Publications (14)18.66 Total impact
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Article: Where have all the GPs gone -- where will they go? Study of Finnish GPs.
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ABSTRACT: BACKGROUND: In this paper a specialist in general practice is referred to as a general practitioner (GP). In Finland only half of all GPs work as a health centre physician. The present aim was to establish what the working places of specializing and specialized physicians in general practice are, and where they assume they will work in the future. METHODS: The study population comprised 5,357 physicians licensed in Finland during the years 1977--1996. Altogether 2,956 questionnaires were returned, a response rate of 55.2%. Those either specializing (GP trainees, n=133) or already having specialized (GPs, n=426) in general practice were included in the study. Respondents were asked what kind of physician's work they would most preferably do. They were further asked what work they assumed they would be doing in the year 2020. RESULTS: Altogether 72% were working in public primary health centres and 14% in the private sector. Of GPs 53% and of GP trainees 70% would most preferably work in health centres. Of GPs 14% would most preferably work as private practitioners and 9% as occupational health physicians. Sixteen per cent assumed they would be working as private practitioners and 35% assumed they would be retired in the year 2020. Of GP trainees 57% assumed they would be working as health centre physicians in 2020. CONCLUSIONS: According to the present findings many experienced GPs will leave their work as a health centre physician. Moreover, several GP trainees do not consider health centre physician's work as a long-term career option. These trends may in the future reflect a recruiting problem in many primary health centres.BMC Family Practice 12/2012; 13(1):121. · 1.80 Impact Factor -
Article: Does the need for professional competencies change during the physician's career?--A Finnish national survey.
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ABSTRACT: Competence consists of a range of skills, knowledge and attitudes that physicians utilize in their work. Different models for defining physician competency areas have been used in medical organizations. The goal of this study was to explore how Finnish physicians perceive the need for different competency areas in their work. The data for this study were collected in a national questionnaire administered by the Finnish Medical Association (response rate = 63%; N = 10,624). The competency framework was derived from the CanMEDS framework (seven areas) and detailed into 11 items focusing on different aspects of physicians' work. The participants were asked to evaluate how much they needed different items in their work. Factor analysis identified three broad competency dimensions: (1) medical knowledge, (2) management skills and (3) interpersonal skills. There were differences in the need for these competency dimensions according to work assignment and age, reflecting occupational status and amount of work experience and specialty. The results were in agreement with the theoretical framework, but the factor analysis compressed the competency areas into three broader dimensions. This study suggests that different positions require different competencies from physicians. Therefore, if physicians are assessed, they should be assessed in accordance with their work.Medical Teacher 01/2011; 33(5):e275-80. · 1.22 Impact Factor -
Article: Choosing a medical specialty--study of Finnish doctors graduating in 1977-2006.
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ABSTRACT: Choosing a medical specialty is an important element predefining a physician's career and life. Although there has been some research in this area of interest, there has not been much research where the profession has been researched as a whole, or where trend data over different generations has been presented. The aim of our study was to ascertain the motives affecting physicians' choice of a medical specialty. The study cohort comprised random sample of 7758 doctors who were registered in Finland during the years 1977-2006. Altogether 4167 questionnaires were returned, giving a response rate of 54%. An electronic questionnaire was used in data collection, supported by a traditional postal questionnaire. Of the respondents, 76% thought the diversity of the field had affected their choices of specialty considerably or very much. For physicians under 35 years old, especially the good example set by colleagues (48%), and opportunities for career development (39%) were more important motives compared to those of older physicians. According to this study, diversity of the work is the main motivating factor affecting physicians' choices of specialty. Especially, younger physicians follow the example set by more experienced colleagues.Medical Teacher 01/2011; 33(8):e440-5. · 1.22 Impact Factor -
Article: The association of distress and sleeping problems with physicians' intentions to change profession: the moderating effect of job control.
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ABSTRACT: The present study examined whether job control moderated the association between stress indicators (distress and sleeping problems) and intentions to change profession among 2,650 Finnish physicians. Ordinal logistic regression analysis was applied. The authors found that high levels of distress and sleeping problems were associated with higher levels of intentions to change profession, whereas high job control was associated with lower levels of intentions to change profession even after adjusting for the effects of gender, age, and employment sector. In addition, high job control was able to mitigate the positive association that distress and sleeping problems had with intentions to change profession. Our findings highlight the importance of offering more job control to physicians to prevent unnecessary physician turnover.Journal of Occupational Health Psychology 10/2009; 14(4):365-73. · 2.07 Impact Factor -
Article: Amount of external CME in groups of specialties: a nation-wide survey among Finnish doctors.
