PDF(Pubmed)
Abstract：
The landscape of general practice has experienced notable transformations in recent decades, profoundly influencing the working conditions of general practitioners (GPs). This study aimed to examine the most salient changes affecting GPs\' daily practices. Through semi-structured qualitative interviews with 15 end-of-career GPs, the study explored how these changes affected work organization, equipment, working hours, work-life balance, job satisfaction, training, patient relationships, and reputation. The interviews revealed that these changes were perceived as barriers, opportunities, or a complex interplay of both for general practice. While the interviewed GPs valued technological advancements and reported positive developments in working conditions, challenges included a gradual reduction in the range of tasks, growing administrative burdens, and less practical training for young physicians. Other changes, such as new doctor-patient dynamics, the transition from single to group practice, and differing professional expectations of the younger generation, were seen as both challenging and strengthening for general practice. By combining these factors and trade-offs observed by end-of-career GPs in our study over the past few decades with general societal changes, we provide ideas for the design of future framework conditions in general practice that might enhance the attractiveness of the profession. These insights offer key considerations that can guide future strategies for general practice and medical education.
摘要：
近几十年来，全科医学的格局经历了显著的转变，深刻影响全科医生的工作条件。这项研究旨在研究影响全科医生日常实践的最显著变化。通过对15名职业生涯末期全科医生的半结构化定性访谈，这项研究探讨了这些变化如何影响工作组织，设备,工作时间,工作与生活的平衡,工作满意度,培训,病人关系,和声誉。采访显示，这些变化被视为障碍，机遇,或两者在一般实践中的复杂相互作用。虽然接受采访的全科医生重视技术进步，并报告了工作条件的积极发展，挑战包括逐步减少任务范围，日益沉重的行政负担，对年轻医生的实践培训较少。其他变化,比如新的医患动态，从单身到团体练习的过渡，以及年轻一代不同的职业期望，被视为具有挑战性和加强一般实践。通过将这些因素和我们在过去几十年的研究中的职业生涯结束全科医生观察到的权衡与一般的社会变革相结合，我们为一般实践中未来框架条件的设计提供了想法，这些想法可能会增强该行业的吸引力。这些见解提供了关键的考虑因素，可以指导未来的一般实践和医学教育战略。
