Gender shift in realisation of preferred type of gp practice: longitudinal survey over the last 25 years

<p>Abstract</p> <p>Background</p> <p>An increasing number of newly trained Dutch GPs prefer to work in a group practice and as a non-principal rather than in a single-handed practice. In view of the greater number of female doctors, changing practice preferences, and discussions on future workforce problems, the question is whether male and female GPs were able to realise their initial preferences in the past and will be able to do so in the future.</p> <p>Methods</p> <p>We have conducted longitudinal cohort study of all GPs in the Netherlands seeking a practice between 1980 and 2004. The Netherlands Institute of Health Services Research (NIVEL) in Utrecht collected the data used in this study by means of a postal questionnaire. The overall mean response rate was 94%.</p> <p>Results</p> <p>Over the past 20 years, an increasing proportion of GPs, both male and female, were able to achieve their preference for working in a group practice and/or in a non-principal position. Relatively more women than men have settled in group practices, and more men than women in single-handed practices; however, the practice preference of men and women is beginning to converge. Dropout was highest among the GPs without any specific practice preference.</p> <p>Conclusion</p> <p>The overwhelming preference of male and female GPs for working in group practices is apparently being met by the number of positions (principal or non-principal) available in group practices. The preference of male and female GPs regarding the type of practice and job conditions is expected to converge further in the near future.</p

Current use and barriers and facilitators for implementation of standardised measures in physical therapy in the Netherlands

In many countries, the need for physical therapists to use standardised measures has been recognised and is recommended in clinical practice guidelines. Research has shown a lack of clinimetric knowledge and clinical application of measurement instruments in daily practice may hamper implementation of these guidelines. The aims of this study are 1) to investigate the current use of measurement instruments by Dutch physical therapists; 2) to investigate the facilitators and barriers in using measurement instruments

Organizational culture, team climate and diabetes care in small office-based practices

Contains fulltext : 71456.pdf ( ) (Open Access)BACKGROUND: Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. METHODS: We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory) and organizational culture (Competing Values Framework), and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. RESULTS: A strong group culture was negatively associated to the quality of diabetes care provided to patients (beta = -0.04; p = 0.04), whereas a more 'balanced culture' was positively associated to diabetes care quality (beta = 5.97; p = 0.03). No associations were found between organizational culture, team climate and clinical patient outcomes. CONCLUSION: Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea that aspects of redesigning care such as teamwork and culture can contribute to higher quality of care. Future research should preferably combine quantitative and qualitative methods, focus on possible mediating or moderating factors and explore the use of instruments more sensitive to measure such complex constructs in small office-based practices

Cijfers uit de registratie van verloskundigen: peiling 2016.

Praktiserende verloskundigen • Op 1 januari 2016 telt Nederland 3.221 werkzame verloskundigen (inclusief waarneemsters). • Van de verloskundigen werkt: ‐ 46% als zelfstandig gevestigde in een eigen praktijk/maatschap; ‐ 28% klinisch; ‐ 17% als waarneemster; ‐ 6% werkt als eerstelijnsverloskundige in loondienst van een zelfstandig gevestigde verloskundige; ‐ 3% werkt als eerstelijnsverloskundige in loondienst van een geboorte‐, gezondheids- centrum, ziekenhuis of vergelijkbare instelling/stichting. • Van de verloskundigen is 98% vrouw en 64% is jonger dan 40 jaar. • Van de verloskundigen werkt de helft parttime, gemiddeld 0,83 FTE (exclusief waarneemsters). • In 2015 hebben: ‐ 63 verloskundigen de praktijk neergelegd; ‐ 119 verloskundigen zich zelfstandig gevestigd. • Van degenen die zich in 2015 vestigden, is 81% begonnen in een groepspraktijk. • Van de eerstelijnsverloskundigen werkt: ‐ 5% in een solopraktijk; ‐ 15% in een duopraktijk; ‐ 80% in een groepspraktijk. • Nederland telt 555 verloskundigenpraktijken. Hiervan is: ‐ 16% een solopraktijk; ‐ 24% een duopraktijk; ‐ 60% een groepspraktijk. • Er zijn 6,8 eerstelijnsverloskundigen per 10.000 vrouwen in de vruchtbare leeftijd (15 t/m 39 jaar). Praktijkzoekende verloskundigen • In 2015 hebben: ‐ 146 verloskundigen hun opleiding voltooid; ‐ 4 verloskundigen een gelijkstelling gekregen. • Er zijn minimaal 78 afgestudeerde verloskundigen op zoek naar een (andere) baan binnen de verloskunde. Van hen is 51% op zoek naar een eigen praktijk of maatschap

Studies of spinels. (VIII) Synthesis and structural study of new antimonates M5II M3III SbO12 by X-ray diffraction and Mössbauer spectroscopy

X-ray and Mössbauer data on spinel antimonates, with formula (MII2MIII3) [MII8MIII2Sb2]O24, with MII = Mg, Zn, Ni and MIII = Fe, Ga are presented. The cationic orderings and distributions are widely discussed and even if no long-range cationic ordering appears, the Mössbauer data show a short-range one. Preliminary magnetic results are also obtained.Preudhomme J., Tarte P., Kenens R., Grandjean F., Gérard A. Studies of spinels. (VIII) Synthesis and structural study of new antimonates M5II M3III SbO12 by X-ray diffraction and Mössbauer spectroscopy. In: Bulletin de la Classe des sciences, tome 66, 1980. pp. 776-791