Procedures performed by general practitioners and general internal medicine physicians - a comparison based on...

Area of Science:

• Primary Care Medicine
• Health Services Research
• Medical Workforce Analysis

Background:

• Addressing a shortage of general practitioners (GPs) in Germany has led to the integration of general internal medicine (GIM) physicians into primary care.
• Previous research indicates distinct practice patterns between GPs and GIM physicians.
• This study investigates procedural differences between these two primary care provider groups.

Purpose of the Study:

• To analyze and compare the application of specific procedures by German GPs and GIM physicians.
• To identify differences in procedural uptake based on routine healthcare data.
• To inform discussions on primary care training and workforce allocation.

Main Methods:

• Utilized invoicing data from the Association of Statutory Health Insurance Physicians in Schleswig-Holstein (2013, 2015).
• Examined the implementation rates of 46 selected primary care procedures.
• Employed the Pearson chi-squared test to identify significant differences between GPs and GIM physicians.

Main Results:

• Significant differences in the application rates of 20 out of 46 procedures were observed between GPs and GIM physicians.
• GPs demonstrated higher rates for health screening (e.g., adolescent exams, well-child visits) and minor surgery.
• GIM physicians more frequently used technology-oriented procedures like ultrasound, ECGs, and ambulatory blood pressure monitoring.

Conclusions:

• Substantial procedural differences exist between German GPs and GIM physicians, impacting primary healthcare provision.
• Findings highlight the need for a discussion on primary care procedure training to ensure comprehensive services.
• Results suggest potential for optimizing vocational training for effective primary healthcare workforce reallocation.