Factors for and against establishing and working in private practice correlated with work-related behavior and experience patterns of Ferman physicians in Schleswig-Holstein: A 2-year longitudinal study
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Friedensau Adventist University, Möckern-Friedensau, Germany (Department of Health and Behavioral Sciences)
Albert-Ludwigs-University Freiburg, Freiburg, Germany (Medical Faculty, Freiburg Institute of Musicians’ Medicine)
University of British Columbia, Vancouver, Canada (School of Population and Public Health)
Online publication date: 2017-04-28
Corresponding author
Edgar Voltmer   

Friedensau Adventist University, Department of Health and Behavioral Sciences, An der Ihle 19, 39291 Friedensau, Germany
Int J Occup Med Environ Health. 2017;30(3):485-98
Objectives: To identify factors in favor of or against establishing and working in private practice, to determine the quality of life and work-related behavior and experience patterns of German physicians working in private practice, and to analyze the correlation of those factors. Material and Methods: A representative sample of physicians in private practice in Schleswig-Holstein, Germany, was surveyed according to a 2-year longitudinal design (T1 – 2008, N = 549 and T2 – 2010, N = 414). The study included 22 items regarding the attractiveness of establishing and working in private practice, and the questionnaires: the Short Form-12 Health Survey (SF-12), and Work-related Behavior and Experience Pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster – AVEM). Results: Job satisfaction among those private practitioners decreased over time but their willingness to choose the profession once again remained unchanged. Patient care and the continuity of physician-patient relationship encouraged establishing and working in private practice; state regulation, financial risk, and administrative effort weighed against it. At both T1 and T2, physicians scored significantly lower for mental health than general population. About 20% of physicians showed a healthy behavior and experience pattern but 40% of them showed the pattern of reduced working motivation. About 20% of participants were at elevated risk for overexertion and for burnout. Physical and mental health as well as the total distribution of patterns did not change significantly during the 2-year observation period. Physicians at higher burnout risk rated tasks related to patient care considerably less positively than those with healthy pattern. Conclusions: In order to improve job satisfaction and quality of life, and to make private practice more attractive, those German physicians require a) improved legislation, b) educational programs that promote the attractiveness of private practice, and c) highly accessible counseling services for the prevention and treatment of stress, overexertion, and burnout. Int J Occup Med Environ Health 2017;30(3):485–498
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