Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

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76 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 ROLE OF MEDICAL SCHOOLS FOR COPING WITH STRESSORS AND FOR KWOWING ABOUT THE FUTURE PROFESSION Finally, some aspects should get more attention from the medical schools. Clinical competences are useful for coping with the stress of emergencies. Other information should also be useful e.g., information on practice organisation, financial issues and preparing for starting to work in a group practice are determinants for a successful professional career. Universities also have a responsibility in supporting students during their specialty choice, and offering a realistic view on the job of a GP. This idea is linked with literature findings which state that attracting and appropriate training the right people 57 , 87 , 148 informing and counseling about marked and career opportunities 147 are effective policies for retention. Young graduates need ‘now how assistance rather then money’ to start their practice. A last task for medical training institutes could be the organisation of continuing medical education and support for GPs. Now the link with the University of training is often cut after graduation. In the literature the latter is found to be moderately effective for GP retaining GPs 149 . 4.6 SUMMARY: MOTIVATIONS OF GENERAL PRACTIONERS WHO LEFT THE PROFESSION A major finding is that many GPs who left the profession experienced feelings of grief and distress. The following factors were found to have influenced their decision: • The high demanding characteristics of the GP profession, in particular linked to the patients’ demand; • The perception of lack of job control; • Some GPs wished to make a positive choice for another career track; • Financial issues were not mentioned as a major reason for leaving the profession. During the interviews the former GPs formulated the following suggestions to prevent GPs from leaving the profession: • Supportive measures as for example group practices, deputizing services; • A specific support for GPs who experience difficulties • Improving the medical training of future general practitioners in the faculties: in particular for coping with stressors (e.g. emergencies) and for getting a better view of their future professional life.
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 77 5 CHAPTER 5: POLICIES INFLUENCING THE ATTRACTION, RECRUITMENT AND RETENTION OF GENERAL PRACTITIONERS (GPS) 5.1 OBJECTIVES Chapter 4 showed some of the reasons why GPs leave the practice, in particular the high demanding characteristics of the profession and the perception of lack of job control. The former GPs formulated the suggestions to prevent GPs from leaving the profession: supportive measures as for example group practices, deputizing services; a specific support for GPs who experience difficulties and finally suggestions to improve the medical training of future general practitioners in the faculties. This chapter reviews the international literature in order to highlight policies able to improve GPs attraction, retention and recruitment: what can be learned about the effectiveness or impact of policies implemented to improve attraction, recruitment and retention? 5.2 LITERATURE SEARCH METHODOLOGY aa The literature search focused on publications and reports on existing policies and on the evaluation of effectiveness on these policies (offering opportunities for evidencebased outcomes). The researchers separated political debates (such as the October 2007 strike of French residents), policy analysis and discussions, policy implications of research not related to policy evaluation, commentaries, editorials and opinions (offering opportunities for intellectual and ideological appeal). For theoretical considerations (cf. Bilodeau et al 2006 16 ), three categories of policy studies are presented (attraction-recruitment-retention). As in the study of factors affecting GPs attraction, recruitment and retention (cf. chapter 2), a substantial body of the policy literature concerns issues in rural practice. Consequently, excluding rural practice-related papers from the literature review would have resulted in a very small number of sources. Keeping rural literature may also be justified by the following reasons. Firstly, some policies, e.g. medical education programs designed to attract and recruit rural practitioners, also address more of less explicitly issues of primary care physicians attraction and recruitment. They may therefore be inspiring sources. Secondly, the issues of GPs attraction-recruitment-retention are not only matters of global GP-to-population ratio, but can be examined under the hypothesis of a heterogeneous density of GPs, i.e. a problem of balance of GPs distribution between areas in industrialized countries such as Australia, Canada, and USA. Finally, a shortage of GPs cannot be excluded in the forthcoming years in specific Belgian areas. 5.2.1.1 Attraction: the role of Universities US MEDICAL SCHOOLS PROGRAMS The USA provides some literature about the role of universities in modulating the supply of GPs. During the 70s and 80s, the absence of regulation of the GP market led to the notion that training more medical students would expand the number of primary care physicians (PCPs, which include GPs, internists, pediatricians and obstetricians). This resulted in an oversupply of specialists and a shortage of PCPs in the early 1990s that, together with the movement towards managed care, compelled policymakers to revisit the issue of physician supply. aa The literature search methodology has already been extensively explained in chapter 3.
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Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

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