Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias
Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias
62 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 • informal negative values on GP are communicated by the academic teachers of the faculty, • high quality clerkships are essential for students to make their specialty choice, • the complexity of general practice is an issue for the students, although their perception of this complexity varies according to the fact that they opted or not for general practice. Some factors play a positive role to attract the students to the GP profession: • a personal affinity becomes clear in the 7 th year of the core curriculum. GP students opt for a large scope of knowledge while other specialty students are more interested in a more circumscribed area of knowledge, • general practice students hold a more positive opinion than other students about the difficult working conditions of GPs (solitary, availability), • however, all students perceive general practice as having less status, with a lower remuneration, The students formulated suggestions in the interviews and quantitative study: • the selection of students should take account of the particular profile of future GP specialists i.e. more oriented towards the human aspects of the profession and to the GP specialty (holistic view, all ages…); • The image and position of general practice departments should improve in the faculties of medicine; • The quality of GP teaching and of GP clerkships should improve as powerful factors to attract the students ; • GP students propose to strengthen the position of general practice in the health care system including e.g., a gate keeping role, a remuneration equal to other specialties, solutions to guarantee the continuity of care.
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 63 4 CHAPTER 4: WHY YOUNG GENERAL PRACTITIONERS CHOOSE TO LEAVE THE PRACTICE: A QUALITATIVE STUDY 4.1 INTRODUCTION The objective of this chapter is to explore the motivations of young GPs to leave general practice. The description of the Belgian statistics in chapter 1 highlighted the increase of GP inactivity in the curative sector, in particular among GPs aged 30 to 49 years. A previous study also concluded that a significant proportion of qualified GPs never work in this profession or move out after a few years 13 . The literature review in chapter 2 identified the following factors contributing to the fact that GPs leave the profession: • difficult working conditions: challenge of maintaining high-quality care, large amount of responsibility, lack of flexibility in working arrangements, heavy workload, increasing demands of patients and from the health system; stressors like night visits and the perception of working in isolation, • life satisfaction: imbalance with family life, • lower financial remuneration than comparable jobs, • some positive attractors were also identified e.g. rewarding professional relationships with patients and colleagues, and the autonomy of the profession. The identification of the motivations of a Belgian sample of GPs who left the profession will complete the literature review and contribute to the policy making for the retention of the GP workforce. 4.2 RESEARCH QUESTION The main research question is to identify the factors that influence the decision making processes of young GPs and what is the interplay of these factors to leave the practice in the first decades of their professional career. Furthermore this study analyzed the suggestions that these GPs propose to improve the retention in the profession. 4.3 METHODS The researchers used semi-structured interviews to collect the data. In contrast to a design starting from a theoretical framework, this study was conducted from a grounded theory perspective. Central in the interviews were the individual experiences and feelings, opinions and attitudes of the target population (so this overview is ‘grounded in the data’). 128 . 4.3.1 Qualitative instrument The literature findings concerning the factors regarding retention were the starting point of the interview guide. 125 , 140 , 141 , 142 , 143 , 144 . The use of the interview guide with pre-determined open-ended questions supported tackling the important topics in each interview by two different interviewers (HB, LS, CD) in both, Flemish and French, languages. A standardized introduction was presented to the participants 128 and they filled a short questionnaire to get baseline data at the beginning of the interview.
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62 Making G<strong>en</strong>eral Practice Attractive: Encouraging GP attraction and Ret<strong>en</strong>tion KCE Reports 90<br />
• informal negative values on GP are communicated by the academic<br />
teachers of the faculty,<br />
• high quality clerkships are ess<strong>en</strong>tial for stud<strong>en</strong>ts to make their specialty<br />
choice,<br />
• the complexity of g<strong>en</strong>eral practice is an issue for the stud<strong>en</strong>ts, although<br />
their perception of this complexity varies according to the fact that<br />
they opted or not for g<strong>en</strong>eral practice.<br />
Some factors play a positive role to attract the stud<strong>en</strong>ts to the GP profession:<br />
• a personal affinity becomes clear in the 7 th year of the core curriculum.<br />
GP stud<strong>en</strong>ts opt for a large scope of knowledge while other specialty<br />
stud<strong>en</strong>ts are more interested in a more circumscribed area of<br />
knowledge,<br />
• g<strong>en</strong>eral practice stud<strong>en</strong>ts hold a more positive opinion than other<br />
stud<strong>en</strong>ts about the difficult working conditions of GPs (solitary,<br />
availability),<br />
• however, all stud<strong>en</strong>ts perceive g<strong>en</strong>eral practice as having less status,<br />
with a lower remuneration,<br />
The stud<strong>en</strong>ts formulated suggestions in the interviews and quantitative study:<br />
• the selection of stud<strong>en</strong>ts should take account of the particular profile<br />
of future GP specialists i.e. more ori<strong>en</strong>ted towards the human aspects<br />
of the profession and to the GP specialty (holistic view, all ages…);<br />
• The image and position of g<strong>en</strong>eral practice departm<strong>en</strong>ts should<br />
improve in the faculties of medicine;<br />
• The quality of GP teaching and of GP clerkships should improve as<br />
powerful factors to attract the stud<strong>en</strong>ts ;<br />
• GP stud<strong>en</strong>ts propose to str<strong>en</strong>gth<strong>en</strong> the position of g<strong>en</strong>eral practice in<br />
the health care system including e.g., a gate keeping role, a<br />
remuneration equal to other specialties, solutions to guarantee the<br />
continuity of care.