Background The Hungarian primary care system faces a severe shortage of family physicians. Medical students’ perceptions of family medicine need to be known and medical students need to be given appropriate and comprehensible information about this speciality. The expected future salary is an important factor in career choice. Most of the family doctors are self-employed and the practices have a corrected capitation-type financing. Although the majority of health care services are covered by social health insurance and are provided for the insured patients free of charge, informal payment is an existing phenomenon with different motivations and consequences. This study aimed to investigate medical students’ knowledge about their future earning opportunities and their attitudes towards informal payment. Methods A cross sectional survey with a self-administered questionnaire was conducted. Each of the four Hungarian medical universities were represented by their medical students who attended family medicine lectures in person from December 2019 to April 2020. The students were asked about their career plans, about their estimations of current and ideal expected salaries and about the effect of expected income for the choice of specialisation. Their attitudes towards informal payment were assessed. Results Response rate was 67.3% (N = 465/691). Almost two-thirds of the participants were women. Only 5% of the respondents (N = 23/462) plan to work as a family doctor in the future. The vast majority (91.9%) of the students had already thought about their future income. On a 10-point Likert scale (1 = ‘no influence’, 10 = ‘very big influence’) 76% answered that the expected future income exerts a considerable (≥5 Likert points) influence on their career choice in general. The mean of the ideal expected monthly income of the residents, GPs and other specialists was €1154 ± 648, €1696 ± 904 and €2174 ± 1594, respectively. The mean of the monthly income for a GP, as estimated by the studenst, was €1140 in rural and €1122 in urban settings. More than four-fifths of the students (N = 375/453) rejected the practice of informal payment. Conclusions Expected salaray is one important aspect in the career choice of medical students, students wish to have more information on this topic. The reported ideal incomes are higher than those expected. This points to a relevant gap. However, most of the students do not accept informal payment as a possibility to close this gap. The expected and the ideal income differ from the real incomes of Hungarian GPs – this indicates the need of bringing objectoive information to the students to enhance attractivity of GP as a carer choice.

Perceived cardiovascular risk and incorrect optimism about this hazard have minimal, if any, influence on attitude towards lifestyle change. Patients' motivation seems not to be primarily health related.

Szegedi Tudományegyetem, Általános Orvostudományi Kar, Családorvosi Intézet és Rendelő, SzegedBevezetés: A XXI. században a családorvosi hivatás változása figyelhető meg. Az elvándorlás, a gyógyítók elöregedése és a hálapénz kérdése meghatározóak az egészségügyi szektor humánerőforrás-krízise szempontjából. Célkitűzés: A szerzők célul tűzték ki a hazai családorvosok és családorvos rezidensek hivatásról és a hálapénzről való vélekedése-inek feltárását. Módszer: Feltáró jellegű kvantitatív vizsgálat családorvosok (n = 363) és családorvos rezidensek (n = 180) körében. Jelen elemzés középpontjában a jövedelemre vonatkozó kérdések, a hálapénzzel és hivatással kapcsolatos vélemények álltak. Eredmények: A válaszadók hivatásválasztásában és hivatástudatában az altruizmus, a szolgálat és a felelősségvállalás a legmeghatározóbb tényezők. A paraszolvencia tekintetében a rezidensminta szignifikánsan elutasítóbb (19,7% vs. 38,3%; p<0,001). A rezidensek kisebb összeget tartanak elfogadhatónak (14,3% vs. 8,9%; p<0,034), valamint nagyobb arányban mondják azt, hogy a befolyt jövedelmet praxisfejlesztésre fordítanák (1,4% vs. 9,4%; p<0,023). Következtetések: A családorvosok és a családorvos rezidensek hivatással kapcsolatos legfontosabb attitűdjei közel azonosak, de a hálapénz kérdéséről a két generáció másként vélekedik. Orv. Hetil., 2016, 157(36), 1438-1444. Kulcsszavak: családorvos, családorvos rezidens, hivatás, hálapénz Opinions of Hungarian family physicians and residents on vocation and informal paymentIntroduction: The changing of the family medicine can be observed in the New Millennium. Migration, the aging of the healers and informal payment are crucial to the human resource crisis of the health sector. Aim: The aim of this study was to investigate the family physicians' and residents' opinions about the vocation and informal payment. Method: Exploratory, quantitative study was carried out among family physicians (n = 363) and family physician residents (n = 180). The central questions of the study were the vocation, the income and the informal payment. Results: The most decisive factors of the carrier choice were altruism, service and responsibility. Residents were significantly rejective (19.7% vs. 38.3%, p<0.001) about informal payment. They would accept smaller amounts of informal payment (14.3% vs. 8.9%, p<0.034), and would spend it on praxis development (1.4% vs.9.4% p<0.023). Conclusions: The attitudes of family physicians and residents are the same in case of the vocation, but on the issue of informal payment, the two generations have different opinions.