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ABSTRACT: Continuing medical education (CME) is an integral part of continuing professional development and a prerequisite for good quality in health care. We aimed to describe and analyse the number of days spent in formal CME outside the workplace by specialty among Finnish doctors of working age. The number of days in formal CME outside the workplace in 2005 reported by specialists was obtained from an annual postal survey, conducted by the Finnish Medical Association in March 2006, of all working-age doctors. Those who had attained their specialist degree before 2005 were included in the study. The 49 specialties were re-categorised into 15 groups. The mean reported number of days and 95% confidence intervals were calculated. Differences were analysed by Poisson regression adjusted for relevant covariates. The response rate to the question about CME was 70.2% (7,374) among specialists. The median age (interquartile range) of the respondents was 49 years (from 44 to 55 years), and 51.7% (3,810) were female. The mean reported number of days in CME was 8.8 (95% CI 8.7-9.0). Neurologists and surgery specialists participated in CME the most frequently (10.3 and 10.4 days) and ophthalmologists the least (7.6 days). In comparison with anaesthesiology and intensive care specialists, most specialists reported having significantly more formal CME, and no group reported having less. Significant variation was observed, and we therefore suggest studies seeking to account for this variation. The results have originally been published in Finnish in the Finnish Medical Journal.BMC Research Notes 01/2009; 2:265. -
Article: Amount of external CME in groups of specialties: a nation-wide survey among Finnish doctors
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ABSTRACT: Abstract Background Continuing medical education (CME) is an integral part of continuing professional development and a prerequisite for good quality in health care. We aimed to describe and analyse the number of days spent in formal CME outside the workplace by specialty among Finnish doctors of working age. Findings The number of days in formal CME outside the workplace in 2005 reported by specialists was obtained from an annual postal survey, conducted by the Finnish Medical Association in March 2006, of all working-age doctors. Those who had attained their specialist degree before 2005 were included in the study. The 49 specialties were re-categorised into 15 groups. The mean reported number of days and 95% confidence intervals were calculated. Differences were analysed by Poisson regression adjusted for relevant covariates. The response rate to the question about CME was 70.2% (7,374) among specialists. The median age (interquartile range) of the respondents was 49 years (from 44 to 55 years), and 51.7% (3,810) were female. The mean reported number of days in CME was 8.8 (95% CI 8.7-9.0). Neurologists and surgery specialists participated in CME the most frequently (10.3 and 10.4 days) and ophthalmologists the least (7.6 days). In comparison with anaesthesiology and intensive care specialists, most specialists reported having significantly more formal CME, and no group reported having less. Conclusions Significant variation was observed, and we therefore suggest studies seeking to account for this variation. The results have originally been published in Finnish in the Finnish Medical Journal.BMC Research Notes. 01/2009; -
Article: Effects of active on-call hours on physicians' turnover intentions and well-being.
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ABSTRACT: This study examined whether active on-call hours and the co-occurrence of lifestyle risk factors are associated with physicians' turnover intentions and distress. Cross-sectional survey data on randomly selected female (N=1571) and male (N=1081) physicians, aged 25 to 65 years, from The Finnish Health Care Professionals Study were used. The outcome measures were turnover intentions and distress (general health questionnaire). Smoking, heavy drinking, overweight, and low physical activity were assessed as lifestyle risk factors. Analyses of covariance were used to analyze the data. After adjustment for gender, age, employment sector, and job satisfaction, the analyses showed that the physicians who had been on active call more than 40 hours per month reported more distress than the group not on call (P=0.046). The physicians with two or more risk factors also had more distress (P<0.001) than those with no risk factors or only one risk factor. There was an interaction between active on-call hours and lifestyle risk factors for turnover intentions (P=0.002). The physicians with two or more lifestyle risk factors who had been on active call more than 40 hours per month had more turnover intentions than the other physicians. On-call duty and the co-occurrence of lifestyle risk factors may both decrease physicians' well being and increase their intentions to leave their job.Scandinavian journal of work, environment & health 10/2008; 34(5):356-63. · 3.12 Impact Factor -
Article: Health, psychosocial factors and retirement intentions among Finnish physicians.
