IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v25y2024i9d10.1007_s10198-024-01687-x.html
   My bibliography  Save this article

Comparing GPs according to their model of practice: are multiprofessional group practices associated with more favourable working conditions?

Author

Listed:
  • Myriam Biais

    (CESP, Inserm UMR 1018, Team Primary Care and Prevention)

  • Matthieu Cassou

    (Institute for Research and Information in Health Economics (IRDES))

  • Carine Franc

    (CESP, Inserm UMR 1018, Team Primary Care and Prevention
    Institute for Research and Information in Health Economics (IRDES))

Abstract

In the generalized context of general practitioner shortages and transitions towards team-based primary care, we investigated how the different practising models relate to general practitioners’ labour supply. More precisely, we analysed the association between practice models—solo, groups of general practitioners, and multiprofessional groups—and their reported labour supply and level of satisfaction with work-life balance. We used a French cross-sectional survey from 2018 that surveyed a representative national sample of 3,032 self-employed general practitioners about their working conditions. We found that the model of practice was significantly associated with differences in physician labour supply at the intensive margin and that group practice appeared to be positively associated with general practitioners’ reported satisfaction with work-life balance. In terms of weekly working time, only practice in groups of general practitioners was associated with a significantly lower labour supply. However, general practitioners in groups–whether groups of general practitioners or multiprofessional groups–reported more annual leave and seemed more willing to diversify their activity by devoting more time to secondary activities, including salaried activities. Consistently, general practitioners working in groups were also more likely than solo practitioners to report being satisfied with their work-life balance. Although group practice, whether multiprofessionnal or not, seems to be well suited to meeting the new aspirations of general practitioners, those working in multiprofessional groups are associated with a higher level of weekly work supply, which might justify special attention from the public authorities.

