General Practitioners' Attitudes to a Recent Change in their Remuneration System

Abstract

The study examines the attitudes of general practitioners in Copenhagen to a recent change in their remuneration system from capitation to a mixed capitation and fee-for-service system. The study was based on two questionnaires, one before and one 18 months after the change, distributed to a primarily self-selected sample of 100 general practioners in Copenhagen City. The questionnaires provided information about certain basic characteristics of the respondents, attitudes to the new remuneration system as compared with the former, and possible changes in attitudes towards professional competence and responsibilities in secondary versus primary care. The majority of the respondents did not feel any changes under the new remuneration system in terms of diagnostic and curative possibilities and their relations to colleagues and patients. Attitudes to secondary versus primary care responsibilities also changed little. The majority felt that there had been an increase in their total work load, but also an improved economic situation in their practice. 21% felt that there was more competition with colleagues and 30% that doctor-patient relationships had suffered as a result of the introduction of a fee-for-service.