Contentment in general practice--for now

A method for extracting electronic patient record data from practice management software systems used in veterinary practice

Background

Data extracted from electronic patient records (EPRs) within practice management software systems are increasingly used in veterinary research. The use of real patient data gives the potential to generate research that can readily be applied to clinical practice. The use of veterinary EPRs for research in the United Kingdom is hindered by the number of different Practice Management System (PMS) providers used by practices, as obtaining and combining data from different systems electronically can be problematic. The use of extensible mark up language (XML) to extract clinical data for research would potentially resolve the compatibility issues between systems. The aim of this study was to establish and validate a method for the extraction of small animal patient records from a veterinary PMS that could potentially be used across multiple systems. An XML schema was designed to extract clinical information from EPRs. The schema was tested and validated in a test system, and was then tested in a real small animal practice where data was extracted for 16 weeks. A 10 % sample of the extracted records was then compared to paper copies provided by the practice.

Results

All 21 fields encoded by the XML schema, from all of the records in the test system, were extracted with 100 % accuracy. Over the 18 week data collection period 4946 records, from 1279 patients, were extracted from the small animal practice. The 10 % printed records checked and compared with the XML extracted records demonstrated all required data was present. No unrequired, sensitive information e.g. costs or services/products or personal client information was extracted.

Conclusions

This is the first time a method for data extraction from EPRs in veterinary practice using an XML schema has been reported in the United Kingdom. This is an efficient and accurate way of extracting data which could be applied to all PMSs nationally and internationally.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-016-0861-y) contains supplementary material, which is available to authorized users.

'It gave me a new lease of life … ': GPs' views and experiences of supervising foundation doctors in general practice

BACKGROUND

General practice is a popular placement in the second year of Foundation training. Evaluations suggest this is a positive experience for most trainee doctors and benefits their perceptions of primary care, but the impact on primary care supervisors has not been considered. At a time when placements may need to increase, understanding the experience of the GP supervisors responsible for these placements is important.

AIM

To explore the views, experiences and needs of GPs who supervise F2 doctors in their practices including their perceptions of the benefits to individuals and practices.

DESIGN AND SETTING

A qualitative approach with GPs from across Severn Postgraduate Medical Education who supervise F2 doctors.

METHOD

Semi-structured interviews with 15 GPs between December 2012 and April 2013.

RESULTS

GP supervisors are enthusiastic about helping F2 doctors to appreciate the uniqueness of primary care. Workload and responsibility around supervision is considerable making a supportive team important. Working with young, enthusiastic doctors boosts morale in the team. The presence of freshly trained minds prompts GPs to consider their own learning needs. Being a supervisor can increase job satisfaction; the teaching role gives respite from the demanding nature of GP work.

CONCLUSION

Supervisors are positive about working with F2s, who lift morale in the team and challenge GPs in their own practice and learning. This boosts job and personal satisfaction. Nonetheless, consideration should be given to managing teaching workload and team support for supervision.

Motives for early retirement of self-employed GPs in the Netherlands: a comparison of two time periods

BACKGROUND

The high cost of training and the relatively long period of training for physicians make it beneficial to stimulate physicians to retire later. Therefore, a better understanding of the link between the factors influencing the decision to retire and actual turnover would benefit policies designed to encourage later retirement. This study focuses on actual GP turnover and the determining factors for this in the Netherlands. The period 2003-2007 saw fewer GPs retiring from general practice than the period 1998-2002. In addition, GPs' retirement age was higher in 2003-2007. For these two periods, we analysed work perception, objective workload and reasons for leaving, and related these with the probability that GPs would leave general practice at an early age.

METHODS

In 2003, a first retrospective survey was sent to 520 self-employed GPs who had retired between 1998 and 2002. In 2008, the same survey was sent to 405 GPs who had retired between 2003 and 2007. The response rates were 60% and 54%, respectively. Analyses were done to compare work perception, objective workload, external factors and personal reasons for retiring.

RESULTS

For both male and female GPs, work perception was different in the periods under scrutiny: both groups reported greater job satisfaction and a lower degree of emotional exhaustion in the later period, although there was no notable difference in subjective workload. The objective workload was lower in the second period. Moreover, most external factors and personal reasons that may contribute to the decision to retire were reported as less important in the second period. There was a stronger decrease in the probability that female GPs leave general practice within one year than for male GPs. This underscores the gender differences and the need for disaggregated data collection.

CONCLUSIONS

The results of this study suggest that the decrease in the probability of GPs leaving general practice within one year and the increasing retirement age are caused by a decrease in the objective workload, a change in GPs' work perception, external factors and personal reasons. Based on the results of this study, we consider workload reduction policies are the most useful instruments to control retention and retirement.

Spatial variation in general medical services income in dublin general practitioners

The general medical services (GMS) scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs). The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

Doctors as patients: a systematic review of doctors' health access and the barriers they experience

BACKGROUND

The need to improve doctors' access to health care by reducing the barriers they experience has been regularly described in the literature, yet the barriers experienced are not well defined, despite the volume of expert opinion in this area.

AIM

To define what is known about doctors' access to health care from the data within the current literature.

DESIGN OF STUDY

A systematic review of studies of doctors' health access.

METHOD

A systematic search of MEDLINE and CINAHL, supplemented by citation searches and searches of the grey literature, identified both quantitative and qualitative studies. Two reviewers used specific criteria for inclusion of studies and quality assessment. The data were tabulated and analysed.

RESULTS

Twenty-six articles met the inclusion criteria. The paucity of data and the overall poor quality of those data are highlighted. Despite this, many doctors appear to have a GP, but this does not ensure adequate health access. Systemic barriers to healthcare access (long hours and cultural issues) are more significant than individual barriers.

CONCLUSION

Expert opinion in this field is supported by poor-quality data. The current knowledge reveals important similarities between doctors and the general population in their healthcare access, especially with mental health issues. Understanding this may help the medical profession to respond to these issues of 'doctors' health' more effectively.