it has been suggested to increase relevant continuing medical education opportunities, simplify promotion channels, and improve their level of diagnosis and treatment of hypertension ( Ye et al, 2020 ).…”