Male General Practitioners Research Articles

Assessment of Knowledge and Attitude of General Practitioners Regarding Autism and Associated Factors at Gondar University Hospital, Gondar, Ethiopia

Background: The neurodevelopmental conditions known as autism spectrum disorders (ASDs) start in early childhood and last the entirety of a person’s life. They are characterized by distorted social interaction, difficulties communicating, and repetitive, stereotypical behavior.Objective: This study sought to evaluate general practitioners (GPs)’ attitudes and knowledge of ASDs and related factors at Gondar University Hospital.Methods: An institutional‐based cross‐sectional study design was used. Using a convenience‐sample method, three‐hundred sixty individuals were chosen for this study. Data were collected using a self‐administered questionnaire. The GPs who took part in this survey were characterized by descriptive statistics. The relationship between the dependent variables (knowledge and attitude) and the sociodemographic characteristics was examined using an independent two‐sample t‐test and Pearson correlation analysis. The Statistical Package for the Social Sciences Version 25 was used for all data analyses.Results: In this study, the GPs had an average age of 31.82 years, with an average of 18 years since graduation and 16 years of practice. Participants’ average overall knowledge and attitude scores on autism were 15.83 (SD = 3.27) and 29.54 (SD = 3.21), respectively, both falling within the moderate range. Using an independent t‐test, we found a significant difference (p < 0.001) between the attitudes of male and female GPs regarding autism. The study also identified weakly significant correlations between GPs’ age and their attitudes toward autism (r = 0.271 ∗∗, p < 0.001) and between years of practice and attitudes (r = 0.105 ∗, p = 0.046). However, no significant correlations emerged between GPs’ knowledge and their age, years since graduation, or years of practice (r = 0.069, p = 0.194; r = 0.069, p = 0.193; and r = −0.053, p = 0.312, respectively). In addition, we observed a weakly significant association (r = 0.004 ∗∗, p < 0.001) between GPs’ knowledge and their attitudes about autism.Conclusion: Based on their total scores, the participants had a moderate level of knowledge and attitudes toward autism. There was a favorable correlation found between the study subjects’ attitudes regarding autism and their age, as well as their practice year. Furthermore, a clear correlation was observed between GPs’ attitudes and their understanding of autism.

Changes in weekly working hours, proportion of doctors with hours above the limitations of European Working Time Directive (EWTD) and time spent on direct patient care for doctors in Norway from 2016 to 2019: a study based on repeated surveys

ObjectivesTo compare the total weekly working hours, proportions with work hours above the limitations of European working time directive (EWTD) and time spent on direct patient care in 2016 and...

Factors associated with general practitioners' routines and comfortability with assessing female genital cutting: a cross-sectional survey

BackgroundFemale genital cutting (FGC) may cause a series of health problems that require specialized healthcare. General practitioners (GPs) are gatekeepers to specialized healthcare services in Norway. To refer girls and women subjected to FGC to appropriate services, GPs need to assess whether the health problems reported by these patients are related to FGC. However, we do not know to what degree GPs assess FGC as a potential cause of the patients' health problems. We also know little about the GPs' patterns of training and knowledge of FGC and their effect on the GPs' assessment of FGC as a potential cause of health problems.MethodWe employed a cross-sectional online survey among GPs in Norway to examine: 1) patterns of received training on FGC, self-assessed knowledge, and experiences with patients with FGC-related problems and 2) the association between these three factors and the GPs' assessment of FGC as a potential cause of patients' health problems. A total of 222 GPs completed the survey. Data were analysed using binary logistic regression, where we also adjusted for sociodemographic characteristics.ResultsTwo-third of the participants had received training on FGC, but only over half received training on FGC-related health problems. Over 75% of the participants stated a need for more knowledge of FGC typology and Norwegian legislation. While the majority of the participants assessed their knowledge of FGC medical codes as inadequate, this was not the case for knowledge of the cultural aspects of FGC. Female GPs were more likely to have experience with patients with FGC-related health problems than male GPs. Among GPs with experience, 46% linked health problems to FGC in patients unaware of the connection between FGC and such health problems. GPs were more likely to assess FGC as a potential cause of health problems when they had experience with patients having FGC-related problems and when they assessed their knowledge of FGC typology and FGC-related medical codes as adequate.ConclusionTo improve their assessment of FGC as a potential cause of patients' health problems, GPs should receive comprehensive training on FGC, with particular emphasis on typology, health problems, and medical codes.

