Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

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118 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 is however at the center of the preoccupations: he/she has not to carry the cost of this revision. Regarding the quality of life, many suggestions concern the GP’s security: a better social status, a health care center for the GPs and less control by the insurance. The role of the GP is central in the health care system because of his/her knowledge of the patient. However, the increase of necessary knowledge and the need for a balance between private and working life call for a multidisciplinary approach to be developed during training and during the practice in all aspects of collaboration. Two policies concern the reinforcement of the use of information technology to facilitate the sources of information and to share the patient’s data for better clinical decisions. Positive relationships with colleagues and the group practice seem the best ways for improving the quality of life and the demands of the GPs’ profession like duty, continuity and ongoing training. However, some respondents thought that sharing common medical records is more appropriate and effective than sharing a common infrastructure whilst the patients should keep a privileged link with one GP. 6.11 LIMITATIONS OF THE STAKEHOLDERS STUDY The questionnaire was quite complex and the interview lasted mostly one-hour. The stakeholders had to read, score and rank 24 policies, each one on four criteria according to the multi-criteria analysis. This made the process sometimes very long although most stakeholders showed a high level of interest during the interview. Some criteria, such as acceptance by other professionals, were considered sometimes as irrelevant while other ones included too many aspects (such as access). The last topic (health organization policies) included perhaps too many policies (10 compared with 4 or 5 for the other topics). Keeping an amount of 5 policies in each group would have been more consistent with the other topics. A last possible limitation has to do with the number of the stakeholders in each of the five groups (policymakers, sectional groups, cause groups, media and GPs). The size of the groups was significant for face-to-face interviews but only allowed a global analysis of the results as the statistical power was too weak to notice any statistical difference between the groups. 6.12 SUMMARY: POLICIES TO BE IMPLEMENTED IN BELGIUM TO IMPROVE ATTRACTION, RECRUITMENT AND RETENTION OF THE GENERAL PRACTITIONERS: A STAKEHOLDERS’ ANALYSIS 6.12.1 Most important policies In the teaching topic, the integration of a GP’s perspective in the Master courses and the obligation of a clerkship in general practice during the masters for all students were the two policies that had the best score for attracting medical students regarding the cost-benefit performance and the acceptance by other health professionals. In the financing policies, the highest scored policy was incentives for practicing in underserved areas (more supported by the non GP stakeholders than by the GP stakeholders and more by the Dutch-speaking stakeholders than by the French-speaking stakeholders). The most-preferred policy was the capitation in addition to other feefor-service (more accepted by GP stakeholders than the other groups). Regarding the work-life balance policies, the support of an “evolving” career and the scrapping of the individual duty obligation are the two most important policies. Among the health care organization policies, three policies stand out: the reinforcement of GPs working together, the improvement of the role of the GP in the multidisciplinary team, the delegation of some administrative tasks.
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 119 6.12.2 Discarded policies Among the teaching policies, the students’ selection strategy was not retained and was considered low on cost-benefit. Furthermore, the development of a Clinical Academic activity for general practice was either not highly ranked and was under performing on the four criteria. The most discarded policy among the financing policies was the combination of wageearning and fee for service. The most discarded policy in the work-life balance policies was the financial compensation of the GPs for their continuous learning activities. Removing the numerus clausus was the least popular health care organization policy among all stakeholders.
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