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未来家庭医生的建议:对家庭医学住院医师和早期职业家庭医生进行定性访谈的结果。

Advice to future family physicians: findings from qualitative interviews with family medicine residents and early-career family physicians.

机构信息

Primary Care Research Unit, Dalhousie Family Medicine, Dalhousie University, 1465 Brenton Street Suite 402, Halifax, NS, B3J 3T4, Canada.

出版信息

BMC Med Educ. 2024 Aug 20;24(1):897. doi: 10.1186/s12909-024-05882-5.

Abstract

BACKGROUND

Canadians continue to report challenges accessing primary care. Practice choices made by primary care providers shape services available to Canadians. Although there is literature observing family medicine practice trends, there is less clarity on the reasoning underlying primary care providers' practice intentions. Advice offered by residents and early-career family physicians may reveal challenges they have experienced, how they have adapted to them, and strategies for new residents. In this paper, we examine advice family medicine residents and early-career family physicians would give to new family medicine residents.

METHODS

Sixty early-career family physicians and thirty residents were interviewed as part of a mixed-methods study of practice patterns of family medicine providers in Canada. During qualitative interviews, participants were asked, "what advice would you give [a new family medicine resident] about planning their career as a family physician?" We inductively analyzed responses to this question.

RESULTS

Advice consisted of understanding the current climate of family medicine (need for specialization, business management burden, physician burnout) and revealed reasons behind said challenges (lack of support for comprehensive clinic care, practical limitations of different practice models, and how payment models influence work-life balance). Subtheme analyses showed early-career family physicians being more vocal on understanding practical aspects of the field including practice logistics and achieving job security.

CONCLUSION

Most advice mirrored current changes and challenges as well as revealing strategies on how primary care providers are handling the realities of practicing family medicine. Multi-modal systemic interventions may be needed to support family physicians throughout the changing reality of family medicine and ensure family medicine is an appealing specialty.

摘要

背景

加拿大人继续报告在获得初级保健方面面临挑战。初级保健提供者的实践选择决定了加拿大可获得的服务。尽管有观察家庭医学实践趋势的文献,但对于初级保健提供者实践意图背后的推理了解较少。住院医师和早期职业家庭医生提供的建议可能揭示了他们所经历的挑战、他们如何适应这些挑战以及为新居民提供的策略。在本文中,我们研究了家庭医学住院医师和早期职业家庭医生会向新的家庭医学住院医师提供的建议。

方法

在对加拿大家庭医学提供者实践模式的混合方法研究中,对 60 名早期职业家庭医生和 30 名住院医师进行了采访。在定性访谈中,参与者被问到:“你会给[一名新的家庭医学住院医师]关于规划他们作为家庭医生的职业生涯提供什么建议?”我们对这个问题的回答进行了归纳分析。

结果

建议包括了解家庭医学的当前情况(专业化的需求、业务管理负担、医生倦怠),并揭示了这些挑战背后的原因(缺乏对综合诊所护理的支持、不同实践模式的实际限制以及支付模式如何影响工作-生活平衡)。子主题分析表明,早期职业家庭医生更能理解该领域的实际方面,包括实践后勤和获得工作保障。

结论

大多数建议反映了当前的变化和挑战,并揭示了初级保健提供者如何应对家庭医学实践现实的策略。可能需要多模式系统干预来支持家庭医生应对家庭医学不断变化的现实,并确保家庭医学是一个有吸引力的专业。

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