Knowledge, attitude and behaviour of general practitioners in Shanghai during the pandemic of COVID-19: a cross-sectional study

ObjectivesTo understand the knowledge, attitude and behaviour of general practitioners (GPs) towards COVID-19 and to provide evidence for improved prevention and control measures against the pandemic.Study designA cross-sectional study was...

Determinants of well-being and their interconnections in Australian general practitioners: a qualitative study

ObjectivesThe well-being of doctors is recognised as a major priority in healthcare, yet there is little research on how general practitioners (GPs) keep well. We aimed to address this gap...

Australian children’s foot, ankle and leg problems in primary care: a secondary analysis of the Bettering the Evaluation and Care of Health (BEACH) data

ObjectivesTo explore children’s foot, ankle and leg consultation patterns and management practices in Australian primary care.DesignCross-sectional, retrospective study.SettingAustralia Bettering the Evaluation and Care of Health program dataset.ParticipantsData were extracted for...

General practitioner gender and use of diagnostic procedures: a French cross-sectional study in training practices

ObjectivesThe acceleration in the number of female doctors has led to questions about differences in how men and women practice medicine. The aim of this study was to assess the...

On the Road from Books to Thomas Lilti's Screen: Where Are the Country Doctors Heading?

On the Road from Books to Thomas Lilti's ScreenWhere Are the Country Doctors Heading? Peter I. Barta (bio) "L'homme est un apprenti, la douleur est son maître" —alfred de musset: "la nuit d'octobre"1 Thomas Lilti (1976–), the French physician and internationally renowned film director, has attained significant recognition for three thematically related films on doctors, offering a kaleidoscopic cinematic representation of the state of medicine in contemporary France and beyond.2 The films are thematically linked and form a trilogy about the training of physicians, life in a large teaching hospital in the metropolis, and general practice in the country. They have elicited an unprecedentedly high level of engagement from the junior physicians in internal medicine on our courses in medical humanities at Texas Tech University Health Sciences Center. Lilti's cinema focuses on the physician as a vulnerable human subject. The first in the trilogy, the film Hippocrate (Hippocrates)—released in 2014—traces the fortunes of a junior doctor (Benjamin Barois, played by Vincent Lacoste) doing his residency in a large Parisian teaching hospital where his own father is the statutory professor and medical director. Actors in the main roles carry over to the two subsequent films. Marianne Denicourt (Dr. Denormandy in Hippocrate) plays the female lead—Dr. Nathalie Delezia—in the second film, Médecin de Campagne (Irreplaceable, 2016)3 and Vincent Lacoste is cast as the central character both in Hippocrate and the third film, Première Année (The Freshmen, 2018).4 The educational aspect dominates not only Hippocrate but the other two films as well: the plot of [End Page 54] Médecin de Campagne involves an established male general practitioner and a junior female doctor joining his practice in a rural area, and Première Année relates the friendship of two first-year medical students at a university in Paris. The specific focus of this article will be on Médecin de Campagne, the artistically most successful piece in the trilogy. Thematically it connects the village doctor with both the world of the hospital and the concerns about training junior physicians. Furthermore, the film unpacks problems related to the gradual disappearance of general practice, especially in remote rural areas. The title alludes to earlier literary texts about the physical and emotional life of "country doctors" whose profession obliges them constantly to be at the service of others in order to prolong lives and remove or minimize pain. Lilti updates these concerns with a clear view of today's shifting paradigm in the medical world where new technologies and corporate business interests keep diminishing the role of the physician. With this in mind, my purpose here will be to assess the place of Lilti's film in its literary context. Lilti's excellent knowledge of his subject matter has been discussed in multiple interviews, including my own with Marianne Denicourt in this issue. Lilti did his residency in a large teaching hospital after he had obtained his medical qualifications. Then he spent many years in general practice. His creation of the characters in Médecin de Campagne undoubtedly draws upon close familiarity with the work they do. "I like having direct contact with patients, and the idea of taking care of several generations of one family. That appealed more to me than surgery, for instance," he said in an interview.5 The trilogy's focus on apprenticeship, professional conflicts at work, and problematic family relations has been the subject of televised and published conversations with Lilti. From these it emerges that Lilti's father is a physician specializing in obstetrics and gynecology and that evidently, he was not especially keen for his son to pursue a career in the arts.6 Lilti comments: "I have always felt the lack of paternal recognition. I grew up feeling constantly deprecated by the doctor father of whom I felt unworthy. I had the impression of never being sufficiently handsome, cultured or intelligent."7 Lilti, unlike his two brothers, became a physician to demonstrate that he does not lack his father's abilities to pursue a career in medicine. The father-son [End Page 55] rivalry and the bad relations between the...

