Purpose: In Norway health authorities are implementing a health care reform in which general practitioners (GPs) are expected to spend more time on individuals with risk factors, preventive health clinics, school health services and people certified sick. We aimed to explore which professional activities GPs consider to be meaningful and how they would like to prioritise tasks.
Method: In a cross sectional online survey 3,270 GPs were invited to consider twenty different activities in general practice. They were asked to rate each of them on a Likert scale anchored from 1 (not meaningful) to 5 (very meaningful). They then selected three activities from the item list - in order of priority - that they would like to spend more time on and three activities that they would like to spend less time on. We used multivariate linear regression to explore associations between meaningfulness scores and age, sex, number of patients listed and size of practice municipality.
Results: Approximately 40% (n=1,308) responded. The most meaningful activities were handling common symptoms and complaints (mean score 4.6), chronic somatic diseases (4.6), terminal care (4.3), emergency health care (4.3), chronic psychiatric diseases (4.1) and risk conditions such as hypertension, hypercholesterolemia and osteoporosis (4.1). The least meaningful activities were practice administration (2.9), school health services (2.8) and issuing health certificates (2.5). Scores on preventive health clinics for children were higher among females than males (mean score 3.4 versus 3.0, adjusted difference 0.36, 95% CI 0.19 to 0.52) and higher among physicians in rural versus urban municipalities (3.4 versus 2.9, adjusted difference 0.34, CI 0.17 to 0.51). Scores on risk conditions were positively associated with number of patients listed, whereas scores on follow up of people certified unfit for work were positively associated with the GPs’ age. The GPs wanted to spend more time on the most meaningful activities except for emergency health care. They wanted to spend less time on health certificates, practice administration, meetings with local health authorities, medically unexplained symptoms, addiction medicine, follow up of people certified sick, psychosocial problems, preventive health clinics for children and school health services.
Conclusion: The GPs found diagnosis and treatment of diseases most meaningful. Their priorities were partly at odds with those of the health authorities.
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