Anita Verhoeven

Job satisfaction among general practitioners: A systematic literature review

Objective: In recent years, the incidence of being overworked and burnt out has increased among general practitioners (GPs). One of the factors that influences the development of burnout is the job satisfaction that physicians experience. Therefore, we conducted a literature review to answer the question: what factors influence the job satisfaction experienced by GPs? Methods: We used two methods to retrieve citations. We searched four literature databases for citations from 1990 until July 2006, and we checked the reference lists of relevant articles. The inclusion criteria were: GPs had to be the subjects of the study, the study had to describe empirical research, the study had to focus on job satisfaction, and the number of subjects had to be greater than 30. Results: We found 24 relevant citations. Factors increasing job satisfaction which were mentioned more than twice were: diversity of work, relations and contact with colleagues, and being involved in teaching medical students. Factors decreasing job satisfaction were: low income, too many working hours, administrative burdens, heavy workload, lack of time, and lack of recognition. Conclusion: Aspects of job satisfaction concerning the content of the profession seem to increase job satisfaction, and aspects concerning employment conditions seem to decrease job satisfaction.

The death of a patient: a model for reflection in GP training

BackgroundThe Dutch government has chosen a policy of strengthening palliative care in order to enable patients to die at home according to their preference. In order to facilitate this care by GPs, we wanted to know how to support them in their training. Therefore we examined the ways in which the death of a patient influences the doctor both at a professional and at a personal level.MethodsBased on a qualitative study, we developed a model for reflection for GP trainees on the meaning of the death of patients and its influence on the GP.The qualitative study was done in 2007 and is based on open in-depth interviews and a focus group. We recruited 18 participants who were highly professional GPs and experienced in talking about the death of patients. We invited GPs from a list of experienced GPs, who in addition are also second-opinion GPs for euthanasia (SCEN-physicians) and from a pool of GP trainers, our intention being to include GPs holding a variety of world views. Interviews were audio-taped and transcribed verbatim. A grounded theory approach was used to analyze the results. Themes were first identified independently by three researchers, then after discussion these three sets were rearranged to one list of themes and their mutual relation were determined. A model for the interaction of the GP at professional and at a personal level was formulated.ResultsForty three themes emerged from the interviews and focus group. These themes fell into three groups: professional values and experiences, personal values and experiences, and the opinions of the GPs as to what constitutes a good death. We constructed a model of the doctor-patient relationship on the basis of these findings. This model enables GP trainees identifying the unique character of the doctor-patient relationship as well as its reciprocity when the two were confronted by the patients impending death.ConclusionsIn dealing with the approaching death of a patient the unique interaction between patient and doctor and the cumulative experiences of doctors with their patients brings about a shift in the GPs own values. The professional development of GP trainees may be facilitated by reflection on the interaction of their own values and beliefs.

Screenen op boezemfibrilleren met single-lead handheld ECG

SamenvattingVraagstelling Atriumfibrilleren (AF) heeft een prevalentie van 4,4% bij personen ≥ 65 jaar. Van alle mensen met AF heeft 25 tot 35% geen klachten (silent AF), maar wel een verhoogd risico op trombo-embolische complicaties waarvoor bij een CHA2DS2-VASc ≥ 2-score een indicatie bestaat voor orale anticoagulantia.

Which Literature Retrieval Method is Most Effective

Decision making in general practice needs to be supported by evidence-based conclusions published in the literature. However, which method for retrieving citations from these publications is most effective for general practitioners has not been determined.