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ABSTRACT: Early retirement among physicians is a worldwide problem and all efforts to try to minimize it are of importance. To investigate whether characteristics of work, organization factors and health factors might be associated with retirement intentions among physicians. Cross-sectional survey data from the Finnish Health Care Professional Study was used. A random sample of Finnish physicians included 682 women and 701 men aged 45-65 years. A three-level retirement intention score was constructed based on responses to two questions asking about (i) willingness to continue working or retiring and (ii) pension-applying considerations. Health indicators used were self-rated health, work ability and sickness absence during the past 12 months. Karasek's job control and Colquitt's organizational justice were measured. Ordinal logistic regression models were used to analyse the data. Self-reports of poor health [odds ratio (OR) 2.17, 95% CI 1.84-2.56], low work ability (OR 2.18, 95% CI 1.12-1.46), taking sickness absence (OR 1.28, 95% CI 1.12-1.46), low job control (OR 1.71, 95% CI 1.50-1.95) and organizational injustice (OR 1.27, 95% CI 1.17-1.39) all independently increased the likelihood of retirement intentions. Low job control strengthened the associations of poor health and low work ability with retirement intentions. In addition, organizational injustice strengthened the associations of poor health and sickness absences with retirement intentions. Low job control and organizational injustice may intensify the effect of poor health on retirement intentions. Promoting control opportunities and organizational justice might help to decrease early retirement among physicians.Occupational Medicine 07/2008; 58(6):406-12. · 1.14 Impact Factor -
Article: Use of quality improvement methods in Finnish health centres in 1998 and 2003.
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ABSTRACT: To evaluate how widely quality improvement methods are used in Finnish primary health centres and how the use has changed over five years. Two national cross-sectional postal enquiries. The questionnaire in 1998 was sent to every other physician graduated during the years 1977-1986, and the questionnaire in 2003 to every other physician graduated during the years 1982-1991. The response rates were 73.9% and 62.2%. The answers of primary healthcare physicians (n = 503 vs. 344) were analysed. The availability of 13 quality improvement methods was solicited. The change over five years was analysed. Opportunity to obtain continuing medical education (CME), in-service training, meetings, opportunity to consult a colleague in own speciality, and agreed guidelines on how a certain problem should be solved were highly reported both in 1998 and 2003. The biggest improvement (16.8%) concerned clinical guidelines. There was also progress with regard to quality improvement manuals at the place of work, opportunity to consult a colleague in another speciality, and computer-assisted monitoring of own work. Many quality improvement methods were highly reported in both 1998 and 2003 in Finnish health centres. The biggest positive change concerns clinical guidelines.Scandinavian journal of primary health care 04/2008; 26(1):12-6. · 2.21 Impact Factor -
Article: The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private.
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ABSTRACT: This study is based on a unique data set for the years 1988-2003 and uses structural equation models to examine the impact of job satisfaction and job dissatisfaction on physicians' intention to switch from public- to private-sector work. In Finland, physicians who work primarily in a public-hospital or health-centre setting can also run a private practice. Therefore, we also analysed the impact of having a private practice on a physician's intention to change sector. We found that private practice had a positive, statistically significant effect on the intention to switch sector in 1998 and 2003. Results also suggest that job satisfaction decreases a physician's intention to switch sector, although for 1998 it had no effect. Surprisingly, job dissatisfaction significantly increased the physicians' intentions to leave the public sector only in the 1988 data.Health Policy 10/2007; 83(1):50-64. · 1.51 Impact Factor -
Article: Factors associated with physicians' choice of working sector: a national longitudinal survey in Finland.
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ABSTRACT: To analyse factors affecting physicians' choice to work in either the public or the private sector. We undertook a longitudinal data analysis in the years 1988, 1993, 1998 and 2003 (n = 12 909) using a multilevel modelling technique. Factors related to economic factors, physician identity, appreciation as well as demographic factors were hypothesised to influence sector choice. Physicians seem to make their career choices prior to graduation, at least to some extent. Wage levels, the physician's personal characteristics and whether or not the physician knew his or her place of work before graduation were the key factors affecting the decision-making process in the years 1988, 1993, 1998 and 2003. Physicians for whom wages were important were less likely to choose the public sector. Also, physicians who regarded themselves as entrepreneurial preferred to work in the private sector. If a physician had worked in the public sector during his or her medical training before graduation, the probability of applying for a vacancy in the public sector was higher. It is not only economic factors, such as salary, that are involved in the physician's decision to choose the working sector.Applied Health Economics and Health Policy 02/2006; 5(2):125-36. -
Article: Managerial skills of principal physicians assessed by their colleagues. A lesson from Finland.
