The British journal of general practice : the journal of the Royal College of General Practitioners
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The World Health Organization encourages comprehensive primary care within an ongoing personalised relationship, including family physicians in the primary healthcare team, but family medicine is new in Africa, with doctors mostly being hospital based. African family physicians are trying to define family medicine in Africa, however, there is little clarity on the views of African country leadership and their understanding of family medicine and its place in Africa. ⋯ The strong district-level clinical and leadership expectations of family physicians are consistent with African research and consensus. However, leaders' understanding of family medicine is couched in terms of specialties and hospital care. African family physicians should be concerned by high expectations without adequate human resource and implementation policies.
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Simulated patient, or so-called 'mystery-shopper', studies are a controversial, but potentially useful, approach to take when conducting health services research. ⋯ Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients' satisfaction with their practice is not related to practice call handling, but is related to appointment availability.
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General practice receptionists fulfil an essential role in UK primary care, shaping patient access to health professionals. They are often portrayed as powerful 'gatekeepers'. Existing literature and management initiatives advocate more training to improve their performance and, consequently, the patient experience. ⋯ Framing the receptionist-patient encounter as one between the 'powerful' and the 'vulnerable' gets in the way of fully understanding the complex tasks receptionists perform and the contradictions that are inherent in their role. Calls for more training, without reflective attention to practice dynamics, risk failing to address systemic problems, portraying them instead as individual failings.
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French GPs in training have an important role in making hospitals function and are the future workforce, however burnout among this group is not uncommon. ⋯ This is the first French national survey about burnout in French GP trainees. It confirms the findings of previous French regional studies, which showed an increased rate of depersonalisation but decreased rates of emotional exhaustion. Trainees play an important role in the French health system: they represent tomorrow's doctors, so these results are worrying for the French public-health system. They imply a need for action by doctors, professional bodies, and healthcare organisations. A few preventive measures could be tested, such as creating an employment contract for trainees, helping trainees to assume responsibilities step by step, and putting more thought into training in outpatient clinics.