Perceptions of time constraints among primary care physicians in Germany

Abstract Background Time constraints during patient visits play a major role for the work stress of primary care physicians. Several studies suggest that there is a critical situation in terms of time constraints in primary care in Germany. Therefore, the following research questions are addressed: (1) What is the time allocated and needed for different types of consultations among primary care physicians in an urban area in Germany? (2) What is the extent of time stress? (3) Are there differences in time stress according to physician characteristics (gender and length of experience) and practice type (single vs. group/shared practice)? Methods Data stem from a face-to-face survey of primary care doctors in Hamburg and adjacent regions. A sample of 128 physicians stratified by a combination of physicians’ gender and length of experience (≤15 years or > 15 years) was used. Physicians were asked about the time needed (in minutes) to provide high quality of care for patients regarding six types of consultations: (1) new patient appointment, (2) routine consultation, (3) complete physical examination, (4) symptom-oriented examination, (5) check-up, and (6) home visit (without drive). Afterwards, they were asked about the average minutes allocated for the six consultations. Time stress was measured by calculating minutes needed minus minutes available. Results Average perceived time needed was higher than time allocated for all six types of consultation. However, there were differences in the magnitude of time stress between the consultation types. Time stress was most pronounced and most prevalent in case of a new patient visit. No significant differences in time stress between male and female primary care physicians were found, while less experienced physicians reported more time stress than those with more experience (> 15 years). Physicians working in a single practice had less time stress than those working in a group or shared practice in case of a check-up visit. Conclusions Perceived time needed is higher than time allocated for various types of consultation among primary care physicians in Germany. Time stress in primary care is particularly pronounced in case of new patient appointments. Early-career physicians are particularly affected by time stress.

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Physician Characteristics and EMR Attitudes

Healthcare Delivery Reform and New Technologies ◽

10.4018/978-1-60960-183-6.ch008 ◽

2011 ◽

pp. 138-149

Author(s):

David Meinert ◽

Dane K. Peterson

Keyword(s):

Primary Care ◽

Medical Records ◽

Primary Care Physicians ◽

Medical Profession ◽

Successful Implementation ◽

Negative Attitudes ◽

Specialty Clinic ◽

Medical Specialists ◽

Positive Attitudes ◽

Physician Characteristics

Despite the numerous purported benefits of Electronic Medical Records (EMR), the medical profession has been extremely reluctant to embrace the technology. One of the barriers believed to be responsible for the slow adoption of EMR technology is resistance by many physicians who are not convinced of the advantages of using EMR systems. This study examined potential characteristics of physicians that might help identify those individuals that are most likely to pose a threat to the successful implementation of an EMR system in a multi-specialty clinic. The results demonstrated that older physicians and physicians with only minimal computer skills are more likely to have negative attitudes regarding EMR technology. Medical specialists were most likely to have positive attitudes with respects to the use of EMR systems, while primary care physicians were most likely to have doubts regarding the purported benefits of EMR technology. [Article copies are available for purchase from InfoSci-on-Demand.com]

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Variations in health services utilization by primary care patients

Health Services Management Research ◽

10.1258/0951484021912888 ◽

2002 ◽

Vol 15 (2) ◽

pp. 116-125 ◽

Cited By ~ 8

Author(s):

Victoria Bolaños-Carmona ◽

Ricardo Ocaña-Riola ◽

Alexandra Prados-Torres ◽

Pilar Gutiérrez-Cuadra

Keyword(s):

Primary Care ◽

Health Service ◽

Primary Care Physicians ◽

Service Use ◽

Patient Characteristics ◽

Important Variable ◽

Services Utilization ◽

Care Groups ◽

Physician Characteristics ◽

Primary Care Patients

This study analyses how both ambulatory care groups (ACGs) and physician characteristics explain the variability in health-service use among primary care patients in Spain. During the period 1996-1997, data derived from 52 152 patients and their 38 respective primary care physicians were collected. The response variables were as follows: number of visits; diagnostic tests requested; and referrals to a specialist. ACGs are an important variable that should be taken into account in order to explain health-service utilization. As for professionals, age and the post they hold are essential factors. Most of the unexplained variability is caused by patient characteristics.

