Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 91
6.3.2 Development of the questionnaire
The questionnaire was developed through several processes: review of previous
instruments, cognitive testing (see appendix 5.4, 5.11 and 5.12), expert reviews and
broader testing. Once the lay-out and content of the questionnaire was decided,
cognitive testing was used to improve the wording, understanding and organization of
the questions. Cognitive testing is a method that improves the link between the
underlying concepts and the questions 200 , 201 . This method is fully described in the
appendix 5.4. This cognitive testing was carried out with different profiles of persons:
some were GPs with a practice (=3), some were GPs without any practice (=2), some
did not work in general practice but had a general knowledge of the themes (=3).
Several experts, who had used the same methodology in their works before, revised the
questionnaire and gave their advice about specific problematic points. A few qualitative
interviews were also conducted to have a deeper insight into the content of the policies
and to improve the formulation of the policies in French and Flemish. Finally a broader
testing was carried out with 10 persons.
6.3.3 Identification of policy options
The policies have been identified in several steps (see appendix 5.2). First, the extensive
literature review carried out in the first part of the study identified several policy
options and factors that may contribute to improve retention/recruitment of GPs.
These policy options were then screened according to the Belgian context. This was
done in the second part of the study, particularly through qualitative interviews of
leavers and medical students. Finally, the list of policies was compared to recent policy
reviews carried out either by the European Observatory 2 or by the Belgian Institutions:
the KCE report 72B on medical supply 7 , the Visitatie Report 202 , or the study related to
General practice Emergency study 203 , as well as policies being currently under
discussion or being developed in Belgium, such as the DMG, Impulseo I, Impulseo II, the
numerus clausus, etc. After a long process, the researchers identified 24 policies,
grouped in four themes (for the list in French and Flemish, see appendices 5.11 and
5.12):
• Teaching and training policies (4 policies):
o To select the students of medicine by taking into account
their social and communication competencies in addition to
their knowledge in exact sciences.
o To develop a clinical activity linked with the Academic
Centers of General Practice.
o To integrate a general practice approach in the general
practice courses of the Master (including the courses of the
specialty), by learning the priority problems from a public
health perspective or by associating specialists and general
practitioners
o To organize compulsory training courses in general practice
for all the students of the Master
• Financing and payment policies (5 policies)
o To increase the consultation fees of the general practice
o To allocate a fixed price per patient in addition of the other
act remunerations (for example : global medical file)
o To diversify the remuneration modalities of the general
practice by combining wage-earning and act remuneration
o To improve the financial incentives for the installation in
geographical zones less covered