„This wait-and-see strategy, we don’t have it here“
Allgemeinärzte in der Notaufnahme einer Universitätsklinik: eine qualitative Untersuchunggerman translation / full article
Family Practitioners in a University Emergency Department
Background: Accident and emergency departments (A&E) are facing increasing numbers of patients. At Hannover Medical School, family practitioners (FPs) have therefore been integrated in the A&E for ambulatory patient care. To date, FPs’ perception of their work at the A&E has not been examined.
Methods: Five doctors from the department of family medicine working in the A&E in 2015 took part in a focus group discussion. The discussion was audiorecorded, transcribed and coded according to Qualitative Description. After open coding in a first step, the category system was developed in a consensus process.
Results: From the FPs’ perspective, the disease spectrum is – apart from some more difficult cases – similar to that in family practice. Patients also have higher expectations regarding diagnostics and care. „Wait-and-see“ as a basic principle of family medicine cannot be used in A&E. Due to the lower priority of their patients, FPs do not always feel equal among the specialised disciplines in A&E. Altogether, FPs appreciate working in a field diverse from their practice, and being part of a multidisciplinary team.
Conclusions: FPs describe working at A&E as professionally rewarding. However, there is a lack of basic principles of family medicine in A&E, such as knowing one’s patient and the option of follow-up consultations. The integration of FP in an A&E is possible and valuable but cannot replace the care provided in family practice.