True believers? Characteristics of general practitioners in Victorian community health centres.
General practitioners have been part of multidisciplinary services in Victoria Community Health Centres (CHCs) for 20 years. This model institutionalizes a high degree of integration between general practitioners and other primary care and community service personnel. Of 51 eligible full-time general practitioners in Victorian CHCs, 46 were interviewed, using a structured questionnaire. General practitioners in CHCs were younger, less experienced and more likely to be female than other general practitioners. Nearly three-quarters were salaried. The philosophy of practice and the conditions of employment were the commonest reasons for entering CHC practice. Teamwork and the conditions of employment were felt to be the biggest advantages of CHC practice, while difficulties with management and the perceived loss of professional ownership and control were the commonest disadvantages. None reported interference from the CHC management in their clinical practice. Nearly a quarter of full-time CHC general practitioners do not undertake any formal community health promotion activities. Forty-five per cent of respondents intended to leave their CHC within the next five years. Universal health insurance has diminished the impact of CHC general practice. The philosophy of CHCs and the salaried nature of the employment continues to attract general practitioners. High staff turnover is a feature of CHC general practice, in part related to young doctors making an initial, but not long-term commitment to CHC practice. However, the loss of professional control and management difficulties should be addressed, as these may contribute to the high turnover.
Montalto
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National Centre for Health Program Evaluation, Melbourne.
Dunt
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D
Young
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D000328:Adult; D000367:Age Factors; D003153:Community Health Services / Q000458:organization & administration; D003154:Community Medicine; D004651:Employment; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D006293:Health Promotion; D006801:Humans; D007348:Insurance, Health; D007400:Interprofessional Relations; D008297:Male; D010348:Patient Care Team; D010563:Personnel Turnover; D010686:Philosophy, Medical; D011320:Primary Health Care; D011331:Private Practice / Q000458:organization & administration; D012456:Salaries and Fringe Benefits; D012737:Sex Factors; D014739:Victoria