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The chronic need to improve the management of pain

Pain Research and Management ◽

10.1155/2003/548943 ◽

2003 ◽

Vol 8 (4) ◽

pp. 187-188 ◽

Cited By ~ 2

Author(s):

Eldon Tunks

Keyword(s):

Primary Care ◽

Palliative Care ◽

Primary Care Physicians ◽

Opioid Analgesics ◽

Care Practice ◽

Eligibility Criteria ◽

Chronic Noncancer Pain ◽

Primary Care Doctors ◽

Third Line ◽

Noncancer Pain

In this issue, Drs Morley-Forster, Clark, Speechley and Moulin report on their survey conducted by Ipsos-Reid in June 2001 (pages 189-194). Only physicians who met the eligibility criteria of having written 20 or more prescriptions for moderate to severe pain in the preceding four weeks or having devoted 20% of their time to palliative care were eligible to participate. Sixty-eight per cent of the respondents thought that moderate to severe chronic pain was not well managed in Canada. Despite this opinion, 23% of physicians in palliative care practice and 34% of primary care doctors stated that they would not use opioids to treat moderate to severe chronic noncancer pain even as a third-line treatment after two previous medications had failed. One-quarter to one-third were concerned about the potential for addiction, and a smaller percentage reported concern about the potential for patient abuse and/or misuse, and side effects. Fear of a College audit resulting in the loss of their medical licence was cited by 10% of primary care physicians. When asked what obstacle hindered their use of strong opioid analgesics, an unexplained 10% of palliative care doctors and 14% of primary care doctors answered "nothing in particular".

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RATE OF DETECTION OF ENDOCRINE DISEASES IN CHILDREN IN THE PRACTICE OF A FAMILY DOCTOR

Modern medical technologies ◽

10.34287/mmt.4(47).2020.7 ◽

2020 ◽

Vol 47 (4) ◽

Author(s):

I. I. Redko ◽

E. N. Chakmazova

Keyword(s):

Primary Care ◽

Sexual Development ◽

Primary Care Physicians ◽

Family Doctor ◽

The State ◽

Individual Development ◽

Endocrine Diseases ◽

Anthropometric Indicators ◽

Pediatric Endocrinologist ◽

Primary Care Doctors

Abstract Introduction. In the context of the reform of modern medicine, endocrine pathology is encountered not only by pediatric endocrinologists, but also by doctors of other specialties, primarily primary care doctors - pediatricians and family doctors. Currently, there is a tendency to increase the prevalence of endocrine pathologists in all age groups of the children's population of Ukraine. Purpose of the study. Assess the frequency and structure of endocrine pathology in children at the primary stage. Materials and methods. In the conditions of children's outpatient clinics 4273 children aged from 0 to 18 years were consulted and examined with an expert assessment of maps of individual development of the child. Children were evaluated anthropometric indicators, the state of the thyroid gland and sexual development. Examination of all children for the presence of endocrine pathologists and confirmation of the diagnosis were carried out on the basis of the Order of the Ministry of Health of Ukraine № 254 of 04.27.2006 "On the approved protocol for the medical support of children for the specialty" Child endocrinology ". Results. Among the total number of children consulted, endocrine pathology was manifested in 36,7 %. The diagnosis of newly diagnosed endocrine pathology was first confirmed in 29,9% of children. Among endocrine pathologists, perovism is occupied by obesity (39,9%), the second – thyroid pathology (36,4%), the third – impaired growth (18,3%), the fourth – impaired sexual development (7,4%). In 40% of cases, a violation of sexual development is combined with a violation of growth. It has been. established that primary care doctors in 40–50% of cases do not perform anthropometry for children at all, the state of sexual development is not evaluated in 70% of cases, which leads to an untimely referral to a pediatric endocrinologist and complicates further treatment. Conclusions. A high percentage of children with first diagnosed endocrine pathology at the stage of primary care and the late delivery by doctors of children to a pediatric endocrinologist was established, which is due to the lack of primary care physicians' assessment of anthropometric indicators of the child’s physical development, thyroid and sexual development. Keywords: endocrine diseases, children, diagnosis, primary care

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Idea on the Clinical Services of Primary Care Physicians

Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) ◽

10.22146/rpcpe.41690 ◽

2018 ◽

Vol 1 (3) ◽

pp. 99

Author(s):

Adi Heru Sutomo ◽

Fitriana Fitriana

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Direct Contact ◽

Health Problems ◽

Primary Care Doctor ◽

Clinical Services ◽

The Family ◽

Patient Health ◽

Primary Care Doctors

The increasing needs and health problems that exist in the community and the more critical the community-related health problems that require the ability of a primary care doctor able to handle existing health problems in the community. Primary care doctor complies with Alma Ata Declaration in 1978 as the backbone of health that makes direct contact with the community, so it is essential for a primary care doctor to involve the patient or the patient as part of the team. Patient experience information or patients given to primary care doctors is expected to further improve the quality of patient health services as individuals and is part of the family and society or community....................

