Préférences des médecins généralistes libéraux en France métropolitaine quant à la délégation des tâches médico-administratives aux secrétaires assistant(e)s médico-social(e)s : étude en analyse conjointe

Abstract

BackgroundA general practitioner's office is an economic unit where task delegation is an essential component in improving the quality and performance of work. AimTo classify the preferences of general practitioners regarding the delegation of medical-administrative tasks to assistant medical-social secretaries. MethodConjoint analysis was applied to a random sample of 175 general practitioners working in metropolitan France. Ten scenarios were constructed based on seven attributes: training for medical secretaries, logistical support during the consultation, delegation of management planning, medical records, accounting, maintenance, and taking initiative on the telephone. A factorial design was used to reduce the number of scenarios. Physicians’ socio-demographic variables were collected. ResultsOne hundred and three physicians responded and the analysis included 90 respondents respecting the transitivity of preferences hypothesis. Perceived difficulty was scored 2.8 out of 5. The high rates of respondents (59%; 95% CI [51.7–66.3]) and transitivity (87.5%; 95% CI [81.1–93.9]) showed physicians’ interest in this topic. Delegation of tasks concerning management planning (OR=2.91; 95% CI [2.40–13.52]) and medical records (OR=1.88; 95% CI [1.56–2.27]) were the two most important attributes for physicians. The only variable for which the choice of a secretary was not taken into account was logistical support. ConclusionThis is a first study examining the choices of general practitioners concerning the delegation of tasks to assistants. These findings are helpful to better understand the determinants of practitioners’ choices in delegating certain tasks or not. They reveal doctors’ desire to limit their ancillary tasks in order to favor better use of time for “medical” tasks. They also expose interest for training medical secretaries and widening their field of competence, suggesting the emergence of a new professional occupation that could be called “medical assistant”.