Suggested Citation

  • Myriam Biais & Matthieu Cassou & Carine Franc, 2024. "Comparing GPs according to their model of practice: are multiprofessional group practices associated with more favourable working conditions?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(9), pages 1625-1640, December.
  • Handle: RePEc:spr:eujhec:v:25:y:2024:i:9:d:10.1007_s10198-024-01687-x
    DOI: 10.1007/s10198-024-01687-x
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-024-01687-x
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10198-024-01687-x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Dumontet, Magali & Buchmueller, Thomas & Dourgnon, Paul & Jusot, Florence & Wittwer, Jérôme, 2017. "Gatekeeping and the utilization of physician services in France: Evidence on the Médecin traitant reform," Health Policy, Elsevier, vol. 121(6), pages 675-682.
    2. Matthieu Cassou & Julien Mousquès & Carine Franc, 2020. "General practitioners’ income and activity: the impact of multi-professional group practice in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1295-1315, December.
    3. Rizzo, John A. & Blumenthal, David, 1994. "Physician labor supply: Do income effects matter?," Journal of Health Economics, Elsevier, vol. 13(4), pages 433-453.
    4. Olivier Chanel & Alain Paraponaris & Christel Protière & Bruno Ventelou, 2017. "Take the Money and Run? Hypothetical Fee Variations and French GPs’ Labour Supply," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 357-377.
    5. Matthieu Cassou & Julien Mousquès & Carine Franc, 2023. "General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France," Post-Print hal-04228634, HAL.
    6. Isabelle Clerc & Olivier L’Haridon & Alain Paraponaris & Camelia Protopopescu & Bruno Ventelou, 2012. "Fee-for-service payments and consultation length in general practice: a work--leisure trade-off model for French GPs," Applied Economics, Taylor & Francis Journals, vol. 44(25), pages 3323-3337, September.
    7. Tomoko Ono & Michael Schoenstein & James Buchan, 2014. "Geographic Imbalances in Doctor Supply and Policy Responses," OECD Health Working Papers 69, OECD Publishing.
    8. Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116, November.
    9. Frank A. Sloan, 1975. "Physician Supply Behavior in the Short Run," ILR Review, Cornell University, ILR School, vol. 28(4), pages 549-569, July.
    10. Daniël van Hassel & Robert Verheij & Ronald Batenburg, 2019. "Assessing the variation in workload among general practitioners in urban and rural areas: An analysis based on SMS time sampling data," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 474-486, January.
    11. Divine Ikenwilo & Anthony Scott, 2007. "The effects of pay and job satisfaction on the labour supply of hospital consultants," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1303-1318, December.
    12. Robert Reynard, 2016. "La qualité de vie dans les territoires français," Revue de l'OFCE, Presses de Sciences-Po, vol. 0(1), pages 33-48.
    13. Isabelle Clerc & Olivier L'Haridon & Alain Paraponaris & Camelia Protopopescu & Bruno Ventelou, 2012. "Fee-for-service payments and consultation length in general practice: a work-leisure trade-off model for French GPs," Post-Print hal-00632162, HAL.
    14. Groenewegen, Peter & Heinemann, Stephanie & Greß, Stefan & Schäfer, Willemijn, 2015. "Primary care practice composition in 34 countries," Health Policy, Elsevier, vol. 119(12), pages 1576-1583.
    15. repec:hal:journl:hal-04166155 is not listed on IDEAS
    16. Mikol, Fanny & Franc, Carine, 2019. "Gender differences in the incomes of self-employed French physicians: The role of family structure," Health Policy, Elsevier, vol. 123(7), pages 666-674.
    17. Sarma, Sisira & Thind, Amardeep & Chu, Man-Kee, 2011. "Do new cohorts of family physicians work less compared to their older predecessors? The evidence from Canada," Social Science & Medicine, Elsevier, vol. 72(12), pages 2049-2058, June.
    18. Divine Ikenwilo & Anthony Scott, 2007. "The effects of pay and job satisfaction on the labour supply of hospital consultants," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1303-1318.
    19. Cassou, Matthieu & Mousquès, Julien & Franc, Carine, 2023. "General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France," Health Policy, Elsevier, vol. 136(C).
    20. Anna Zaytseva & Pierre Verger & Bruno Ventelou, 2022. "United, can we be stronger? Did French general practitioners in multi-professional groups provide more chronic care follow-up during lockdown?," Post-Print hal-03660015, HAL.
    21. Livio Garattini & Marco Badinella Martini & Alessandro Nobili, 2023. "General practice in the EU: countries you see, customs you find," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 153-156, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Matthieu Cassou & Julien Mousquès & Carine Franc, 2020. "General practitioners’ income and activity: the impact of multi-professional group practice in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1295-1315, December.
    2. Barbara Broadway & Guyonne Kalb & Jinhu Li & Anthony Scott, 2017. "Do Financial Incentives Influence GPs' Decisions to Do After‐hours Work? A Discrete Choice Labour Supply Model," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 52-66, December.
    3. Guyonne Kalb & Daniel Kuehnle & Anthony Scott & Terence Chai Cheng & Sung‐Hee Jeon, 2018. "What factors affect physicians' labour supply: Comparing structural discrete choice and reduced‐form approaches," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 101-119, February.
    4. Cassou, Matthieu & Mousquès, Julien & Franc, Carine, 2023. "General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France," Health Policy, Elsevier, vol. 136(C).
    5. Terence C. Cheng & Pravin K. Trivedi, 2015. "Attrition Bias in Panel Data: A Sheep in Wolf's Clothing? A Case Study Based on the Mabel Survey," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1101-1117, September.
    6. Andreassen, Leif & Di Tommaso, Maria Laura & Strøm, Steinar, 2013. "Do medical doctors respond to economic incentives?," Journal of Health Economics, Elsevier, vol. 32(2), pages 392-409.
    7. Boris Kaiser, 2017. "Gender-specific practice styles and ambulatory health care expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1157-1179, December.
    8. Kalb, Guyonne & Kühnle, Daniel & Scott, Anthony & Cheng, Terence Chai & Jeon, Sung-Hee, 2015. "What Factors Affect Doctors' Hours Decisions: Comparing Structural Discrete Choice and Reduced-Form Approaches," IZA Discussion Papers 9054, Institute of Labor Economics (IZA).
    9. Johar, Meliyanni, 2010. "The effect of a public health card program on the supply of health care," Social Science & Medicine, Elsevier, vol. 70(10), pages 1527-1535, May.
    10. Terence Chai Cheng & Anthony Scott & Sung-Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2010. "What Factors Influence the Earnings of GPs and Medical Specialists in Australia? Evidence from the MABEL Survey," Melbourne Institute Working Paper Series wp2010n12, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    11. Terence Chai Cheng & Anthony Scott & Sung‐Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
    12. Christophe Loussouarn & Carine Franc & Yann Videau & Julien Mousquès, 2021. "Can General Practitioners Be More Productive? The Impact of Teamwork and Cooperation with Nurses on GP Activities," Health Economics, John Wiley & Sons, Ltd., vol. 30(3), pages 680-698, March.
    13. Divine Ikenwilo & Anthony Scott, 2007. "The effects of pay and job satisfaction on the labour supply of hospital consultants," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1303-1318.
    14. Hanel, Barbara & Kalb, Guyonne & Scott, Anthony, 2014. "Nurses’ labour supply elasticities: The importance of accounting for extensive margins," Journal of Health Economics, Elsevier, vol. 33(C), pages 94-112.
    15. Ester Manna, 2017. "Customer‐oriented employees: Blessing or curse for firms?," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 26(4), pages 842-875, December.
    16. Lukas Kwietniewski & Mareike Heimeshoff & Jonas Schreyögg, 2017. "Estimation of a physician practice cost function," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 481-494, May.
    17. Isabelle Clerc & Olivier L’Haridon & Alain Paraponaris & Camelia Protopopescu & Bruno Ventelou, 2012. "Fee-for-service payments and consultation length in general practice: a work--leisure trade-off model for French GPs," Applied Economics, Taylor & Francis Journals, vol. 44(25), pages 3323-3337, September.
    18. Yip, Winnie C., 1998. "Physician response to Medicare fee reductions: changes in the volume of coronary artery bypass graft (CABG) surgeries in the Medicare and private sectors," Journal of Health Economics, Elsevier, vol. 17(6), pages 675-699, December.
    19. Chunzhou Mu & Shiko Maruyama, 2013. "Salient Gender Difference in the Wage Elasticity of General Practitioners' Labour Supply," