General practitioners' management of occupational diseases: a qualitative study in French-speaking Switzerland.

IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL
Gaubicher Coline, Staeger Philippe, Danuser Brigitta, Abderhalden-Zellweger Alessia, Krief Peggy, Mediouni Zakia
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Abstract

Background: Work-related health problems are a frequent reason for consultation with primary care physicians; however, few studies report on the way general practitioners' (GPs) approach work-related health issues with their patients.

Aim: To investigate the practices of Swiss GPs in regarding work-related health issues presented by their patients, and to identify the resources and difficulties they faced.

Methods: Semi-structured interviews were conducted with 12 GPs, transcribed, and analyzed thematically.

Results: GPs do explore their patients' occupational field. However, the data collected are limited, even though doctors recognize that a high proportion of mental and musculoskeletal disorders may be work-related. Work-related disease insurance issues are a frequent concern in GPs everyday practice, often causing a discomfort regarding these issues. Exchanges between GPs and employers regarding work-related health issues are relatively uncommon but can yield positive outcomes when they occur. Occupational risk prevention is confined to certain high-risk exposures. When asked to express their difficulties in dealing with work-related issues, GPs mention the lack of dedicated time, insurance issues, contact with employers or the lack of it and lack of training. As for resources, GPs mainly identify specialist doctors, but still, only few of them mention occupational physicians.

Conclusions: Some work-related pathologies, whether frequent or serious, are not systematically investigated by GPs. This raises the question of their detection and probable under-reporting. To improve anamnesis, identification, and referral practices for occupational health issues, we suggest a targeted training for GPs, strengthened networking among stakeholders-such as occupational physicians, employers and insurers- and a revision of medical billing structures to better support the management of work-related diseases for both GPs and occupational physicians.

全科医生对职业病的管理:瑞士法语区的定性研究。
背景:与工作有关的健康问题是向初级保健医生咨询的常见原因;然而,很少有研究报告的方式全科医生(全科医生)处理工作相关的健康问题与他们的病人。目的:调查瑞士全科医生在处理病人提出的与工作有关的健康问题方面的做法,并确定他们面临的资源和困难。方法:对12名全科医生进行半结构化访谈,进行转录,并进行主题分析。结果:全科医生确实对患者的职业领域进行了探索。然而,收集到的数据是有限的,即使医生认识到很大比例的精神和肌肉骨骼疾病可能与工作有关。与工作有关的疾病保险问题是一个常见的问题,在全科医生的日常实践中,经常引起不适关于这些问题。全科医生和雇主之间就与工作有关的健康问题进行交流的情况相对较少,但一旦发生,就会产生积极的结果。职业风险预防仅限于某些高危暴露。当被问及在处理与工作有关的问题时遇到的困难时,全科医生提到了缺乏专门的时间、保险问题、与雇主的联系或缺乏联系和缺乏培训。在资源方面,全科医生主要是指专科医生,但提及职业医生的仍然很少。结论:一些与工作相关的疾病,无论是频繁的还是严重的,都没有被全科医生系统地调查。这就提出了检测和可能漏报的问题。为了改善职业健康问题的记忆、识别和转诊实践,我们建议对全科医生进行有针对性的培训,加强利益相关者(如职业医生、雇主和保险公司)之间的联系,并修订医疗计费结构,以更好地支持全科医生和职业医生对与工作有关的疾病的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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