General practitioners treating their own family members: a cross-sectional survey in Germany

BackgroundIn Germany, there are neither guidelines provided by the medical associations nor a public discussion about general practitioners (GPs) treating their family members. Only few studies on this topic from the primary care setting exist. The aim of this study is to describe GPs’ treatment of family members and to generate empirical data on the most common reasons for this.MethodsIn June 2018 we conducted a postal survey among GPs in the North Rhine region of Germany. The questionnaire was developed in a stepwise process including initial expert panels, interviews with GPs, item construction workshops, cognitive pre-tests and pilot testing with 40 questionnaires. The final questionnaire addressed: type and frequency of treatment, documentation and place of treatment, engagement as the official GP as well as reasons for and against the treatment. For data evaluation, descriptive and explorative statistical analyses were conducted.ResultsOverall, 393 questionnaires were returned (response rate 39.8%). 96.7% of the GPs had treated at least one family member during the last 12 months. Services that were provided frequently (more than three times in the last 12 months) included the prescription or dispensing of medication (partner 45%, children 37%, parents 43%, partner’s parents 26%), physical examinations (partner 18%, children 24%, parents 25%, partner’s parents 15%), and the arrangement or provision of laboratory tests (partner 14%, children 7%, parents 16%, partner’s parents 9%). Less than one third of the study participants always treated their relatives in their office. Male GPs more often provided care to family members (except children) registered in their practice. Senior male GPs treated their relatives more often than junior female GPs. Family members were most commonly treated for practical reasons.ConclusionThe subject of GPs treating their relatives is of high everyday relevance, since nearly all GPs are involved in the treatment of their family members. Frequent at-home treatments and low documentation rates may indicate risks due to deviating from the professional routine.

Patients with chronic diseases: Is sexual health brought up by general practitioners during appointments? A web-based study

ObjectivesMany chronic diseases and their medications may induce sexual problems. This study aimed to evaluate whether general practitioners (GPs) raise sexual health issues during appointments with patients who have chronic diseases. Study designA web-based questionnaire was distributed to a random sample of 1,000 GPs in Finland. Main outcome measuresThe study aim was to determine GPs’ self-reported inquiry into sexual problems with patients who have chronic diseases and GPs’ awareness of medications inducing sexual problems. ResultsOnly 16.2% of the GPs inquired about sexual health issues, typically during appointments dealing with reproductive organs. A majority (66.9%) considered sexual problems to be side-effects of medications, but only 17.9% followed up about them. Compared to male GPs, female GPs were more likely to inquire about gynecologic patients’ sexual issues (OR 1.77, 95% CI 1.05–2.99), but less likely to ask about them with urologic (OR 0.56, 95% CI 0.35–0.91) and neurologic patients (OR 0.35, 95% CI 0.17–0.72). The GPs aged 40–49 and 50–65 were more likely than those aged 27–39 to inquire about sexual health issues among patients with cardiovascular (OR 2.87, 95% CI 1.11–7.44, OR 2.89, 95% CI 1.16–7.19) and neurologic (OR 4.63, 95% CI 1.45–14.82, OR 5.68, 95% CI 1.87–17.23) diseases. ConclusionsGPs seldom inquire about sexual problems with patients who have chronic diseases or after prescribing medications for these conditions, which may lead to underdiagnosis and undertreatment of sexual problems.

Antibiotic treatment of community-acquired pneumonia: A questionnaire survey in Danish general practice.

Discrepancies exist in Danish guidelines for the treatment of bacterial community-acquired pneumonia (CAP). This study aimed to investigate how general practitioners (GPs) treat adults with CAP and explore associations between GP characteristics and treatment duration. In autumn 2020, GPs in the North Denmark Region were asked to complete an electronic questionnaire on antibiotic prescribing for CAP. Information about GP gender, age, experience and type of practice was obtained. Multivariable logistic regression was used to analyse the association between GP characteristics and treatment duration. A total of 298 GPs were invited to participate of whom 108 completed the survey. Penicillin V was used as first line treatment for CAP by all participants. Treatment duration varied from 5 (54.6%) to 10 days (8.3%). A 5-day course of penicillin was less likely to be prescribed by male GPs (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.13-0.94) and more likely to be prescribed by GPs with 5-9years of experience in general practice (OR 5.03, 95% CI 1.09-23.21) compared to those with 10-19 years of experience. Variation in antibiotic treatment of CAP emphasises the importance of generating solid evidence about the optimal duration regarding both effectiveness and safety.

