Abstract
OBJECTIVE: To determine the effect on a cohort of family physicians of health care system reforms in Ontario and the relationship of reforms to their career satisfaction. DESIGN: Follow-up survey in 1999 of a cohort initially studied in 1993, posing many of the original questions along with some new ones. Four focus groups of other Ontario family physicians. SETTING: Family practices in Ontario. PARTICIPANTS: All family physicians who had received certification after completing a family medicine residency between 1989 and 1991 and were practising in Ontario in 1993. This report addresses only those members of the cohort who continued to practise family medicine in Ontario (N = 236). Four focus groups with a total of 27 family physicians. MAIN OUTCOME MEASURES: Reaction to health care system reforms. Perceived effect of reforms on practice. Current perception of quality of health care system and level of career satisfaction and changes in these variables since 1993. RESULTS: Response rate was 53% of original cohort. Only three of 13 selected health reforms were believed to have had a favourable effect. Physicians reported lower levels of satisfaction with their careers. Overall quality of the health care system was perceived by both respondents and focus group members to have declined. Several difficulties affected practice and personal life. CONCLUSION: Family physicians viewed the effect of health care reforms negatively and were significantly less satisfied with their careers than they were in 1993. Better consultation with stakeholders before implementation of reforms is needed to ensure that these stakeholders understand the likely effects of these reforms.
Full Text
The Full Text of this article is available as a PDF (185.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Forster J., Rosser W., Hennen B., McAuley R., Wilson R., Grogan M. New approach to primary medical care. Nine-point plan for a family practice service. Can Fam Physician. 1994 Sep;40:1523–1530. [PMC free article] [PubMed] [Google Scholar]
- Grol R., Mokkink H., Smits A., van Eijk J., Beek M., Mesker P., Mesker-Niesten J. Work satisfaction of general practitioners and the quality of patient care. Fam Pract. 1985 Sep;2(3):128–135. doi: 10.1093/fampra/2.3.128. [DOI] [PubMed] [Google Scholar]
- Sullivan P., Buske L. Results from CMA's huge 1998 physician survey point to a dispirited profession. CMAJ. 1998 Sep 8;159(5):525–528. [PMC free article] [PubMed] [Google Scholar]
- Woodward C. A., Cohen M., Ferrier B., Brown J. Physicians certified in family medicine. What are they doing 8 to 10 years later? Can Fam Physician. 2001 Jul;47:1404–1410. [PMC free article] [PubMed] [Google Scholar]