Resident and early-career family physicians’ focused practice choices in Canada: a qualitative study

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Monisha Kabir¹  Ellen Randall²  Goldis Mitra³  M Ruth Lavergne⁴  Ian Scott⁵  David Snadden⁶  Lori Jones⁷  Laurie J Goldsmith⁸  Emily G Marshall⁴  Agnes Grudniewicz⁹ 

[1] University of Ottawa, Ottawa, ON, and research associate, Division of Palliative Care, Bruyère Research Institute;School of Population and Public Health, University of British Columbia;Department of Family Practice, Faculty of Medicine, University of British Columbia;Department of Family Medicine, Primary Care Research Unit, Dalhousie University;Department of Family Practice, Faculty of Medicine, University of British Columbia, BC, Director, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia;Department of Family Practice, Faculty of Medicine, University of British Columbia, BC. Northern Medical Program, Prince George;Department of History, University of Ottawa, and Carleton University;GoldQual Consulting, and adjunct professor Faculty of Health Sciences, Simon Fraser University;Telfer School of Management, University of Ottawa

关键词: family practice;    general practice;    health policy;    internship and residency;    primary health care;    qualitative research;   

DOI  :  10.3399/BJGP.2021.0512

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background Focused practice within family medicine may be increasing globally, but there is limited research on the factors contributing to decisions to focus practice.Aim To examine the factors influencing resident and early-career family physician choices of focused practice across three Canadian provinces.Design and setting A subset of qualitative interview data were analysed from a study across British Columbia, Ontario, and Nova Scotia, Canada.Method Included in the analysis were a total of 22 resident family physicians and 38 early-career family physicians in their first 10 years of practice who intend to or currently practise in a focused area. Comparisons were made for participant types, provinces, and the degree of focused practice, while identifying themes related to factors influencing the pursuit of focused practice.Results Three key themes were identified of factors contributing to choices of focused practice: self-preservation within the current structure of the healthcare system; support from colleagues; and training experiences in medical school and/or residency. Minor themes included: alignment of practice with skills, personal values, or ability to derive professional satisfaction; personal lived experiences; and having many attractive opportunities for focused practice.Conclusion Both groups of participants unanimously viewed focused practice as a way to circumvent the burnout or exhaustion they associated with comprehensive practice in the current structure of the healthcare system. This finding, in addition to other influential factors, was consistent across the three provinces. More research is needed to understand the implications of resident and early-career family physician choices of focused practice within the physician workforce.

【 授权许可】

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