Effects of GP characteristics on unplanned hospital admissions and patient safety. A 9-year follow-up of all Norwegian out-of-hours contacts.

BackgroundThere are substantial differences in hospital referrals between general practitioners (GPs); however, there is little research on the consequences for patient safety and further healthcare use.ObjectiveTo investigate associations between out-of-hours GP characteristics, unplanned hospital admissions, and patient safety.MethodsThis cohort study included all Norwegian out-of-hours services contacts from 2008 to 2016, linked to registry data on patient characteristics, healthcare use and death, and GP age, sex, specialist status, out-of-hours service experience, and prior admission proportion. We estimated the impact from GP characteristics on (i) immediate unplanned hospital admissions for “all conditions,” (ii) immediate unplanned hospital admissions for “critical conditions,” (iii) 30-day unplanned hospital admissions, (iv) 30-day hospital costs, and (v) 30-day risk of death. To limit confounding, we matched patients in groups by age, time, and location, with an assumption of random assignment of GPs to patients with this design.ResultsPatients under the care of older and male GPs had fewer immediate unplanned hospital admissions, but the effects on cumulative 30-day unplanned hospital admissions and costs were small. The GPs’ prior admission proportion was strongly associated with both immediate and 30-day unplanned hospital admissions. Higher prior admission proportion was also associated with admitting more patients with critical conditions. There was little evidence of any associations between GP characteristics and 30-day risk of death.ConclusionsGPs’ prior admission proportion was strongly associated with unplanned hospital admissions. We found little effects on 30-day mortality, but more restrictive referral practices may threaten patient safety through missing out on critical cases.

Good hygiene practice application in the private sector, Tunisia.

Healthcare-associated infections (HCAIs) occurring outside of health facilities are underestimated because there are a lack of structured preventive organization and absence of epidemiological surveillance. HCAI prevalence is likely to grow with the increase in patient care outside of health institutions. To set up a situational analysis of good hygiene practices among private general practitioners (GPs) to better organize HCAI prevention in this sector. A descriptive cross-sectional study was conducted between November 2017 and March 2018, using a self-administered questionnaire among all GPs in Sousse City, Tunisia. Participation rate was 93.1%. There was a predominance of male GPs (63%), with a sex ratio of 1.7:1. Up-to-date vaccination status was reported by 82 (75.9%) of GPs. Fifty-six (51.3%) GPs used hydroalcoholic solutions, 13 (12.1%) adopted autoclaving, and 106 (98.1%) wore gloves during invasive care. Blood exposure accidents (BEAs) were reported by 38 (35.2%; declared in 26.3% of cases) and were more prevalent in the group aged > 50 years who used significantly more reusable equipment. BEAs were primarily due to needle-stick injuries (86.8%). We identified the priority axes to be considered in organizing HCAI prevention in the private sector, which allows guidance of GPs, avoiding their isolation and compensating for their lack of training and information. This requires willingness and a culture of improving the quality and safety of care in this sector. Committed involvement of several stakeholders at different levels of decision-making in health care is needed.

General practitioners’ self-reported competence in the management of sexual health issues – a web-based questionnaire study from Finland

Objective Although sexual problems are common, they are rarely brought up in appointments with general practitioners (GPs). We aimed to assess the barriers that hinder GPs from bringing up sexual health issues and to evaluate the need for education on sexual medicine. Design A web-based questionnaire was used. Setting Four fields were included: A) the self-reported competence in discussing sexual health and treating patients with these issues, B) the barriers to bringing up patients’ sexual health problems, C) the source of education on sexual medicine and D) the need for education on sexual medicine. Subjects A random sample of 1000 GPs in Finland (a response rate of 43.5%, n = 402). Main outcome measures GPs’ self-assessed competence in discussing and treating sexual health issues, related barriers to bringing up the topic and the reported need for education. Results The main reasons reported for not bringing up sexual health issues were shortness of the appointment time (85.6%), a lack of knowledge (83.6%) and a lack of experience with sexual medicine (81.8%). The male GPs reported better competence in discussing the issues and treating male patients, whereas the female GPs reported better competence in discussing the issues with female patients. No differences emerged between genders regarding treating female patients. Nearly 90% of the GPs expressed needing more education about sexual medicine. Conclusions Although the GPs reported good competence in discussing sexual health issues with their patients, several barriers to bringing up sexual health issues emerged. Continuing education was desired and could lessen these barriers. Key points Only a few studies have evaluated the competence of general practitioners (GPs) in addressing sexual health issues with their patients. In our study, the GPs reported a high competence in discussing patients’ sexual health issues regardless of the patient’s gender. However, several barriers to bringing up sexual health issues in appointments emerged. A majority of the GPs expressed a need for continuing education about sexual medicine.

Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey.

BackgroundIn 2020, around 1.4 million new prostate cancer (PCa) cases were recorded worldwide. Early detection of PCa by prostate-specific antigen (PSA) screening remains debated, leading to different specialist-specific recommendations in PCa guidelines. This study aimed to assess attitudes toward and use of PSA testing among urologists in Germany and general practitioners (GPs) in Lower Saxony (Germany).MethodsA nationwide questionnaire was sent to urologists via the mailing lists of the Professional Association of German Urologists and the German Urological Society. A version of the questionnaire for GPs was sent to email addresses via the Association of Statutory Health Insurance Physicians Lower Saxony. The online questionnaires covered use of PSA testing, information communication, handling of test results, and handling of/knowledge about national and international guidelines and recommendations on early detection of PCa. Statistical analysis was performed at a descriptive level.ResultsIn total, 432 of 6,568 urologists (6.6%) and 96 of 1,579 GPs (6.1%) participated in this survey. Urologists and GPs differed in their attitudes and approaches toward PSA testing. Most urologists (86.8%, n=375) judged the test as “very meaningful” or “meaningful”, compared with 52.1% (n=50) of GPs. Almost two-thirds of the urologists (64.4%, n=278) viewed the PCa mortality reduction by PSA testing as proven, compared with one-fifth of GPs (20.8%, n=20). Almost 80% of male urologists (79.9%, n=291) indicated that they would undergo a PSA test in the future (again), compared with 55.1% of male GPs (n=38). In addition, 56.3% (n=243) of urologists stated that “considerably more than half” or “almost all” men aged 45 years or older received a PSA test, compared with 19.8% (n=19) of GPs.ConclusionsUrologists are more convinced about the PSA test than GPs. PSA testing is therefore used more often in urological settings, although the preselected patient population must be considered. In accordance with specialist-specific recommendations, GPs show a more reserved approach toward PSA testing. Instead of focusing on different attitudes and recommendations on PSA testing, the exchange between specialist groups should be improved to achieve a consistent approach to PSA testing.

Characteristics of general practitioner referrals to podiatrists in Australia, 2000–2016

ObjectiveThe aim of the study was to describe patterns of referral to podiatrists by general practitioners (GPs) in Australia. Study designThis is a continuous cross-sectional study of Australian general practice activity. MethodsWe analysed data from the Bettering the Evaluation and Care of Health program, collected from April 2000 to March 2016 inclusive. Data were summarised using descriptive statistics with 95% confidence intervals around point estimates. Multivariate logistic regression was used to identify GP and patient characteristics independently associated with referral. ResultsThe data set included 1,568,100 encounters, including 5,912 podiatry referrals. Referrals increased from 7.0 to 39.5 per 1000 population over the evaluation period. In multivariate analyses, female GPs were more likely than male GPs to refer, and GPs aged ≥55 years were less likely to refer. Patients referred to podiatrists were more likely to be aged ≥85 years, be Indigenous, be from an English-speaking background and have previously been seen at the practice. The problem generating the highest number of referrals was diabetes. After the introduction of Medicare funding, referred patients were more likely to be women, be aged >45 years, have a healthcare card, be socio-economically disadvantaged and have previously been seen at the practice. ConclusionsGP referral to podiatrists in Australia increased markedly after the introduction of Medicare funding and appears to be targeted to those with the greatest need. Further research is required to determine whether this policy has improved outcomes and is cost-effective.

Male hypogonadism and general practitioners in the UK. How to increase case recognition, without compromising diagnostic accuracy?

Male hypogonadism and general practitioners in the UK. How to increase case recognition, without compromising diagnostic accuracy?