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ABSTRACT: The purpose of this paper was to discover the views of doctors regarding the managerial skills of their principal physicians and the views of doctors of their postgraduate specialist training in management. This was done by sending out a questionnaire to every second physician registered in 1977-1986 in Finland. They were asked to evaluate their principal physician's managerial skills using a visual analogue scale. A five-point Likert scale was used to inquire how much training doctors had received for different professional tasks, including management, during their specialist training. Of all the 318 principal physicians in this study, 85 percent reported that they had had too little training for managerial skills. It was found that doctors in leading positions, both in public hospitals and the primary health care sector, are aware of the need of training for managerial and leadership skills.Journal of Health Organisation and Management 02/2003; 17(6):457-62. -
Article: Improvement in undergraduate medical education: a 10-year follow-up in Finland.
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ABSTRACT: Several studies have revealed that undergraduate medical education does not adequately prepare students for their work as physicians. There have been attempts to solve this problem in curriculum reforms in medical faculties. In this article, Finnish physicians' opinions on their undergraduate medical education are analysed. In 1988, a postal questionnaire was mailed to 2632 physicians registered during 1977-86, and altogether 1745 questionnaires were returned (66.3%). A follow-up study was done in 1998, and a questionnaire was sent to 2529 physicians who graduated between 1987 and 1996; 1822 questionnaires were returned (73.1%). Half of the respondents considered undergraduate education to correspond well with the requisite diagnostic skills and hospital doctors' work in general. In older and more traditional medical faculties (Helsinki, Oulu and Turku) education in primary healthcare work was considered insufficient. Also, more than 80% of the respondents felt they received too little teaching in administrative work. They reported that both traditional and younger, community-oriented faculties (Kuopio and Tampere) had considerably improved their education, especially in primary healthcare, during the 10-year follow-up. However, there were still clear differences between the education in the respective types of faculty as evaluated by their graduates. There is still room for improvements in undergraduate medical education, the better to meet the real needs of practising physicians in different fields of health care.Medical Teacher 02/2002; 24(1):52-6. · 1.22 Impact Factor -
Article: Evaluation of undergraduate medical education in Finnish community‐oriented and traditional medical faculties: a 10‐year follow‐up
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ABSTRACT: Objectives This study focused on Finnish physicians’ views of their undergraduate medical education. Differences between traditional and community-oriented medical faculties were examined and changes which had taken place during a 10-year follow-up period were also assessed.Methods The study was based on data retrieved from a postal survey made among Finnish physicians in 1998. The study population consisted of all doctors who graduated between 1987 and 1996 (n=4926); those born on odd-numbered days were selected for this study (n=2492). A postal questionnaire and two reminders were sent to those selected, and 1822 questionnaires were returned, giving a response rate of 73·1%.ResultsPhysicians who graduated from the community-oriented faculties were more satisfied with their undergraduate medical education when compared with their colleagues graduating from traditional faculties. There were some differences between the universities with respect to education for hospital work. The teaching of primary health care, however, was clearly more effective in community-oriented faculties. The proportion of graduates who were satisfied with their primary care education was over 70% in community-oriented faculties, whereas in the traditional faculties it was only 35–45%.Conclusions According to graduates, the community-oriented medical school curriculum better meets the needs of practising physicians than that in traditional faculties. In curriculum reforms, more emphasis should be placed on comprehensive medical education, which includes both primary and secondary health care.Medical Education 11/2000; 34(12):1016 - 1018. · 3.18 Impact Factor
Top co-authors
Top Journals
Institutions
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2011
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Kuopion Yliopistollinen Sairaala
Kuopio, Province of Eastern Finland, Finland
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2000–2011
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Finnish Medical Association (Finland)
Helsinki, Province of Southern Finland, Finland
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2008–2009
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National Institute for Health and Welfare, Finland
Helsinki, Province of Southern Finland, Finland -
University of Tampere
- Medical School
Tampere, Western Finland, Finland
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2003
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University of Kuopio
- Department of Public Health and General Practice
Kuopio, Province of Eastern Finland, Finland
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