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104 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 Figure 4: Criteria of work-life balance policies: radar by policy. Additional stakeholders’ suggestions for the balance between work and quality of life relate to the security of the work: a better social status, a health center for the GPs, less control from the insurance institutions. Two suggested policies concern the use of information technology. On one hand, it should improve the availability and selection of scientific information. On the other hand, the sharing of patient’s data should optimize the decisions regarding their care. Good relationships between colleagues and the group practice seem the best ways for improving the quality of life. Most stakeholders acknowledge that the society is changing as well as the profession and that the GPs should have the possibility to organize their profession to meet their private and professional goals. 6.6.2.4 Health care organization policies The most important policy concerns the GPs working together, with a mean rank of 1.91 and a score of 5.68 (table 9). It is important to note that working together may not necessarily imply working in the same place. Indeed, sharing medical records is more appropriate and effective than sharing a common infrastructure whilst the patients should also keep a privileged link with one GP. Indeed, our results show that sharing a common infrastructure comes at the sixth place and has a mean rank of 2.30 and a mean score of 5.50. The delegation of administrative activities is also very important for the respondents with a mean rank of 2.03 and a mean score of 5.40. The improvement of the role of the GP in the multidisciplinary team is slightly less important than the delegation of the administrative activities with a mean rank of 2.04 but more important when linked with criteria with a mean score of 5.54. The positive open-ended comments provided for the GPs working together suggest that it will increase quality of life, satisfaction in the work and multidisciplinary approach due to the practice with colleagues. However, this type of practice should not be an obligation: the solo-GPs should not be penalized.
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 105 Regarding the delegation of the administrative activities, it seems more than necessary to decrease them to give more time to GPs to perform medicine. However, the interviewees think it would be better to decrease the work than to add help. One of the conditions behind the improvement of the role of the GP in the multidisciplinary team is the fact that it should be paid. Furthermore, the time for the meetings and their conditions (face-to-face, phone or email) should also be clear. Table 19: Preferred health organization policies: mean ranks and scores (n=102) Most preferred health organization policy Mean Mean rank score 1. GPs working together 1.91 5.68 2. Delegation of administrative activities 2.03 5.40 3. Improvement of the role of the GP in the multidisciplinary team 2.04 5.54 4. Delegation of specific clinical tasks to other health professions 2.12 4.82 5. Limitation of the excessive use of the second line 2.19 5.09 6. GPs sharing a common infrastructure 2.30 5.50 7. Creation of a nurse-assistant master 2.60 5.01 8. Incentives for working in underserved areas 2.66 5.27 9. Removal of the Numerus Clausus 3.39 3.89 10. Support of a local resource agency for GPs 4.00 4.27 Some respondents are positive about the most discarded policy (to support a local resource agency for GPs) but negative comments are more important and concern the administrative characteristics and burdens of these agencies. The suggestions go in the way of reinforcing the existing structures, for example the GPs’ circles, to perform this mission. Fostering GPs to work together and improving its role in the multidisciplinary team are two major strategies according to the 4 criteria (figure 5). Limiting the use of the 2 nd line is a good strategy for improving attraction and cost-benefit: but it is poorly acceptable by the other health professions and performs badly regarding accessibility. Scrapping the numerus clausus and creating local resource agencies were mostly two ineffective strategies on the four criteria (figure 6). The delegation of either clinical tasks or administrative tasks as well as the organization of a new master course for nurse-assistants had mixed results: although their effect on attraction would be good, they were judged as a poor cost-benefit measure. Figure 5: Criteria of organisation policies: radar by policy.
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