Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 149 No. 3536 (2019)

One in seven Swiss physicians has left patient care – results from a national cohort study from 1980–2009

  • Sven Streit
  • Bruno R. da Costa
  • Sandro Christensen
  • Kali Tal
  • Ryan Tandjung
  • Peter Jüni
DOI
https://doi.org/10.4414/smw.2019.20116
Cite this as:
Swiss Med Wkly. 2019;149:w20116
Published
02.09.2019

Summary

AIMS OF THE STUDY

Physician shortage is problematic, but the percentage of physicians who left patient care in Switzerland is unclear. We set out to describe this percentage and determine whether gender or language region was associated with leaving patient care.

METHODS

We analysed the National Registry (Medreg) of all physicians who graduated between 1980 and 2009 in Switzerland. Based on the last known working status noted in Medreg, physicians were classified as “probably involved in patient care” or “potentially left patient care”. We drew an unrestricted random sample of 250 from each category. We searched professional directories / social media to classify each sample. Those with undetermined status received a questionnaire that asked their working status. We quantified the percentage of physicians who left patient care and used Poisson and Cox regression to determine rates and the association of leaving patient care with gender, language region, and year of graduation.

RESULTS

We identified 23,112 living physicians in Medreg in 2015. Of these, 18,406 (79.6%) were probably involved in patient care and 4706 (20.4%) had potentially left patient care. In the random sample of 250 physicians probably involved in patient care, 237 were involved in patient care, 11 had left and the status of 2 was undetermined (0.8%). In the random sample of 250 physicians who had potentially left patient care, 109 were involved in patient care, 109 had left, and the status of 32 was undetermined (12.8%). We estimated that 13.6% of physicians had left patient care (95% confidence interval [CI] 11.1–16.1%). According to the most realistic scenario, the rate of physicians who had left patient care was 1.2 per 100 physicians/year (95% CI 0.9–1.6) for those who had graduated between 1980 and 1994, and 1.8 per 100 physicians/year (95% CI 1.4–2.3) for those who graduated between 1995 and 2009 (adjusted hazard ratio 1.74, 95% CI 1.12–2.71). There was no evidence that the risk of leaving patient care was associated with gender or language region.

CONCLUSIONS

Approximately one in seven physicians in Switzerland who graduated between 1980 and 2009 left patient care. Leaving patient care was not associated with gender, but the probability of leaving patient care was increased considerably in physicians who graduated more recently. Interventions that aim at keeping physicians in the work force and encourage their return to practice are sorely needed.

