Otto Pichlhöfer, MD Department for General Practice and Family Medicine Center for Public Health at the Medical University of Vienna Währinger Straße 13a A-1090 Wien, AUSTRIA Tel. +43(1)4277-65960 Fax. +43(1)25 33033 4532
Abstract: BACKGROUND: Throat infections with Group A Streptococci have a high incidence and are, therefore, a considerable health problem. It is, therefore, desirable to distinguish this bacterial infections from viral infections of the upper respiratory tract. We report about the application of an immunologic rapid antigen detection test for Group A Streptococci and its medical and economic implications. METHODS: In a cross-sectional cohort study, 30 family physicians documented the application of the test in 519 patients. Follow-up costs were compared with 109 family physicians who did not have access to the test. RESULTS: 40.27% of tests performed were positive for Streptococci. 99% of those patients received antibiotic treatment - predominantly with Penicillin. From those patients who had shown a negative test result, only 18.4% received antibiotic treatment. Both patients and physicians welcomed the availability of the test. We did not find any significant difference regarding the economic effect of the test. CONCLUSIONS: The employment of a rapid antigen detection test for Group A Streptococci in patients with acute pharyngitis increases therapeutic certitude and guideline-conform prescription of antibiotics among family physicians. We, therefore, assume that potential side effects of unnecessary antibiotic treatments could be minimized.
Abstract: AIM: To estimate the relative job satisfaction of Austrian family physicians and other specialists with respect to whether or not they obtained training in the desired specialty. METHODS: In this cross-sectional study, we re-examined the previous data on allocation of medical training posts in Austria. All board-certified physicians practicing in Vienna were surveyed with a 12-item questionnaire. We analyzed the association between respondents' desired and practiced medical specialty and their answer to the question of whether they thought they would have had greater job satisfaction in a different medical specialty. We also calculated their relative job satisfaction. RESULTS: Of 8127 licensed physicians, 2736 (34%) completed the questionnaire in two mailings. Of physicians who completed the questionnaire, 50.3% (43.2% of men) did not obtain the training in their desired specialty and 65.1% stated that they had originally desired a different specialty. There was a significant difference in relative job satisfaction between specialists who got their desired medical specialty (n=1005) and those who did not (n=697) (0.95 vs 0.62 of maximum 1, P<0.001). No significant difference in relative job satisfaction was found between family physicians who had originally wanted to become specialists (n=679) and specialists who had originally wanted to become family physicians (n=533; 0.89 vs 0.81; P=0.01; chi(2) test). CONCLUSION: A high percentage of family physicians in Austria had originally wanted to become practitioners of a different specialty. Among physicians who did not receive training in their desired medical specialty, family physicians showed a significantly higher relative job satisfaction than specialists. Obtaining the desired medical specialty is a strong predictor of relative job satisfaction among specialists, but not among family physicians.
Abstract: Aims: At some point in her career a physician makes a specialty choice hoping that eventually practicing her chosen medical specialty (CMS) will result in her optimal job satisfaction. On the other hand anecdotal evidence suggests that the medical job selection process in Austria is at best arbitrary and therefore many physicians do not attain their CMS. The aims of this study were to assess the extent to which physicians fail to attain their CMS and how that affects actual job satisfaction. Methods: All board-certified physicians practicing in Vienna were polled with a 12-item questionnaire sent out in two mailings. Their actual job satisfaction was correlated to their expected job satisfaction had they attained their CMS. Results: Of the 8,127 physicians included in the study 2,736 (34%) completed the questionnaire. 50.3% of all physicians and 65.1% of family physicians (FPs) did not attain their CMS. There was a significant difference in RJS between specialists who reached their CMS (RJS=0.95) and those who didn’t (RJS=0.62) (Chi-square p<0.000). No significant difference in RJS could be found between FPs who originally aspired to become specialists (RJS=0.89) and specialists who originally wanted to become FPs (RJS=0.81). Conclusion: There is a high percentage of FPs in Austria who had originally aspired to becoming specialized in a different discipline. Nevertheless they obtained a high level of job satisfaction in Family Medicine. The contrary can be observed in specialists who do not fare well when not having attained their CMS.