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PREFACE

Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) ◽

10.22146/rpcpe.41689 ◽

2018 ◽

Vol 1 (3) ◽

pp. 97

Author(s):

Michael Kidd ◽

Hari Kusnanto

Keyword(s):

Primary Care ◽

Health Education ◽

Primary Care Physicians ◽

Independent Learning ◽

School Students ◽

Family Doctors ◽

New Graduates ◽

Prevention And Health Promotion ◽

Primary Care Doctors ◽

The Government

................ The Government of Indonesia has recently launched the nation’s postgraduate family medicine residency training programs, based in 17 universities spread across the country. For the first time, medical graduates will receive postgraduate training in comprehensive primary medical care. Formal assessment at the end of training will lead to Fellowship of the Indonesian College of Primary Care Physicians. These new graduates will lead the transformation of health care in this country............One of the main tasks of primary care doctors or family doctors is disease prevention and health promotion. Health education is a way that most take to promote public health. The research articles in this edition show us about how health education is implemented with the aim of general society such as school students, health cadres and puskesmas officers. Education and experience (experiential-based) trigger behavior changes which are then expected to improve health status1. How health education is implemented can affect the results to be achieved. For example, the interactive learning process can achieve the expected results, rather than independent learning and lectures2..............

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Physician Characteristics and EMR Attitudes

Health Information Systems ◽

10.4018/978-1-60566-988-5.ch095 ◽

2011 ◽

pp. 1491-1502

Author(s):

David Meinert ◽

Dane K. Peterson

Keyword(s):

Primary Care ◽

Medical Records ◽

Primary Care Physicians ◽

Medical Profession ◽

Successful Implementation ◽

Negative Attitudes ◽

Specialty Clinic ◽

Medical Specialists ◽

Positive Attitudes ◽

Physician Characteristics

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Primary Care Physicians' Attitude Toward Diagnosis and Treatment of Late-life Depression

CNS Spectrums ◽

10.1017/s1092852900024299 ◽

2002 ◽

Vol 7 (11) ◽

pp. 784-790 ◽

Cited By ~ 5

Author(s):

Jeffrey S. Harman ◽

Ellen L. Brown ◽

Thomas Ten Have ◽

Benoit H. Mulsant ◽

Greg Brown ◽

...

Keyword(s):

Primary Care ◽

Medical Education ◽

Primary Care Physicians ◽

Late Life ◽

The Elderly ◽

Late Life Depression ◽

Primary Care Settings ◽

Care Groups ◽

Physician Characteristics ◽

Barrier To Care

ABSTRACTUnderdiagnosis and undertreatment of late-life depression is common, especially in primary care settings. To help assess whether physicians' attitude and confidence in diagnosing and managing depression serve as barriers to care, a total of 176 physicians employed in 18 primary care groups were administered surveys to assess attitudes towards diagnosis, treatment, and management of depression in elderly patients, (individuals over 65 years of age). Logistic regression was performed to assess the association of physician characteristics on attitudes. Nearly all of the physicians surveyed felt that depression in the elderly was a primary care problem, and 41% reported late-life depression as the most common problem seen in older patients. Physicians were confident in their ability to diagnose and manage depression, yet 45% had no medical education on depression in the previous three years. Physicians' confidence in their ability to diagnose, treat, and manage depression, and their reported adequacy of training, do not appear to correspond to the amount of continuing medical education in depression, suggesting that physician overconfidence may potentially be serving as a barrier to care.

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THE ROLE OF THE PRIMARY DOCTOR IN THE EARLY DIAGNOSIS OF ENDOCRINE DISEASES IN CHILDREN.

