Influence of Work Environment Factors on the Motivation of Bulgarian General Practitioners
Nevena Ivanova
Keywords: work environment factors, motivation, general practitioner
Aim:
To study influence of work environment factors on the motivation of Bulgarian general practitioners (GPs)
Method:
a pilot study of 50 GPs was conducted in Plovdiv. A special questionnaire was developed
Results:
36 of participants were female (72%), 14 (28%) male, divided into 5 age groups 25-34 years (16%), 35-44 (4%), 45-54 ( 8%), 55-64 ( 66%), 65 and older (6%). 98% were individual practices, 76% were located in a city. 42 (84%) GPs have specialty in general medicine. 4 Work environment factors were divided into 3 groups-financial and economic, organizational and legal. The first group included the following elements-amount of net profit, amount of user fee, amount of capitation, amount of payment for additional activities - preventive, dispensary examination, vaccination, etc. Тhe second group included regulatory standards (referral limitations for laboratory testing and consultations), a restriction on the prescription of some medications, performing activities outside the basic package. The third group included content of the basic package of activities and obligation to provide 24-hour medical assistance. 98% of GPs consider that financial and economic factors influence positively their motivation, whereas in 96% and 97% organizational and legal respectively had a negative effect on it. Each group element was rated in terms of it’s influence on professional motivation from 1(weakest) to 5 (strongest). With the greatest positive influence were amount of net profit and capitation (5). The strongest negative effect caused referral limitations for laboratory testing and consultations and obligation to provide 24-hour medical assistance (5).
Conclusions:
Motivation is a complex process that is influenced by many factors of the professional environment and is essential for achieving quality medical care. Organizational and legal changes in primary care in Bulgaria are needed to improve the professional motivation of general practitioners.
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