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Original article

Vol. 154 No. 7 (2024)

Current and future workforce of general internal medicine in Switzerland: a cross-sectional study

DOI
https://doi.org/10.57187/s.3861
Cite this as:
Swiss Med Wkly. 2024;154:3861
Published
16.07.2024

Summary

AIM OF THIS STUDY: General internal medicine is a crucial element in healthcare systems. Understanding how many people are and will be working in this field is important to maintain and improve quality for patients in healthcare systems. This can provide a basis for political decisions.

METHODS: We conducted a cross-sectional study to analyse the current and future workforce of generalists (general practitioners and internists in hospitals) in Switzerland. The Swiss Society of General Internal Medicine (SSGIM) distributed a survey to all members. Respondents were asked about their current average workload in 2023 and planned workload in 2033. The responses were used to calculate full-time equivalent (FTE) for the current and future workforce of generalists and to extrapolate FTE for all active SSGIM members. To model the demand by 2033, we derived different scenarios.

RESULTS: Of all 6,232 active SSGIM members, 2,030 (33%) participated: 46% female, 25% (largest age group) 56-65 years old, 19% still in postgraduate training. The average workload in 2023 was 78% for female and 87% for male generalists; the FTE extrapolated to all active SSGIM members in 2023 was 5,246. By 2033, 1,935 FTEs (36%) will retire, 502 FTEs (10%) will reduce their workload, 116 FTEs (2%) will increase their workload and 2,800 FTEs (53%) will remain in the workforce with the same workload as in 2023. To maintain the same workforce as in 2023, 2,321 new FTEs (44%) will be needed by 2033. To fill this gap of 232 FTE new generalists per year, we modelled different scenarios with assumptions of interest, workload, migration and dropouts.

CONCLUSIONS: Within only one decade, 44% of the current workforce of generalists will disappear, mainly due to retirement and decreased workload. To fill this gap, various scenarios need to be incorporated. Politicians are called upon to create the political framework to create attractive training and working conditions for generalists to address the future demand for healthcare services.

