Dual practice and multiple job holding among Iranian general practitioners: rate and effective factors.

Abstract

BACKGROUND Physician's dual practice is a common phenomenon in both developing and developed countries. This study aimed to investigate the rate and factors affecting the dual practice of general practitioners (GPs) as the most important primary care providers in Iran. METHODS This cross-sectional study was conducted on the data of 666 Iranian GPs, derived from a national survey. In this work, a researcher-made checklist was used to collect the required information. Multinomial logistic regression was used to examine the factors affecting concurrent employment in both public and private sectors and the factors affecting employment in more than one place (either public or private). RESULTS About 23.51% of the GPs were only working in the public sector, and 57.84% only in the private sectors. Also, 18.65% were working in both the private and public sectors. Results also indicated that 26.17% of the GPs were working in two or more places (whether public or private). Male GPs (p < .1) as well as the GPs with higher earnings expectations (p < .01) were more likely to have dual practice. Besides, the GPs working in small towns and villages (compared with Tehran, as capital of Iran; p < .05) were less likely to have dual practice. Gender (male) and earnings expectations had a significant effect on working in more than one place (p < .01). CONCLUSION The most important and significant factor affecting GPs' dual practice in Iran was their financial expectations. Thus, appropriate policies to modify physicians' income expectations and reforms such as improving tariffs setting should be adopted in the health systems.