General practitioners treating their own family members: a cross-sectional survey in Germany

Springer Science and Business Media LLC - Tập 23 Số 1 - 2022
Natalie Alida Mücke1, Alexandra Schmidt2, Christine Kersting2, Vera Kalitzkus1, Michael Pentzek3, Stefan Wilm1, Achim Mortsiefer2,1
1Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
2Chair of General Practice II and Patient-Centredness in Primary Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Witten, Germany
3Institute of General Practice, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

Tóm tắt

AbstractBackgroundIn Germany, there are neither guidelines provided by the medical associations nor a public discussion about general practitioners (GPs) treating their family members. Only few studies on this topic from the primary care setting exist. The aim of this study is to describe GPs’ treatment of family members and to generate empirical data on the most common reasons for this.MethodsIn June 2018 we conducted a postal survey among GPs in the North Rhine region of Germany. The questionnaire was developed in a stepwise process including initial expert panels, interviews with GPs, item construction workshops, cognitive pre-tests and pilot testing with 40 questionnaires. The final questionnaire addressed: type and frequency of treatment, documentation and place of treatment, engagement as the official GP as well as reasons for and against the treatment. For data evaluation, descriptive and explorative statistical analyses were conducted.ResultsOverall, 393 questionnaires were returned (response rate 39.8%). 96.7% of the GPs had treated at least one family member during the last 12 months. Services that were provided frequently (more than three times in the last 12 months) included the prescription or dispensing of medication (partner 45%, children 37%, parents 43%, partner’s parents 26%), physical examinations (partner 18%, children 24%, parents 25%, partner’s parents 15%), and the arrangement or provision of laboratory tests (partner 14%, children 7%, parents 16%, partner’s parents 9%). Less than one third of the study participants always treated their relatives in their office. Male GPs more often provided care to family members (except children) registered in their practice. Senior male GPs treated their relatives more often than junior female GPs. Family members were most commonly treated for practical reasons.ConclusionThe subject of GPs treating their relatives is of high everyday relevance, since nearly all GPs are involved in the treatment of their family members. Frequent at-home treatments and low documentation rates may indicate risks due to deviating from the professional routine.

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Tài liệu tham khảo

Mortsiefer A. "Diese Tabletten schreibt mir immer meine Mutter auf".: Wie können Ärzte verantwortlich mit Krankheitsfällen in ihrer eigenen Familie umgehen? In: Kalitzkus V, editor. Familienmedizin in der hausärztlichen Versorgung der Zukunft. Düsseldorf: Dup Düsseldorf Univ. Press; 2013.

Bundesärztekammer. (Muster-)Berufsordnung für die in Deutschland tätigen Ärztinnen und Ärzte. 2018. https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/pdf-Ordner/MBO/MBO-AE.pdf. Accessed 31 Jan 2022.

American Medical Association. Code of Medical Ethics: AMA; 2016.

Medical Board of Australia. Codes, Guidelines and Policies; 2014.

Câmara Dos Deputados. Deputados; 1932.

General medical council. Good medical practice regulating doctors good medical practice; 2006.

Canadian medical Accociation. Code of Ethics and Professionalism: CMA; 2018.

Helsedirektoratet. Helsepersonelloven med kommentarer; 2012.

De Norske Legeforening. Etiske regler for leger; 2015.

KNMG. Richtlijn niet-aangaan of beëindiging behandelingsovereenkomst: KNMG. 2005. https://www.knmg.nl/advies-richtlijnen/knmg-publicaties/geneeskundige-behandelingsovereenkomst.htm. Accessed 31 Jan 2022.

Committee on Bioethics. Policy statement--Pediatrician-family-patient relationships: managing the boundaries. Pediatrics. 2009;124:1685–8. https://doi.org/10.1542/peds.2009-2147.

Snyder L. American College of Physicians Ethics Manual: sixth edition. Ann Intern Med. 2012;156:73–104. https://doi.org/10.7326/0003-4819-156-1-201201031-00001.