Decision-making, barriers, and facilitators regarding cervical cancer screening participation among Turkish and Moroccan women in the Netherlands: a focus group study

ABSTRACT OBJECTIVES Whether the lower Dutch cervical cancer (CC) screening participation of Turkish- and Moroccan-Dutch women is based on informed decision-making is unknown. Our aim was to explore how and why Turkish- and Moroccan-Dutch women decide to participate or not in the current Dutch CC screening programme as well as to learn their perceptions on self-sampling. DESIGN Six focus group discussions were conducted between March and April 2019 with Turkish (n = 24) and Moroccan (n = 20) women in the Netherlands, aged 30–60 years. Questions were based on an extended version of the Health Belief Model. Discussions were transcribed verbatim and thematically analysed. RESULTS Participants lacked knowledge about CC and its screening, and seemed to be unaware of the cons of CC screening. Perceived barriers for screening were lack of a good command of the Dutch language, having a male general practitioner, fatalism, shame and taboo, and associations of CC with lack of femininity and infertility. Other barriers were fear of the test result, cancer, suffering, death, and leaving their children behind after death. Perceived facilitators were a high perceived severity of disease, social support, and short procedure time. An additional religious facilitator included the responsibility to take care of one’s own health using medical options that God provided. Participants had low self-efficacy expectations towards performing correct self-sampling. CONCLUSIONS Although participants’ informed-decision making seems to be limited, this study showed that women do not only consider factual medical information, but also practical, emotional, cultural, and religious aspects prior to deciding to screen or not. Information materials should be tailored to these aspects, as well as translated to appropriate languages due to lack of a good command of the Dutch language. Self-efficacy expectations towards performing correct self-sampling should be enhanced to promote informed CC screening participation among Turkish- and Moroccan-Dutch women.

Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region

BackgroundHome blood-pressure measurement (HBPM) is recommended for the diagnosis of hypertension and monitoring of patients with hypertension. Since 2013, the French National Health Insurance Body (FNHIB) has promoted HBPM to general practitioners (GPs). The objective of the study was to evaluate the practice of HBPM by French GPs to diagnose and monitor hypertension, 3 years after the beginning of the FNHIB campaign.MethodsWe conducted a postal survey from 7 March to 31 May 2016. All of the 1040 GPs practising in the Auvergne region in France were invited to participate, using a self-reporting questionnaire. We obtained information on the characteristics of the GPs, and their practice regarding the use of HBPM. Use of HBPM was reported as “never, occasionally, regularly and systematically”. Frequency of HBMP use was analysed using multivariate ordered logistic regression model.ResultsA total of 569 (54.7%) GPs responded to the survey. They were 50.3 (± 11.5) years old, 241 (43.0%) were female, and 352 (62.7%) worked in urban areas. Among them, 530 (94.5%) reported the use of HBPM for diagnosis and 519 (92.5%) for monitoring hypertension. To diagnose hypertension, younger GPs (OR = 0.97; 95% CI: 0.95–0.98), GPs practising in a group (OR = 1.45; 95% CI: 1.00–2.10) and in an MHC (OR = 2.09; 95% CI: 1.15–3.78), as compared to GPs with individual practices, and Clinical Tutors, as compared to non-Clinical Tutors, (OR = 1.92; 95% CI: 1.33–2.79) reported more frequent use of HBPM. To manage hypertension, female GPs, as compared to male GPs, (OR=1.47; 95% CI: 1.04–2.06), younger GPs (OR = 0.98; 95% CI: 0.97–0.99), and Clinical Tutors (OR = 1.90; 95% CI: 1.31–2.75) reported more frequent use of HBPM.ConclusionsOur survey reveals that 3 years after the introduction of the FNHIB incentives, the use of HBPM by participating GPs to diagnose and manage hypertension is well established. A larger survey of GPs from other regions would make it possible to verify whether our results can be extrapolated to France as a whole.

The use of ultrasound in primary care: longitudinal billing and cross-sectional survey study in Switzerland

BackgroundUltrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice.MethodsThis is a quantitative study, analyzing 15 years of billing data from 213 GPs in Central Switzerland, and cross-sectional survey data completed by 61 GPs attending 26 certification and refresher courses offered by the Swiss Society of Ultrasound in Medicine (SGUM).ResultsAccording to billing data, 49% of the GPs used ultrasound and provided 130,245 exams to 67,180 patients between 2004 and 2018. Over the years, ultrasound use became more frequent among GPs. Male GPs provide more ultrasound exams than female GPs. Patients that are female, ≥65 years, and multi-morbid had more ultrasound exams compared to males, patients < 65 years, and those with only one morbidity, respectively. GPs provided a mean of 129 ultrasound exams per physician-year. Abdominal ultrasound comprised almost 69% of all exams. According to survey data, indications covered many organ systems and clinical conditions, with abdominal indications being most frequent among them.ConclusionsThe use of ultrasound is high among general practitioners and it covers a wide range of clinical indications. Ultrasound is utilized primarily in the diagnosis of clinical indications of the abdomen, and more often for female than male patients.