What challenges hamper Kenyan family physicians in pursuing their family medicine mandate? A qualitative study among family physicians and their colleagues.

BACKGROUND: Since 2005, Kenyan medical universities have been training general practitioners, providing them with clinical, management, teaching and research skills, in order to enhance access to and quality of health care services for the Kenyan population. This study assesses what expectations family physicians, colleagues of family physicians and policy makers have of family medicine, what expectations family physicians live up to and which challenges they face. METHODS: Family physicians were observed and interviewed about their expectations and challenges concerning family medicine. Expectations among their colleagues were assessed through focus group discussions. Policy makers' expectations were assessed by analysing the governmental policy on family medicine and a university's curriculum. RESULTS: Roles perceived for and performed by family physicians included providing comprehensive care, health care management, teaching, and to a lesser extent community outreach and performing research. Challenges faced by family physicians were being posted in situations where they are regarded as just another type of specialist, lack of awareness of the roles of family physicians among colleagues, lack of time, lack of funds and inadequate training. CONCLUSIONS: The ministry's posting policy has to be improved to ensure that family physicians have a chance to perform their intended roles. Creating an environment in which family physicians can function best requires more effort to enlighten other players in the health care system, like colleagues and policy makers, about the roles of family physicians.

Online medical literature consultation habits of academic teaching physicians in the EU and CIS countries: a cross-sectional study.

BACKGROUND: Both in the Commonwealth of Independent States (CIS) and in the European Union (EU2004), ample availability of up to date medical scientific literature is important for progress in medical science and for the education of the next generation of healthcare workers. The aim of this research is to assess if the use of online medical literature among academic teaching (AT) physicians is at the same level in the CIS as in the EU2004. METHODOLOGY/PRINCIPAL FINDINGS: In the capital cities of the CIS and the EU2004 member states, AT physicians holding an academic position at least equivalent to an associate professor and performing the three classical tasks in academic medicine (teaching, research and patient care) were interviewed about their use of and familiarity with the Internet and 9 online literature services, including journals and bibliographical databases such as PubMed (Medline), The Cochrane Library and Web of Science. Library staff members were interviewed about the availability of these online literature services at their libraries. About 750 physicians and 40 library staff members were invited for participation. Eventually 124 AT physicians and 22 library staff members participated. Internet was everywhere available, but used daily by more AT physicians in the EU2004 (71% versus 48% in the CIS, P = .005). AT physicians in the EU2004 accessed a higher percentage of all articles online (74% versus 43% in the CIS, P<.001). PubMed (P<.001), The Cochrane Library (P<.001) and Web of Science (P<.003) were used more frequently in the EU2004. In the EU2004 more AT physicians were familiar with Open Access journals (89% versus 51% in the CIS, P<.001). CONCLUSIONS/SIGNIFICANCE: AT physicians in the CIS use online medical literature less than in the EU2004. It is recommended that the awareness of freely available online literature services such as Open Access journals is enhanced among AT physicians and library staff members, especially in the CIS.