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Working as a locum GP: their professional role in organizational context.

Batenburg, R., Hassel, D. van, Velden, L. van der. Working as a locum GP: their professional role in organizational context.: , 2012. 16 p. Abstract. In: European Health Management Association. Abstractbook EHMA Annual Conference 2012 'Public healthcare: who pays, who provides? 13-15 june 2012, Bern.
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Context: The workforce of General Practitioners (GPs) in the Netherlands is closely monitored and planned to ensure their pivotal role in primary care and the Dutch health care system. While the majority of GPs have their own practice or are employed by other GP practices or health community centres, a relatively small but important group are GP locums (GPs on call). This group is hard to monitor as there are frequently changing work locations and have a deviant (i.e. more dynamic) career pattern. Still, the contribution of GP locums to the flexibility of the GP workforce is of increased importance. Methods: All GPs that were a member of the Dutch GP Association (LHV) and indicated that they primarily work on call, received an on-line questionnaire in the spring of 2010 and the spring of 2011. In 2010 34% of the 1,460 GPs approached responded, in 23% of the 1,491. With the survey, the GP locums were queried about their motives and preferences with regard to their duties. Other questions informed about the type of tasks, their professional role and the type of practices they work for. The attitude and behaviour of the GP locums can be related to a number of background characteristics. Most importantly, we applied bivariate and multivariate analyses to explore the role of gender and career phase on the different profiles of the GP locums, which can be empirically created using the survey data. Results: A basic profile distinction that be seen between GP locums that are at the beginning of their career and those that are longer ahead in their working life after being registered as a GP. Older and more experienced GP locums tend to work for fewer different and changing practices, while the younger GPs work more hours and shifts for more employers. Motives also differ between these two groups. While starting GP locums are often driven by financial motives, experienced GP locums merely prefer working independently, not being responsible for management duties. Interesting profile differences also occur between men and women. Female GP locums indicate to aim for a salaried position in a later career stage and prefer the flexibility of their position, while male GP locums aim for practice ownership and are significantly more willing to move locations. Conclusions: GPs on call, GP locums, are an important group as a highly flexible segment of the Dutch GP workforce. From our survey, this group appears to be quite diverse in composition, behaviour and attitude. These differences are important to acknowledge in monitoring and planning' the GPlocums. Given the increased pressure on health care costs and quality assurance in primary care, it is recommended to specifically regard how GP locums can optimally contribute to the future challenges. As this group frequency changes employers, some other actor or organization should provide some human resource policy to support them. Some temporary employment agency appear to play such a role, but it can be useful to create other institutions they guide GP locums through their career and most importantly, retain their capacity the future workforce needs in a developed primary care system.