The Provision of Health Care by Family Physicians in Taiwan as Illustrated With Population Pyramids

Explaining the Role of Physicians in Urban Comprehensive Health Service Centers After Implementing Health Transformation Plan in Southeast of Iran: A Qualitative Study

Background: Health transformation plan (HTP) in Iran was established in 2014 to promote primary health care through expanding and strengthening the first level of services in urban and rural areas. The activities of physicians and their colleagues in comprehensive health service centers have increased access and improved community health. Conducting various studies on the urban physicians’ roles can help policymakers achieve the goals. Objectives: This study aimed to explain the role of physicians working in urban, comprehensive health service centers after implementing the HTP. Methods: Participants in this qualitative study consisted of physicians, healthcare providers, managers, and experts, working in urban health centers selected by a purposive sampling method. The data were collected by semi-structured interviews. After data saturation, they were analyzed by conventional content analysis. Results: After interviewing 35 people and several stages of review, coding, and using the experience of experts, the data were classified into six main categories, 11 subcategories, and 33 codes. Factors influencing the role of physicians were service delivery, electronic health records, resources, community culture, monitoring, supervision, and practical suggestion. The participants expressed the workload, referral system, integrated electronic health record, financial resources, human resources, equipment, and public participation as some aspects related to the role of physicians. Conclusions: Based on the current study, human and financial resources should be managed to retain the physicians in this plan. In addition, increasing the quality of services, improving electronic health records, and attention to public culture can be considered.

To Work at Clinics or at Hospitals? Analysis of Family Physician Recruitment Advertising in Taiwan

Family physicians act as gatekeepers of the healthcare system and have an indispensable role in providing holistic care in the primary care system. While previous studies had focused on the geographic maldistribution of family physicians, the current study investigated the distribution of job opportunities for family physicians by analyzing recruitment advertisements posted in medical association journals, as an indirect way to observe the marketplace demand for physicians. We collected all the recruitment advertisements for family physicians in the twelve issues of the Taiwan Medical Journal, the official organ of the Taiwan Medical Association, in 2018. In contrast to 124 new trainees annually, 739 advertisements for family physicians were posted within the entire year. After eliminating repeated advertisements, there were 302 distinct advertisements, of which hospitals accounted for 18.9% (n = 57). The job opportunities at hospitals were offered mainly by regional hospitals (n = 26) and community hospitals (n = 29), but only two by medical centers. Family physicians in Taiwan were in great demand not only by primary care clinics but also by hospitals. The role of family physicians in hospitals is worth further study.