Beaulieu Marie-Dominique, Dory Valérie, Pestiaux Dominique, Pouchain Denis, Rioux Marc, Rocher Guy, Gay Bernard, Boucher Laurier
Département de médecine familiale, Université de Montréal, Centre de recherche du CHUM, Hôpital Notre-Dame, Pavillon L-C Simard, 1560 Sherbrooke E, 8th Floor, Montreal QC, H2L 4M1, Canada.
Can Fam Physician. 2009 Aug;55(8):e14-20.
To explore the conceptions that family medicine residents from 3 countries have of the roles and responsibilities of family physicians in order to gain a better understanding of challenges that might transcend the specific contexts of different health care systems.
Qualitative study using focus groups.
Resident training programs in France, Belgium, and Canada.
A total of 57 residents in the last year of training.
Ten focus groups were conducted in 3 countries: 2 in France, 3 in Belgium, and 5 in Canada. All focus groups were held in different cities, with residents registered in different universities in France and Canada and with residents from the same university in Belgium. The study was informed by Abbott's conceptual framework on the system of professions. Each 90-minute focus group was moderated by the same researchers. The transcripts were analyzed according to the immersion-crystallization method.
Respondents shared common conceptions of the family physician's role: continuity of care and patient advocacy were seen as the foundations of the discipline. Respondents also shared a sense of discomfort about how accessible they were expected to be for patients and about the scope of family practice. They saw family medicine as flexible and reported that they strove for balance between their professional and personal life goals. All respondents strongly believed that their profession was undervalued by the medical schools where they trained.
This exploratory study suggests that there are more similarities than differences in the understanding that future family physicians from different countries have of their discipline and of their careers. We observed a tension between a desire to develop a "new general practice" and the more traditional vision of the discipline. The culture in academic settings appears to contribute to the persistent low appeal of being a primary care physician.
探讨来自3个国家的家庭医学住院医师对家庭医生角色和职责的看法，以便更好地理解可能超越不同医疗体系具体背景的挑战。
采用焦点小组的定性研究。
法国、比利时和加拿大的住院医师培训项目。
共有57名处于培训最后一年的住院医师。
在3个国家开展了10个焦点小组：法国2个，比利时3个，加拿大5个。所有焦点小组在不同城市举行，法国和加拿大的住院医师来自不同大学，比利时的住院医师来自同一所大学。该研究以阿博特关于职业体系的概念框架为依据。每个90分钟的焦点小组由同一名研究人员主持。根据沉浸-结晶法对访谈记录进行分析。
受访者对家庭医生的角色有共同看法：连续性照护和为患者代言被视为该学科的基础。受访者对于期望他们为患者提供的可及性以及家庭医疗的范围也有不适感。他们认为家庭医学具有灵活性，并表示努力在职业和个人生活目标之间取得平衡。所有受访者都坚信他们所学专业在培训他们的医学院校中未得到重视。
这项探索性研究表明，不同国家未来的家庭医生对其学科和职业的理解中，相似之处多于差异。我们观察到在发展“新的全科医疗”的愿望与该学科更传统的愿景之间存在紧张关系。学术环境中的文化似乎导致了成为初级保健医生的吸引力持续低迷。
