Certification Tasks as Part of Primary Health Care Physicians' Work and Time Use
Abstract
The study examined work content, time management, and working arrangements among primary health care (PHC) physicians. The data consisted of a self-reported one-day time use and the boarder questionnaire focusing on working conditions, stress factors and psychosocial resources. The data was collected from doctors working in PHC (health centers, occupational health care or student health care) between November 2013 and February 2014. For 226 physicians sent the questionnaire (convenient sample). The response rate for the time use report was 60 % and with sufficient accuracy both queries answered 51% of the physicians. The stress factors and psychosocial resources were compared with questionnaire study among Finnish physicians (n=3 782), more precise to those working in the health centers and municipal occupational health care in 2010.
The physicians’ average length of the working day was approximately 7 hours and 18 minutes; 38% of the hours were spent in ambulatory care. The proportion of the work time spent on other patient contacts (emergency care, area of special responsibility) was 16%, and phone contacts with the patient were 8%. Physicians’ psychosocial resources were fairly good but stress related to data systems with low usability and time pressure was common. Patient-related stress of physicians working in health centers challenges physicians’ wellbeing compare with the results of other PHC units in Finland.
Physicians’ certification practices were assessed to take relatively much time (8 hours per month). The time required per certification varies according to the complexity of the certification (from 5 minutes to hours). The certification practices were seen as consuming too many working hours, and to too many authorities. The attitude towards certification tasks was more negative among doctors working in health centers than among those working in occupational health care or student health care. However, the certifications from a physician were considered important for the patient.
To encourage minimising such certifications practices where physicians’ expertise does not necessary need is an essential proposal to improvement. In some clear-cut cases, the right to make certificates could be extended to other professions (registered nurses, physiotherapists, psychologists) or certifications could be automatized through electronical patient records and national patient archive (Kanta). Furthermore new openings to the electronic transfer of physicians’ certificates are needed, besides some new pilots have already been started between THL (National Institute for Health and Welfare) and Kela (The Social Insurance Institution of Finland).
Authors
Tuulikki Vehko, Laura Pekkarinen, Riikka Lämsä, Anna-Mari Aalto, Lauri Virta, Simo Kokko, Ilmo Keskimäki, Marko Elovainio
Additional Information
- Peer-Reviewed: no.
- Open Access: yes.
- Cite as: Vehko, T., Pekkarinen, L., Lämsä, R., Aalto, A., Virta, L., Kokko, S., Keskimäki, I., & Elovainio, M. (2015). Lääkäreiden ajankäyttö, työolot ja lausunnot perusterveydenhuollossa. Terveyden ja hyvinvoinnin laitos. https://urn.fi/URN:ISBN:978-952-302-567-7
