General practitioners' acceptability to handle unscheduled visits: a french nationwide cross-sectional survey

The increasing demand for emergency department (ED) services has led to overcrowding, impacting the quality and accessibility of healthcare. The objectives were to evaluate how general practitioners (GPs) manage unscheduled visits, including patients redirected from emergency departments and/or medical dispatch centers, and to identify potential barriers to accepting these patients.

We conducted a cross-sectional survey in France from April 2020 to March 2021, utilizing a self-administered, web-based, anonymous pre-tested questionnaire distributed among the members of professional society and social network. The questionnaire was divided into three sections, namely: (1) demographics of GP respondents; (2) current organization for handling unscheduled visits, and (3) potential barriers to implementing dedicated schedule slots for patients redirected from EDs. We used multivariable logistic regression to investigate associations between personal and practice characteristics.

A total of 1,317 GPs participated in the survey. The majority were female (59%), aged between 31 and 40 years (43%) and located in semi-rural areas (66%). Overall, 89% reported to allocate specific slots for unscheduled care visits. However, only 16% had their slots open to emergency/dispatch center-referred patients. The majority (83%) of GPs showed no interest in setting aside dedicated slots for ED redirected patients, 62% were against sharing information about their unscheduled visit slots with EDs, and 88% opposed the automatic scheduling of ED patients into their clinics. The main barriers to the implementation of dedicated slots for unscheduled visit were a lack of interest (46%), time constraints (48%), and organizational challenges (9%). GPs with smaller patient bases and those using computerized systems showed greater openness to communicate availability for unscheduled care.

Most French GPs surveyed, representing approximatively 2% of the overall French GP population, integrate daily slots for unscheduled visits into their practice but they are typically reserved for their existing patient base. The survey further revealed that two-thirds of these GPs are unwilling to communicate the availability of these slots to EDs. Additionally, an even larger proportion would refuse to allow automatic scheduling of ED patients into their clinics if redirection strategies were implemented at their local hospitals.