[Exploring the prospects for general practitioners over 55 years old from three counties of western France]

Medical demography and the practice of medicine will be influenced by the personal plans of GPs and their decisions to stop practicing in the coming years. This study aims to understand the events that could potentially worsen the medical demography in terms of shortages of GPs for primary care in the short term.

455 GPs (all aged over 55 years) practicing in three districts of western France were selected to participate in this prospective study. 258 valid and complete questionnaires (56%) were received. With the use of a special programme, SPSS version 1.5, an overall comprehensive analysis and one by geographical sub-regional groups were performed.

When queried about their plans or wishes for their practice between the present time and their age of 65, of the responding physicians, 27% wanted to continue working under the same conditions, 10% were undecided, and 63% wanted to stop or adjust their professional activity before age 65. The main reasons and factors motivating these plans were their current time constraints, the workload related to administrative tasks and the continuity of care; moreover, GPs noted the demands and expectations of patients, professional burnout and difficulties in obtaining a healthy work-life balance as factors contributing to these plans.

Physicians who wanted to stop practicing (30%) were the least satisfied with their work and seem to have anticipated this plan of action given that they reduced their number of hours in the office and on-call. Those who wish to adapt their work time (33%) are for the most part satisfied even if they work more, but 70% want to reduce their work hours.

The impact of these projects is a potentially heavy one, especially since two of the counties concerned have a low medical density and high rate of practicing physicians. Government measures currently proposed do not seem to respond to the evolution of private practice expected by GPs over 55 years.