The role of the district medical officer after the pandemic - a qualitative study. / Rollen som kommuneoverlege etter pandemien ­ en kvalitativ studie.

BACKGROUND: While district medical officers' role was described as unclear and lacking visibility before the COVID-19 pandemic, their community medicine expertise became highly significant in the management of the pandemic. We wished to investigate district medical officers' perceptions of their role after the pandemic was over. MATERIAL AND METHOD: The study was designed as a theory-driven qualitative interview study. Twelve district medical officers in the Norwegian county of Innlandet were interviewed in the autumn of 2022. The data were subjected to thematic analysis. RESULTS: The study identified a number of factors associated with the capabilities, motivation, and structural and organisational framework of district medical officers that were assumed to impact on the execution of their role and participation in decision-making processes in the local authorities. The district medical officers found that their role had become clearer and more visible during the pandemic, but they had low expectations of being more involved and having a stronger voice in the development of future health services in the municipalities. One proposed measure is to devise a guide for the district medical officer function, such that the local authorities are given clear guidelines on the district medical officers' areas of responsibility and the issues in which they should be involved. INTERPRETATION: The district medical officers felt that 'the pandemic effect is over', and that they had to fight their way back into important decision-making arenas. Measures at individual and organisational level can help ensure the optimal use of district medical officers' community medicine expertise in the municipalities.

The organisation and value of autopsies.

BACKGROUND: There has been a considerable reduction in the frequency of autopsies over the past few decades. We wanted to investigate whether doctors consider this a proper and natural development, or whether they consider that autopsies should be given a higher priority, and in such case, how. MATERIALS AND METHODS: Resources, organisation and opinions on autopsy practice were registered using a questionnaire sent to all pathology departments at Norwegian hospitals, and to all doctors in the clinical departments of Haukeland University Hospital in Bergen, Norway. RESULTS: 392 clinicians replied (percentage of replies 50.3 %). Of these, 82 % considered autopsies to be a good means of quality assurance and quality control of the clinical work. 83 % considered that more autopsies should be performed on a national basis, and 65 % considered autopsies to be just as important today as previously, in spite of technological advances in medicine. However, 80 % of the clinicians attended autopsy demonstrations less than twice a year. The waiting time for autopsy reports was long - 66 days, on average. A majority of clinicians considered that reducing this time would lead to more autopsies being ordered. DISCUSSION: Hospital doctors still consider autopsy to be a good means to assure the quality of clinical work. A reduction in the time needed to complete an autopsy report and better communication between clinicians and pathologists should be given priority.