Private or salaried practice: how do young general practitioners make their career choice? A qualitative study

Abstract

Background: Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. Methods: A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Results: Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice.Conclusions: National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

Patient house calls in Attica and Thessaloniki, Greece (2005-2015): a model for out-of-hospital multispecialty emergency medicine

“…Recently published studies showed that young physicians dismiss home visits [ 21 ]. Besides financial incentives, key factors that could enhance the physician’s willingness to participate in a home call include override of barriers like schedules and travel time, personal safety and liability, and further development of applications (diagnostic devices/tests, communication with doctors of other specialties) through technological advances that could increase the degree of certainty in working diagnosis [ 1 , 2 ].…”

Burnout in French General Practitioners: A Nationwide Prospective Study

“…Although some GPs do not usually seek their peers for advice-alleging lack of time-they recognize that clinical discussions solved during clinical discussions [21]. Encouraging peer arrangements should be a key intervention [21,41,51], both within the specialty and with other specialists [29,41]. Group practice may also benefit the socials needs that physicians have.…”

“…Even though national rural areas have difficulties in recruiting doctors, they had a significantly lower burnout prevalence. This may be related to the greater satisfaction given by their relationship with patients, clinical autonomy, and life in small communities [2,12,27,49,[51][52][53][54].…”

Primary Care Physicians’ Personal and Professional Attributes Associated With Forgoing Own Care and Presenteeism: A Cross Sectional Study

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