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.19.4.25 ◽

2019 ◽

Vol 19 (4) ◽

pp. 25-28

Author(s):

I.I. Redko ◽

E.N. Chakmazova

Keyword(s):

Primary Care ◽

Sexual Development ◽

Primary Care Physicians ◽

Age Groups ◽

The State ◽

Family Doctors ◽

Endocrine Diseases ◽

Anthropometric Indicators ◽

Pediatric Endocrinologist ◽

Primary Care Doctors

In the context of the reform of modern medicine, endocrine pathology is encountered not only by pediatric endocrinologists, but also by doctors of other specialties, primarily primary care doctors - pediatricians and family doctors. Currently, there is a tendency to increase the prevalence of endocrine pathologists in all age groups of the children's population of Ukraine. Purpose of the study. To assess the frequency of detection of the most common endocrine diseases in children by primary care doctors and the timeliness of referral to a pediatric endocrinologist. Materials and methods. In the conditions of children's outpatient clinics, 4273 children were consulted and examined, aged from 0 to 18 years. Children were evaluated anthropometric indicators, the state of the thyroid gland and sexual development. Examination of all children for the presence of endocrine pathologists and confirmation of the diagnosis were carried out on the basis of the Order of the Ministry of Health of Ukraine No. 254 of 04/27/2006. "On the approved protocol for the medical support of children for the specialty" Child endocrinology ". Results. Among the total number of children consulted, endocrine pathology was manifested in 36.7%. The diagnosis of newly diagnosed endocrine pathology was first confirmed in 29, 9% of children. Among endocrine pathologists, perovism is occupied by obesity - 39.9%, the second - thyroid pathology - 36.4%, the third - impaired growth - 18.3%, the fourth - impaired sexual development - 7.4%. In 40% of cases, a violation of sexual development is combined with a violation of growth. It has been established that primary care doctors in 40-50% of cases do not perform anthropometry for children at all, the state of sexual development is not evaluated in 70% of cases, which leads to an untimely referral to a pediatric endocrinologist and complicates further treatment. Findings. A high percentage of children with first diagnosed endocrine pathology at the stage of primary care and the late delivery by doctors of children to a pediatric endocrinologist was established, which is due to the lack of primary care physicians' assessment of anthropometric indicators of the child’s physical development, thyroid and sexual development.

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FACTORS OF WORKING ENVIRONMENT INFLUENCING OCCUPATIONAL STRESS AMONG PRIMARY HEALTH CARE DOCTORS IN UKRAINE

Wiadomości Lekarskie ◽

10.36740/wlek201905216 ◽

2019 ◽

Vol 72 (5) ◽

pp. 1038-1042

Author(s):

Maryna V. Shevchenko ◽

Tetiana P. Yurochko ◽

Iryna I. Hrechko

Keyword(s):

Primary Care ◽

Occupational Stress ◽

Work Experience ◽

Primary Care Physicians ◽

Strong Association ◽

Working Environment ◽

Professional Activity ◽

Common Symptom ◽

Family Doctors ◽

Primary Care Doctors

Introduction: Stress is considered to be a very common pathology among primary care doctors, since practically any professional activity requires significant emotional, mental and practical efforts. The aim has determined the factors associated with occupational stress and compare the difference of behavior patterns which is used to reduce stress among primary care doctors in Ukraine. Materials and methods: The authors used medical-statistical methods as well as analyzed questionnaires of the sociological survey conducted among general practitioners and family doctors of the primary care level from various regions of Ukraine. Results: Occupational stress is a common symptom among primary care physicians of different ages and genders in Ukraine. For primary care doctors the most common symptoms related to occupational stress were found to be burnout (n=93), poor night’s sleep (n=84) and tiredness (n=84). Female doctors experience more often symptoms such as frequent headaches tiredness, burnout, whilst for male doctors feelings of irritation and anxiety are more common indicators of occupational stress. Work experience also has a strong association with experiencing stress related to “unrealistic expectations from their patients with complex medical and social problems” (s.df=.082). Young doctors with work experience of less than 5 years and those who have worked for more than 20 years in the industry similarly find it stressful to deal with such “complex patients”. Conclusions: Primary care doctors in Ukraine, from many different demographic backgrounds, experience high levels of occupational stress; this is a common health condition, which can have devastating personal and professional consequences.

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