Swiss primary care doctors give their healthcare system highest marks in international comparison

Bern, 14.02.2023 - Switzerland’s primary care doctors have given their own healthcare system the highest marks in an international comparison. Over half of them are satisfied with the care and services they provide, though job satisfaction has declined in the last few years while perceived stress levels have tangibly increased. New GPs are predominantly female; and a clear trend can be seen towards group medical practices. These are the findings of the latest survey of the international primary medical care community which has been conducted in ten countries under the aegis of the Commonwealth Fund Foundation.

Switzerland is a regular participant in the international surveys of the Commonwealth Fund Foundation. For 2022 it was primary care doctors who were polled, a group which includes general practitioners (GPs), internists and paediatricians. Of the 1 114 primary care doctors who were surveyed in Switzerland, more than 90 per cent described the overall performance of their healthcare system as good or very good – the highest level (once again) in any of the countries studied, and a result that was achieved despite the recent impact of the COVID-19 pandemic.  

The majority (81 per cent) of the Swiss-based doctors polled consider the quality of the healthcare they provide to have remained as good as it had been in pre-pandemic times throughout the pandemic period. Only 11 per cent felt a deterioration therein. This was the best result among the ten countries which participated in the survey, and is a testament to the Swiss system’s ability to provide such quality care even in crisis situations.

Increasing stress

More than half (58 per cent) of the Swiss-based doctors polled considered themselves very or even extremely satisfied with their work within their practice – again the highest percentage of any of the countries involved, as it had also been in 2019. At the same time, however, the percentage figure here is a clear decline on 2019, as it was in almost all the countries surveyed.

Switzerland also saw an increase in the proportion of primary care doctors who felt stressed in their job. Some 43 per cent of Swiss-based respondents regarded their work as very or extremely stressful – a tangible increase on the 37 per cent of 2019, but still the second-lowest level among the countries surveyed. One possible reason for the increase in stress levels could be the COVID-19 pandemic: over half (56 per cent) of the doctors polled felt that their workload had increased somewhat or significantly as a result of the pandemic.

The stress levels reported also varied among the types of doctors polled, with paediatricians (32 per cent) experiencing the lowest stress levels. One third of respondents described themselves as highly satisfied with their work/life balance, the highest proportion recorded in any of the countries polled.

For more than two thirds (68 per cent) of primary care doctors in Switzerland, the time spent on administrative activities such as invoicing is a major problem. This was the highest such percentage among all the participating countries, and is a clear increase on the 61 per cent recorded in the previous 2019 survey. At the same time, however, many respondents reported spending less than 10 per cent of their working hours on such administrative duties.

Fewer new doctors in the GP field

Almost half (48 per cent) of the primary care doctors in Switzerland are aged 55 or over – a high proportion compared to the other countries polled. The Swiss Confederation has taken a range of actions over the past few years to strengthen the country’s primary medical care. The numbers of medical students qualifying as internists or GPs have been increasing since 2016. The proportion of women in the GP field has also grown, from just under a third (30 per cent) in 2012 to almost a half (46 per cent) last year. The feminisation within this sector may be due at least in part to the possibility of part-time working arrangements. But the numbers of new doctors joining the GP community remain low, especially for men.

Decline in solo practices

The latest Commonwealth Fund Foundation international primary care doctor survey also confirms the trends towards group practices and away from long working weeks. Over the past ten years, the proportion of such physicians working in a group practice has increased from 44 to 67 per cent.

At the same time, a decline has been seen in the numbers of primary care doctors working long weeks of 45 hours or more. While 68 per cent of respondents reported working such long weeks ten years ago, the corresponding figure was only 50 per cent last year. Almost a quarter of the doctors polled work between 35 and 44 hours a week, while a further quarter have a working week of under 35 hours.

Half of all respondents plan to sign up to Electronic Patient Dossier

More and more primary care doctors (82 per cent) now maintain their patients’ health records in electronic form. In a comparison with the corresponding figure (70 per cent) for the previous such survey in 2019, it is primarily the older doctors and the paediatricians who have come round to this approach. But Switzerland is still last in this respect among the ten countries polled.

Three per cent of the Swiss-based primary care doctors polled make use of the Electronic Patient Dossier (EPD) and are affiliated to a corresponding data community. A large proportion (57 per cent) of respondents plan to sign up to EPD soon, while 40 per cent expressed no such intention – primarily those doctors who were already at or above retirement age, or those working in solo practices. The highest percentage of respondents who had already committed to EDP – over 6 per cent – was found in French-speaking Switzerland.

Current plans envisage the further development of EPD in a two-step process, along with efforts to further broaden its use. The Federal Council took the first actions in January to these ends, and has now sent corresponding proposals for consultation.

The study also shows that primary care doctors in Switzerland rank low in international terms when it comes to exchanging data (such as laboratory data or clinical pictures) electronically with other healthcare professionals. Apart from email communications, the e-health offerings of primary care doctors to their patients in Switzerland remain relatively limited.

Switzerland has been participating in the International Health Policy Surveys of the Commonwealth Fund Foundation since 2010. The Commonwealth Fund is a private not-for-profit foundation which aims to promote efficient and well-functioning healthcare systems that provide better access to health insurance and to improve the quality of the services and benefits provided.

The 2022 Commonwealth Fund Foundation International Health Policy Survey was aimed – as it had previously been in 2012, 2015 and 2019 – at doctors active in the primary care field. Alongside Switzerland, the further participating countries were Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, the UK and the USA. In Switzerland the survey was conducted on behalf of the Federal Office of Public Health (FOPH) and in close collaboration with the Swiss Medical Association (FMH). The 2022 survey polled 1 114 primary care doctors in Switzerland’s three main language regions.

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