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Observational Study
. 2022 Nov 22;39(6):1009-1016.
doi: 10.1093/fampra/cmac025.

Challenges and experiences of general practitioners during the course of the Covid-19 pandemic: a northern Italian observational study-cross-sectional analysis and comparison of a two-time survey in primary care

Angelika Mahlknecht  1 , Verena Barbieri  1 , Adolf Engl  1 , Giuliano Piccoliori  1 , Christian J Wiedermann  1   2
Affiliations
Observational Study

Challenges and experiences of general practitioners during the course of the Covid-19 pandemic: a northern Italian observational study-cross-sectional analysis and comparison of a two-time survey in primary care

Angelika Mahlknecht et al. Fam Pract. .

Abstract

Background: General practitioners (GPs) have been among the frontline workers since the outbreak of the Covid-19 pandemic. Reflecting and analyzing the ongoing pandemic response of general practice provides essential information and serves as a precondition for outlining future health policy strategies.

Objective: To investigate the effects of the pandemic on GPs' daily work and well-being and to describe needs for improvement in primary care highlighted by the pandemic.

Methods: A 2-time cross-sectional online survey involving GPs in a northern Italian region was conducted in September 2020 and March/April 2021.

Results: Eighty-four GPs (29.6% of invited GPs) participated in the first survey, and 41 GPs (14.4%) in the second survey. Most GPs experienced a notable workload increase which was tendentially higher during the advanced stages of the pandemic. A notable increase between the first and the second survey was noted regarding the frequency of Covid-related patient contacts and phone calls. Communication with health authorities and hospitals was rated as improvable. Psychological distress among GPs tended to increase over time; female GPs were more affected in the first survey. Most practices introduced major changes in their workflow, mainly appointment-based visits and separating Covid-19-suspected patients. Availability of protective equipment considerably increased over time. In the second survey, the GPs felt more prepared to self-protection and outpatient treatment of Covid-affected patients.

Conclusion: The work of GPs has been substantially impacted by the ongoing Covid-19 pandemic. Efforts should be undertaken to efficiently strengthen primary care which plays an important role in pandemic events.

Keywords: Covid-19; cross-sectional survey; general practice; mental health; primary care physicians; workload.

Plain language summary

The Covid-19 pandemic has considerably impacted the way of daily working of general practitioners (GPs). Several studies have been conducted which reflected the immediate response of general practice to the pandemic at its early stages, but studies assessing the ongoing situation are missing. This study responded to this need and aimed to illustrate the challenges, difficulties, and the personal well-being of GPs during the first pandemic wave and during the second/third pandemic wave. The study consisted of a 2-time online survey of GPs in a northern Italian province. The 84 GPs participating in the first survey and 41 GPs participating in the second survey indicated a notable workload increase due to the pandemic. The availability of protective equipment and of clinical guidance about how to treat Covid-19-affected patients in their homes was poor at the beginning but increased considerably over time. Psychological distress was slightly increasing. Most GPs modified their workflow and practice organization. Adequate support for general practice is required in pandemic events to enable GPs to provide safe and high-quality care; needs for improvement especially concern the provision of resources and the communication with public health institutions and hospitals.

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