Task profiles of district doctors in Estonia and general practitioners in Finland.

ABSTRACT

OBJECTIVE: To compare the task profiles of primary care doctors in two societies district doctors in Estonia and general practitioners in Finland. DESIGN: A uniform questionnaire was developed and used in 30 European countries in 1993 (The European Study of GP Task Profiles). The questionnaire was sent to a random sample of Estonian district doctors and Finnish health centre doctors. Data from 139 respondents in Estonia and 239 respondents in Finland were obtained. MAIN OUTCOME MEASURES: Personal and practice information, proportion of doctors performing certain medical procedures in their practices by themselves and being the first contact in relation to different problems. RESULTS: The Finnish general practitioners (GPs) had more consultations per day, the Estonian district doctors made remarkably more home visits. Participation in on-duty work was 82% among the Finnish and 22% among the Estonian doctors. Most of the Finnish GPs worked by appointment, while this was uncommon in Estonia. More than 80% of the Estonian district doctors reported that they seldom or never performed the listed procedures by themselves. In Finland, more than 80% of the respondents carried out the procedures almost always by themselves. Handling children's and women's health problems was more frequent in Finland than in Estonia. The profiles of managing acute problems and problems of the elderly people were quite similar in both countries. The tackling of psychosocial problems as the first contact showed lower performance in both countries compared with somatic health problems. CONCLUSIONS: The task profiles of the Estonian district doctors and the Finnish GPs differed considerably. The distribution of the Estonian doctors' answers gives evidence for the existence of specialization already within primary health care where certain problems almost never reach the district doctor. The results of the present study supported the curriculum design for the retraining of currently practising district doctors.