Gold KJ, Goldman EB, Kamil LH, Walton S, Burdette TG, Moseley KL. No appointment necessary? Ethical challenges in treating friends and family. N Engl J Med. 2014;371:1254–8. https://doi.org/10.1056/NEJMsb1402963.

Scarff JR, Lippmann S. When physicians intervene in their relatives' health care. HEC Forum. 2012;24:127–37. https://doi.org/10.1007/s10730-011-9174-5.

Giroldi E, Freeth R, Hanssen M, Muris JWM, Kay M, Cals JWL. Family physicians managing medical requests from family and friends. Ann Fam Med. 2018;16:45–51. https://doi.org/10.1370/afm.2152.

Reagan B, Reagan P, Sinclair A. 'Common sense and a thick hide'. Physicians providing care to their own family members. Arch Fam Med. 1994;3:599–604. https://doi.org/10.1001/archfami.3.7.599.

Gerst T. Im Zwiespalt- Wenn die Familie Patient ist. Deutsches Ärzteblatt. 2015;112:A768-9.

Elm E von, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335:806–8. https://doi.org/10.1136/bmj.39335.541782.AD.

Bauer J, Maier W, Müller R, Groneberg DA. Primary Care in Germany - equal access for everyone? Dtsch Med Wochenschr. 2018;143:e9–e17. https://doi.org/10.1055/s-0043-110846.

Pentzek M, Wollny A, Herber OR, Porst R, Icks A, Abholz H-H, et al. Item construction in sequential mixed methods studies. Zeitschrift für Allgemeinmedizin. 2012;88:520–7.

IQTIG. Methodische Grundlagen V1.0. 15.09. Berlin: Institut für Qualitätssicherung und Transparenz im Gesundheitswesen; 2017.

Kassenärztliche Bundesvereinigung (KBV). Arztgruppe. 2018. https://gesundheitsdaten.kbv.de/cms/html/16393.php. Accessed 11 Oct 2021.

Rennert M, Hagoel L, Epstein L, Shifroni G. The care of family physicians and their families: a study of health and help-seeking behaviour. Fam Pract. 1990;7:96–9. https://doi.org/10.1093/fampra/7.2.96.

Knuth J, Bulian DR, Ansorg J, Büchler P. When you operate on friends and relatives: results of a survey among surgeons. Med Princ Pract. 2017;26:235–44. https://doi.org/10.1159/000456617.

Forsythe M, Calnan M, Wall B. Doctors as patients: postal survey examining consultants and general practitioners adherence to guidelines. BMJ. 1999;319:605–8. https://doi.org/10.1136/bmj.319.7210.605.

Dusdieker LB, Murph JR, Murph WE, Dungy CI. Physicians treating their own children. Am J Dis Child. 1993;147:146–9. https://doi.org/10.1001/archpedi.1993.02160260036018.

Gendel MH, Brooks E, Early SR, Gundersen DC, Dubovsky SL, Dilts SL, et al. Self-prescribed and other informal care provided by physicians: scope, correlations and implications. J Med Ethics. 2012;38:294–8. https://doi.org/10.1136/medethics-2011-100167.

Vassbø B, Hagen HR, Hunskår S. Habilitetsproblem i fastlegepraksis. Tidsskr Nor Lægeforen. 2016;16:2207–9.

Gjengedal S, Rosvold EO. Norske legers medisinske behandling av egen familie; 2005.

Nik-Sherina H, NG C-J. Doctors treating family members: A qualitative study among primary care practitioners in a teaching hospital in Malaysia. Asia Pacific J Fam Med. 2006;5:1-6.

Walter JK, Pappano E, Ross LF. A descriptive and moral evaluation of providing informal medical care to one's own children. J Clin Ethics. 2009;20:353–61.

La Puma J, Stocking CB, La Voie D, Darling CA. When physicians treat members of their own families. Practices in a community hospital. N Engl J Med. 1991;325:1290–4. https://doi.org/10.1056/NEJM199110313251806.

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