References

  1. Kringos D, Boerma W, Hutchinson A, Saltman RB. Building primary care in a changing Europe. Eur Obs Heal Syst Policies. 2015;(Observatory Studies Series 38):172.
  2. Starfield B. Primary Care: Concept. Evaluation, and Policy; 1992.
  3. Europe W. The european definition of primary care / family medicine. Europe. 2002.
  4. Ferrer RL, Hambidge SJ, Maly RC. The essential role of generalists in health care systems. Ann Intern Med. 2005 Apr;142(8):691–9. 10.7326/0003-4819-142-8-200504190-00037 DOI: https://doi.org/10.7326/0003-4819-142-8-200504190-00037
  5. Misky AT, Shah RJ, Fung CY, Sam AH, Meeran K, Kingsbury M, et al. Understanding concepts of generalism and specialism amongst medical students at a research-intensive London medical school. BMC Med Educ. 2022 Apr;22(1):291. 10.1186/s12909-022-03355-1 DOI: https://doi.org/10.1186/s12909-022-03355-1
  6. Etz R, Miller WL, Stange KC. Simple rules that guide generalist and specialist care. Fam Med. 2021 Sep;53(8):697–700. 10.22454/FamMed.2021.463594 DOI: https://doi.org/10.22454/FamMed.2021.463594
  7. Büro für arbeits- und sozialpolitische Studien BASS. Bundesamt für Gesundheit BAG: Ärztinnen und Ärzte. 2022;2023:3.
  8. Stierli R, Rozsnyai Z, Felber R, Jörg R, Kraft E, Exadaktylos AK, et al. Primary care physician workforce 2020 to 2025 - a cross-sectional study for the canton of bern. Swiss Med Wkly. 2021 Sep;151(35-36):w30024. 10.4414/SMW.2021.w30024 DOI: https://doi.org/10.4414/SMW.2021.w30024
  9. Schweizerische Gesellschaft für Allgemeine Innere Medizin (SGAIM). Website. https://www.sgaim.ch/de/ueber-uns/portraet. Accessed December 1, 2023.
  10. Streit S, da Costa BR, Christensen S, Tal K, Tandjung R, Jüni P. One in seven Swiss physicians has left patient care - results from a national cohort study from 1980-2009. Swiss Med Wkly. 2019 Sep;149(September):w20116. 10.4414/smw.2019.20116 DOI: https://doi.org/10.4414/smw.2019.20116
  11. Bundesamt für Statistik. Statistiken aller Medizinalberufe; Website. https://www.bag.admin.ch/bag/de/home/zahlen-und-statistiken/statistiken-berufe-im-gesundheitswesen/statistiken-medizinalberufe1/statistiken-aller-medizinalberufe.html. Accessed March 22, 2024.
  12. Bundesamt für Gesundheit. Statistiken Ärztinnen/Ärzte; Website. https://www.bag.admin.ch/bag/de/home/zahlen-und-statistiken/statistiken-berufe-im-gesundheitswesen/statistiken-medizinalberufe1/statistiken-aerztinnen-aerzte.html. Accessed March 22, 2024.
  13. Neue Zürcher Zeitung, 55-Stunden-Woche: Damit muss den künftigen Ärztinnen niemand mehr kommen, Website. https://www.nzz.ch/schweiz/55-stunden-woche-damit-muss-den-kuenftigen-aerztinnen-und-aerzten-niemand-kommen-ld.1768569. Accessed March 22, 2024.
  14. Bundesamt für Statistik. Szenarien zur Bevölkerungsentwicklung der Schweiz und der Kantone 2020 – 2050. BFS Aktuell. 2020:16. https://www.bfs.admin.ch/asset/de/14963221
  15. Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context—global shortages and international migration. Glob Health Action. 2014 Feb;7(1):23611. 10.3402/gha.v7.23611 DOI: https://doi.org/10.3402/gha.v7.23611
  16. Anderson M, O’Neill C, Macleod Clark J, Street A, Woods M, Johnston-Webber C, et al. Securing a sustainable and fit-for-purpose UK health and care workforce. Lancet. 2021 May;397(10288):1992–2011. 10.1016/S0140-6736(21)00231-2 DOI: https://doi.org/10.1016/S0140-6736(21)00231-2
  17. Vinci RJ. The Pediatric Workforce: Recent Data Trends, Questions, and Challenges for the Future. Pediatrics. 2021 Jun;147(6):e2020013292. 10.1542/peds.2020-013292 DOI: https://doi.org/10.1542/peds.2020-013292
  18. Hendrickson RC, Slevin RA, Hoerster KD, Chang BP, Sano E, McCall CA, et al. The Impact of the COVID-19 Pandemic on Mental Health, Occupational Functioning, and Professional Retention Among Health Care Workers and First Responders. J Gen Intern Med. 2022 Feb;37(2):397–408. 10.1007/s11606-021-07252-z DOI: https://doi.org/10.1007/s11606-021-07252-z
  19. Marco CA, Courtney DM, Ling LJ, Salsberg E, Reisdorff EJ, Gallahue FE, et al. The Emergency Medicine Physician Workforce: projections for 2030. Ann Emerg Med. 2021 Dec;78(6):726–37. 10.1016/j.annemergmed.2021.05.029 DOI: https://doi.org/10.1016/j.annemergmed.2021.05.029
  20. O’Reilly-Jacob M, Chapman J, Subbiah SV, Perloff J. Estimating the Primary Care Workforce for Medicare Beneficiaries Using an Activity-Based Approach. J Gen Intern Med. 2023 Oct;38(13):2898–905. 10.1007/s11606-023-08206-3 DOI: https://doi.org/10.1007/s11606-023-08206-3
  21. Card SE, Clark HD, Elizov M, Kassam N. The Evolution of General Internal Medicine (GIM) in Canada: international Implications. J Gen Intern Med. 2017 May;32(5):576–81. 10.1007/s11606-016-3891-z DOI: https://doi.org/10.1007/s11606-016-3891-z
  22. Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med. 2001 Jan;20(1):61–7. 10.1016/S0749-3797(00)00258-0 DOI: https://doi.org/10.1016/S0749-3797(00)00258-0
  23. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997 Oct;50(10):1129–36. 10.1016/S0895-4356(97)00126-1 DOI: https://doi.org/10.1016/S0895-4356(97)00126-1
  24. Obsan Bericht 04/2022, Zukünftiger Bestand und Bedarf an Fachärztinnen und -ärzten in der Schweiz, Teil 1: Total der Fachgebiete, Hausarztmedizin, Pädiatrie, Psychiatrie und Psychotherapie sowie Orthopädie; Website. https://www.obsan.admin.ch/de/publikationen/2022-zukuenftiger-bestand-und-bedarf-fachaerztinnen-und-aerzten-der-schweiz. Accessed March 22, 2024.
  25. Schweizerische Gesellschaft für Allgemeine Innere Medizin. Website. https://www.sgaim.ch/de/themen/nachwuchs/mehrvielfaltgibtsnirgends. Accessed March 22, 2024.

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