References

  1. Kraft E, Hersperger M. Ärzteschaft in der Schweiz – die Feminisierung der Medizin. Schweiz Arzteztg. 2009;90(47):1823–5. doi:https://doi.org/10.4414/saez.2009.14776
  2. Dominiczak P. Female doctors who work part-time after having children put NHS under strain. The Telegraph. 2013 June 5
  3. Petterson SM, Liaw WR, Tran C, Bazemore AW. Estimating the residency expansion required to avoid projected primary care physician shortages by 2035. Ann Fam Med. 2015;13(2):107–14. doi:.https://doi.org/10.1370/afm.1760
  4. Hedden L, Barer ML, Cardiff K, McGrail KM, Law MR, Bourgeault IL. The implications of the feminization of the primary care physician workforce on service supply: a systematic review. Hum Resour Health. 2014;12(1):32. doi:.https://doi.org/10.1186/1478-4491-12-32
  5. Krauthammer C. Why doctors quit. The Washington Post. 2015 May 28.
  6. Detsky AS, Gropper MA. WHy physician leaders of health care organizations should participate in direct patient care. Ann Intern Med. 2016;165(7):519–20. doi:.https://doi.org/10.7326/M16-0820
  7. Lister S. Ministers take doctor's battle to Europe. The Times. 2010.
  8. Hehli S. Mediziner versinken in der Papierflut. Neue Zür Ztg. 2016 January 6
  9. Mache S, Bernburg M, Vitzthum K, Groneberg DA, Klapp BF, Danzer G. Managing work-family conflict in the medical profession: working conditions and individual resources as related factors. BMJ Open. 2015;5(4):e006871. doi:.https://doi.org/10.1136/bmjopen-2014-006871
  10. Hehli S. Wenn Ärztinnen ihren Kittel an den Nagel hängen. Neue Zür Ztg. 2015 February 5
  11. Degen C, Li J, Angerer P. Physicians’ intention to leave direct patient care: an integrative review. Hum Resour Health. 2015;13(1):74. doi:.https://doi.org/10.1186/s12960-015-0068-5
  12. Hann M, Reeves D, Sibbald B. Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. Eur J Public Health. 2011;21(4):499–503. doi:.https://doi.org/10.1093/eurpub/ckq005
  13. Hill EJ. Work-Family Facilitation and Conflict, Working Fathers and Mothers, Work-Family Stressors and Support. J Fam Issues. 2005;26(6):793–819. doi:.https://doi.org/10.1177/0192513X05277542
  14. Yavas U, Babakus E, Karatepe OM. Attitudinal and behavioral consequences of work‐family conflict and family‐work conflict: Does gender matter? Int J Serv Ind Manage. 2008;19(1):7–31. doi:.https://doi.org/10.1108/09564230810855699
  15. Fuß I, Nübling M, Hasselhorn H-M, Schwappach D, Rieger MA. Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences. BMC Public Health. 2008;8(1):353. doi:.https://doi.org/10.1186/1471-2458-8-353
  16. Treister-Goltzman Y, Peleg R. Female Physicians and the Work-Family Conflict. Isr Med Assoc J. 2016;18(5):261–6.
  17. Dumelow C, Littlejohns P, Griffiths S. Relation between a career and family life for English hospital consultants: qualitative, semistructured interview study. BMJ. 2000;320(7247):1437–40. doi:.https://doi.org/10.1136/bmj.320.7247.1437
  18. Adám S. Magas a munkahelyi és a családi szerepek közötti konfliktus prevalenciája az orvosnok körében: a társas támogatás hiánya mint lehetséges rizikótényezo [High prevalence of work-family conflict among female physicians: lack of social support as a potential antecedent]. Orv Hetil. 2009;150(50):2274–81. In Hungarian. doi:.https://doi.org/10.1556/OH.2009.28583
  19. Young R, Leese B, Sibbald B. Imbalances in the GP Labour Market in the UK: Evidence from a Postal Survey and Interviews with GP Leavers. Work Employ Soc. 2001;15(4):699–719. doi:.https://doi.org/10.1177/095001701400438161
  20. Scott A, Gravelle H, Simoens S, Bojke C, Sibbald B. Job Satisfaction and Quitting Intentions: A Structural Model of British General Practitioners. Br J Ind Relat. 2006;44(3):519–40. doi:.https://doi.org/10.1111/j.1467-8543.2006.00511.x
  21. Bornschein S, Erbas B, Borelli S, Emminger C, Hesse J, Pilz J, et al. Arbeitszeit und Arbeitszufriedenheit angestellter und beamteter Arzte in München. Ergebnisse einer anonymen Befragung [Working hours and job satisfaction among physicians in hospitals and general practice in Munich. Results of an anonymous questionnaire]. Gesundheitswesen. 2006;68(8-9):535–44. In German. doi:.https://doi.org/10.1055/s-2006-927070
  22. Petterson SM, Rayburn WF, Liaw WR. When Do Primary Care Physicians Retire? Implications for Workforce Projections. Ann Fam Med. 2016;14(4):344–9. doi:.https://doi.org/10.1370/afm.1936
  23. Pantenburg B, Luppa M, König HH, Riedel-Heller SG. Burnout among young physicians and its association with physicians’ wishes to leave: results of a survey in Saxony, Germany. J Occup Med Toxicol. 2016;11(1):2. doi:.https://doi.org/10.1186/s12995-016-0091-z

Most read articles by the same author(s)

<< < 1 2