Family Doctor Department, Medical College in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland.
Fam Pract. 2011 Aug;28(4):437-43. doi: 10.1093/fampra/cmr003. Epub 2011 Mar 10.
The establishment of family medicine (FM) in Poland following political reform.
To describe family doctors' (FD) experiences during the introduction of FM.
A qualitative study of 25 FDs in Poland, using thematic analysis of semi-structured interviews. Open-structured narrative-based interviews with five FDs were then used to deepen understanding of the major emergent themes. Fifteen of 25 had a different initial specialization to FM; 10 of 25 overseas work experience.
Many doctors were driven by personal circumstances to engage with this new discipline, which provided a better fit with their life circumstances and a chance to escape from hierarchical structures characterizing the old regime. Personal experience of role models helped embrace FM, whereas adherence to ingrained biomedical approaches led to difficulty with exposure to common problems and could facilitate burnout. Shifting relationships in the reformed system caused tensions between primary and secondary care. While relationships with patients and specialists were being renegotiated, the concept of an independent FD practice surfaced. We observed that the most serious problems that the doctors encountered were circumstances related to the former health care system, in contrast to any lack of professional skills.
This is a rare qualitative study exploring Polish doctors' perspectives of the health care reform after the collapse of communism in Central and Eastern Europe. This analysis of newly qualified FDs has provided an insight into the authentic experiences, and motivation of grass roots FM pioneers in Poland.
波兰在政治改革后建立了家庭医学（FM）。
描述家庭医生（FD）在引入 FM 时的经验。
对波兰的 25 名 FD 进行了定性研究，使用半结构化访谈的主题分析。然后，对 5 名 FD 进行了基于开放性叙述的深入访谈，以加深对主要新兴主题的理解。25 名中有 15 名最初的专业领域与 FM 不同；10 名有海外工作经验。
许多医生出于个人情况而从事这一新学科，这与他们的生活环境更加契合，并为摆脱旧体制特征的等级结构提供了机会。个人对榜样的经验有助于接受 FM，而坚持根深蒂固的生物医学方法则导致难以接触常见问题，并可能导致倦怠。改革后的系统中关系的转变导致初级保健和二级保健之间的紧张关系。在重新协商与患者和专家的关系的同时，独立的 FD 实践的概念出现了。我们观察到，医生遇到的最严重的问题是与前医疗保健系统有关的情况，而不是任何专业技能的缺乏。
这是一项罕见的定性研究，探讨了共产主义垮台后中东欧国家医疗保健改革中波兰医生的观点。对新合格的 FD 的分析深入了解了波兰基层 FM 先驱者的真实经历和动机。
