Dual practice and multiple job holding among Iranian general practitioners: Rate and effective factors

Abstract

Background: Physician's dual practice is a common phenomenon in both developing and developed countries. This study aimed to investigate the rate and factors affecting the dual practice of general practitioners (GPs) as the most important primary care providers in Iran. Methods:This cross-sectional study was conducted on the data of 666 Iranian GPs, derived from a national survey. In this work, a researcher-made checklist was used to collect the required information. Multinomial logistic regression was used to examine the factors affecting concurrent employment in both public and private sectors and the factors affecting employment in more than one place (either public or private).Results: About 23.51% of the GPs were only working in the public sector, and 57.84% only in the private sectors.Also, 18.65% were working in both the private and public sectors. Results also indicated that 26.17% of the GPs were working in two or more places (whether public or private). Male GPs (P < .1) as well as the GPs with higher earnings expectations (P < .01) were more likely to have dual practice. Besides, the GPs working in small towns and villages (compared to Tehran, as capital of Iran) (P < .05) were less likely to have dual practice. Gender (male) and earnings expectations had a significant effect on working in more than one place (P < .01).

Current knowledge of physicians’ dual practice in Iran: A scoping review and defining the research agenda for achieving universal health coverage

“…Another underlying factor of dual practice was gender. Dual practice rates were higher in males than females; these findings were reported in four studies [10][11][12]15].…”

“…Forms. Six studies examined the simultaneous employment of physicians in the public and private sectors [9][10][11][12][13][14]. Four studies were conducted to examine the employment of physicians and specialists in more than one place of service delivery [5,10,15,16].…”

“…Extent. Five studies reported the rates of dual practice for general practitioners and medical specialists [5,11,12,15,21]. These rates were reported to be 18.65% for general practitioners working in both public or private sectors, 26.17% for general practitioners working in two or more job places (either public or private) [11], 57% for surgeons working in the public sector, 70% for non-full-time specialists in multiple job holdings, 58% for non-faculty member specialists in multiple job holdings, 69% for urinary tract and genital and neurosurgery [21], 63.1% for surgical specialists in other service locations [12], 47.7% for specialists in various medical specialties [15], and 42.3% for public medical specialists in the private sector [5].…”

“…In nine studies, the motivators and factors affecting dual practice were studied among physicians and specialists [5, 9-12, 14-16, 21]. In five studies, earning incentives and financial incentives were considered the predominant motivators of dual practice; in particular, a lower salary in the public sector compared to the private sector was the main reason for physicians' and specialists' dual practice [5,[9][10][11]14]. It was indicated that full-time specialists and female specialists spent less time providing services than full-time general practitioners.…”

Influencing factors on the tendency of general practitioners to join in urban family physician program: a cross-sectional survey on Iranian physicians

“…This issue can be explained by target income hypothesis [29]. According to this theory, whatever the gap between actual and target income for GPs be more, they seeks the ways to be enabled them to decrease the gap through attaining more income [30][31][32][33]. So it seems UFPP might close the GPs to their target income or conform to their economic expectations.…”