Diabetes and depression are considered global epidemics. Both have multifactorial aetiologies, including external, environmental factors and internal factors in connection with physiological processes as well as genetic variants triggering disease onset. Although the co-occurrence of diabetes and depression is well described, the mechanisms underlying these diseases and their interactions are still not entirely revealed. The authors aimed to present known and potential explanations of the co-occurrence of these diseases and to highlight the importance of their timely diagnosis and effective treatment, as their co-occurrence may increase morbidity and mortality. Screening for depression among diabetes patients and for diabetes among patients with depression may decrease the incidence of complications and consequences of this comorbidity and may foster more effective treatment. General practitioners play a key role in the care of both diseases by providing timely diagnosis and adequate treatment potentially leading to a better quality of life, slower disease progression and decreased risk of complications. Orv Hetil. 2019; 160(21): 807–814.

Összefoglaló. A cukorbetegség és a depresszió kapcsolatáról számos tanulmány született. A szorongás és a diabetes közti összefüggést már kevesebben vizsgálták, pedig jelentős szerepük van a szorongásos kórképeknek is, hiszen nagyon gyakori a két betegség együttes előfordulása. A diabetes már önmagában is nagy betegségterhet jelent a betegek számára, a társuló pszichiátriai kórképek pedig tovább rontják a kezelés minőségét, ezért fontos a korai felismerésük és kezelésük. Jelen összefoglaló közleményünk célja a szorongásos kórképek és elsősorban a 2-es típusú cukorbetegség közti összefüggés feltárása. Több elmélet született a köztük lévő kapcsolat magyarázatára. Egyesek szerint szerepet játszhat benne a közös etiológiai háttér, mások szerint a cukorbetegség diagnózisa és a gondozásával kapcsolatos feladatok vezetnek szorongáshoz. Megint mások pedig ellentétes irányból vizsgálva a köztük lévő kapcsolatot, arra a megállapításra jutottak, hogy a szorongás különböző fiziológiai mechanizmusokon keresztül vezethet cukorbetegséghez. A szorongás és a diabetes közti kapcsolat irányától függetlenül javasolt a depresszió mellett a szorongásnak a szűrése és minél korábbi kezelése a cukorbetegek körében, így csökkennének a komorbiditásból származó szövődmények, a kezelési nehézségek, javulna a betegek életminősége és a terápiával való együttműködésük. Orv Hetil. 2021; 162(31): 1226–1232. Summary. The relationship between diabetes and depression has been evaluated in numerous studies. The association between diabetes and anxiety was less investigated, although the importance of anxiety disorders is underlined by its frequent co-occurrence with diabetes. Diabetes alone carries a significant disease burden for patients. Comorbidity with psychiatric disorders deteriorates the quality of care, therefore early treatment and diagnosis of these conditions are essential. The aim of the present review is to outline the relationship between anxiety and mainly type 2 diabetes. There are several theories to explain the relationship between them. Some researchers suggest that common etiological background may play a role in their co-occurrence, some believe that the diagnosis of diabetes and the burden of self-management lead to anxiety, while others – investigating the relationship from the opposite direction – suggest that anxiety leads to diabetes through physiological mechanisms. Independently of the direction of the relationship, screening for anxiety and timely treatment among diabetic patients may decrease the risk of complications, the difficulty in treatment arising from the co-occurrence of these two conditions and may improve patients’ quality of life and adherence to therapy. Orv Hetil. 2021; 162(31): 1226–1232.