University of Lübeck, Institute of Family Medicine, Ratzeburger Allee 160, 23538, Lübeck, Germany.
BMC Health Serv Res. 2022 Jun 24;22(1):821. doi: 10.1186/s12913-022-08199-5.
The increase of centralization developments in primary and secondary care practices may cause the organizational needs to increase as well, as the practices grow in size. This continuous change is observed in different stages in various countries since, from the perspective of a physician, it is reinforced by the benefits it adds to flexible work configuration, professional exchange and specialization. However, in order to benefit from the joint practice system, the proper managerial skills of practice managers are required, as doctors are not naturally prepared to fulfill such tasks. This study thus aims to gain insight into physicians' views in group practices and acquire a greater understanding of expectations towards practice management and the emerging role of practice managers (PM).
A cross-sectional study design was employed which utilized an anonymous online questionnaire. In total, 3,456 physicians were invited to participate in the study between February 8 and March 17 2021 by the Association of Statutory Health Insurance Physicians of Baden-Württemberg, Germany. Bivariate and multivariate analyses were applied to characterize the expectations of physicians towards practice management.
The survey yielded 329 replies (9,5%). 50% of the participating practices already had a PM employed. In general, these practices were larger than practices without a PM. Most physicians (85%) considered a medical background to be essential for the task of a PM. While practices without a PM considered it important for PMs to have medical qualifications, practices with a PM favored qualifications in business administration. 77.2% of physicians preferred to educate and recruit PMs out of their current practice staff. Competence in organizational tasks, such as coordination of tasks and quality management, was considered to be an essential skill of a PM and had the highest agreement levels among those surveyed, followed by staff management of non-physicians, billing, bookkeeping, staff management of physicians and recruiting. Based on multivariate regression analysis, larger practices valued the role of a PM more and were more likely to employ a PM. Notably, the effect that size had on these items was more substantial for generalists than specialists.
The benefits and importance of PMs as well as the potential for delegation are recognized, in particular, by larger practices. The positive feelings that physicians who already employ PMs have towards their contribution to ambulatory care are even more significant. Pre-existing medical support staff has been identified to be the most desirable candidates for taking on the role of PM.
初级和二级保健实践的集中化发展可能会导致组织需求增加，因为实践的规模在不断扩大。自从从医生的角度来看，这种持续的变化在不同国家的不同阶段都得到了观察，因为它增加了灵活的工作配置、专业交流和专业化的好处。然而，为了从联合实践系统中受益，需要有适当的实践经理管理技能，因为医生并非天生就具备履行此类任务的能力。因此，这项研究旨在深入了解医生在团体实践中的观点，并更深入地了解他们对实践管理的期望以及实践经理（PM）的新兴角色。
本研究采用横断面研究设计，利用匿名在线问卷对德国巴登-符腾堡州法定健康保险医师协会邀请的 3456 名医生进行了调查。2021 年 2 月 8 日至 3 月 17 日期间，共收到 329 份回复（9.5%）。参与调查的医生中有 50%的人所在的实践已经聘请了 PM。一般来说，这些实践比没有 PM 的实践规模更大。大多数医生（85%）认为 PM 的医学背景对于他们的工作至关重要。虽然没有 PM 的实践认为 PM 具有医学资格很重要，但有 PM 的实践更倾向于选择具有工商管理资格的人。77.2%的医生更愿意从当前实践的员工中培养和招聘 PM。组织任务协调和质量管理等方面的能力被认为是 PM 的一项重要技能，在接受调查的人中得到了最高的认同，其次是对非医生的员工管理、计费、簿记、医生的员工管理和招聘。基于多变量回归分析，较大的实践更重视 PM 的作用，更有可能聘请 PM。值得注意的是，这种规模对这些项目的影响在全科医生中比专科医生更为显著。
人们认识到 PM 的好处和重要性，以及委托的潜力，特别是在较大的实践中。已经雇佣 PM 的医生对他们对门诊护理的贡献持积极态度，这一点更为重要。已经确定，现有的医疗支持人员是最适合担任 PM 角色的人选。
