Back to the program

Clinical skills of general practitioners in XXX: a cross-sectional study

Sara ESTEVES ARAÚJO CORREIA, Leonor VARELA-LEMA, Linda B. COTTLER, Jasjit S. AHLUWALIA, Angela J. TORRES IGLESIAS and Mónica PÉREZ-RÍOS

Background: Quality service delivery in primary care requires motivated and competent health professionals. In the XXX private sector, General Practitioners (GPs) with no postgraduate training in family medicine offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in XXX.To evaluate GPs’ training and experience in the skills required for comprehensive primary care.A cross-sectional descriptive survey in 13 primary care clinics in the private sector. A questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The selection of 78 clinical skills was based on the primary-care subset of clinical skills required in training of family physicians. Study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed in SPSS.GPs were mostly aged <40 years, with ≤10 years of experience, and there was an equal sex distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear nose and throat (ENT) and eyes, women’s health, and orthopaedics. The GPs lacked training in specific skills such as proctoscopies, contraceptive devices, skin procedures, intra-articular injections, red reflex tests, and use of genograms.Majority of the GPs were young and not considering a career in family medicine. GPs performed poorly in some of the essential and basic skills required in primary care. A redesign of the health system’s approach to gatekeeping and care pathways could encourage patients to obtain more cost-effective and accessible services at the primary care clinics. An important factor to consider would be incentives, such as fee-for-service, to motivate GPs to perform some of the procedures.Comprehensiveness could be improved by deploying family physicians to the clinics, continuing professional development and postgraduate training in Family Medicine.A change in the scope of practice would also need to be supported by the organisation’s infrastructure, equipment, supply chain, workforce, funding, and health information systems.