parisian general practitioners in training and their supervisors Study of 37 situations Eric Galam 1 Romain Multon 1 Tiphanie Bouchez 2 Tel AvivJaffa Israël 2021222324 May 2016 ID: 557027
Download Presentation The PPT/PDF document "Disagreements about patient care between" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Disagreements about patient care between parisian general practitioners in training and their supervisors. Study of 37 situations.Eric Galam (1), Romain Multon (1), Tiphanie Bouchez (2)
Tel Aviv-Jaffa – Israël
20-21-22-23-24 May 2016
Background
Workplace conflicts have a negative impact on satisfaction and performance of work team members
Aim To clarify and analyze disagreements about patients care between general practitioners in training (GPTs) and their supervisors
MethodFive focus groups were conducted, involving 25 GPTs, stating 37 disagreement situations with their supervisor about patient care. Interviews were recorded, transcribed and analyzed using a qualitative method to highlight the main encountered problems
Results : sources of conflicts 1) factors likely to turn disagreement into an irreconcilable conflict, 2) consequences about quality of care3) impact on GPTs empowerment
ConclusionsPractical solutions to help disagreements playing a positive role in empowering GPT and strengthening their professional ethics. Management training of proven or potential conflict can usefully clarify and optimize students hidden curriculum towards professionalism.
(1) Family Practice Department; Paris Diderot University (2) Family Practice Department, Nice-Sophia Antipolis Universitycorresponding author : Pr Eric GALAM eric.galam@univ-paris-diderot.fr
How
old is the GPT ?
Reasons for disagreement :
4) end of life or palliative hospital care 5) Impact of the hierarchical link between senior and GPT6) GPT’s personality, his conception of responsibility7) knowledge exchange and "commercial" stakes
Place of
disagreement
senior from another service : 16senior from the same service : 4Emergency : 13Ambulatory : 8
Medical ErrorSerious Event preventable : 4GP succed to prevent problem : 7Therapeutic relentlessness : 5No consequence for the patient : 21
GPT
decides (18/37)Team agreement : 7senior allows GPT decision : 2GPT against senior : 2GPT relies on another senior : 2GPT seeks his hierarchy : 2GPT decision senior absent :3
Senior
decides (19/37)Everybody agree : 1GPT makes but don't agree : 13GPT obliged by his hierarchy : 1GPT seeks another senior : 2After saying his disagreement : 1
Turning disagreement into conflict n=
36Feeling of underestimation GPT's skills : 10 Feeling of lack of involvement of senior : 8Weak patient or end of life : 10 Feeling of non-compliance with recommendations : 4Feeling of complacency prescription :3 Feeling of disempowerment for GPT : 1
Senior refuses
exam : 7 GPT doesn't agree : 8 Treatment :14 Hospi, monitoring,transfer : 8 Request for a specialist : 1 Not enough autonomy : 2