Procedures and technical aptitude of primary care physicians: which practice?

Objective: There is little knowledge of the practices of private physicians in Switzerland. However, this knowledge is a prerequisite for definition of the learning objectives in post-graduate and continuous education. Objective: To ascertain the procedural skills of family physicians and general internists and compare them with variables such as education and the location of practice.

Methods: Questionnaire containing 68 procedural skills sent to all family physicians and general internists in the Cantons of Valais (VS) and Geneva (GE).

Results: 142/204 questionnaires (69%) were analyzed. A mean of 28.7 skills are practiced by the physicians. The internists use fewer procedures than the generalists. There is no difference between generalists practising in VS and GE, nor between location of the practice (urban or rural). The internists in GE and/or those practising in urban settings use fewer procedures than those practising in VS and in rural locations. Internists practising in rural setting use the same number of procedures than the generalists. Fifteen procedures are used by > or = 75% of physicians, 6 of these concern X-ray procedures. 60% of the procedures are used more frequently by the generalists, in particular surgical, ENT and gynecological procedures. There is no difference between generalists and internists as far emergency procedures or procedures in the cardiological and pneumological domain are concerned.

Conclusions: The number of procedures depends nor only on the speciality of the private physician (generalist or general internist), but also and mainly on the location of the practice, the density of physicians and emergency practice. These findings can be used in defining the learning objectives of the primary care curriculum.