The attitude and perceptions of doctors at Letaba Hospital towards family medicine: A qualitative study

Abstract

Background: It was noted that family medicine (FM) was not used properly by doctors at Letaba Hospital. Anecdotally, misconceptions and misunderstandings about FM were reported. An exploration was recommended to understand the perceptions and attitudes of doctors at Letaba Hospital with regard to FM. Identifying doctors’ misconceptions and the possible reasons for mistaken beliefs about FM by other specialists could offer possible solutions.Methods: A qualitative study was conducted that attempted to identify the perceptions of doctors about FM and to explore their attitudes towards this specialty.Results: The primary findings indicate more positive than negative perceptions of other disciplines towards FM. The participants viewed FM as the centre of the healthcare system, with prevention being its core business. This includes a holistic approach, the continuity of care, being community-based, and receiving recognition as a specialty. Family medicine was described by various medical personnel as making a positive contribution to the healthcare system. They note the role of FM discipline in district hospitals, its support of primary health- care and its ability to fill the gaps in the healthcare system, including surgical skills. The few negative perceptions that were identified mostly related to the status of FM as a specialty and doctors’ level of surgical ability. Based on individual interviews, 11 themes were extracted and a ‘wheel’ model was created, depicting the core values of the FM discipline.Conclusion: The study concluded that most participants have a positive perception of the role of FM, similar to the views of the senior staff in the discipline itself. The concerns from most participants are in the area of preventative medicine, which has not been given enough priority in South Africa and where doctors are expected to rapidly attend to long queues and manage casualties. There was also concern of a perceived lack of surgical skills.

Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature

“…Lack of defined FM role within healthcare system A major limiting factor is the lack of a defined role of FM within the healthcare system. 10,21,24,35,41,46,56,57,65,[72][73][74][75][76][77][78] The key reasons for this were identified as a lack of career pathway, inappropriate deployment, and lack of critical mass to be visible within the healthcare system. Confusion over the role of FPs extended to policymakers, patients, other doctors, medical students and FPs.…”

“…Confusion over the role of FPs extended to policymakers, patients, other doctors, medical students and FPs. 24,32,35,41,46,74,75 Many sources noted that there is an absence of a clear career path and a lack of consultant posts. 58,65,79 Such problems contribute to reduced interest in applying for FP training and a 'brain drain' whereby FPs, frustrated by the lack of opportunities to advance their careers, take jobs in other countries or in other specialties or sectors.…”

“…20 Several sources mentioned other specialties being suspicious of, or looking down on, FM, fuelled by a lack of clearly defined roles and scope of practice for FPs. 21,35,46 Lack of FM faculty A shortage of FPs who can act as faculty within FM programmes was identified. 19,20,36,58,62,63,66,77,79,80 It was found that, whilst graduating FPs were encouraged to work within FM faculty, they lack the necessary training to work as educators.…”