Attitudes of medical students and junior physicians towards working self-employed in private practice in Northern and Western Europe: a systematic review

Juliana Meyer*, Sofie Gjessing, Jette Kolding Kristensen, Steffen Flessa

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Aim
A shortage in primary care physicians has been a well-known challenge in many Western countries for several years. In addition, we currently see a trend in primary care, where an increasing number of physicians work as employees instead of being self-employed, even among general practitioners. To address this shortage, knowledge of the future specialists’ attitudes toward working self-employed is needed. This qualitative systematic review aims to explore the attitudes of future specialists towards self-employment in private practice, and what factors influence these attitudes.

Subject and methods
We conducted a systematic search using PubMed, Embase, and Web of Science. We developed a search strategy that collected terms for future specialists, career choices, and self-employment and linked these with the Boolean operator “AND”. We analysed the results using a qualitative content analysis, as both qualitative and quantitative studies were included in the research.

Results
Self-employment is less attractive to future specialists. In particular, women prefer to be employed and receive a fixed salary. The main factors that influence the decision as to whether to become self-employed or not are financial conditions, bureaucracy and non-medical tasks, organisation, job satisfaction during residency, personal responsibility, career opportunities, specialty-dependent factors, personal environment, and education.

Conclusion
Among future specialists, being self-employed is less attractive than being an employee. Students should be better informed about future career opportunities to make an informed decision. However, it should be examined whether other forms of organisation are more in line with the wishes of future specialists.
Original languageEnglish
JournalJournal of Public Health
Volume31
Issue number11
Pages (from-to)1759–1772
Number of pages14
ISSN1613-2238
DOIs
Publication statusPublished - Nov 2023

Keywords

  • Career choice
  • Future specialists
  • Private practice
  • Prospective physician
  • Self-employment

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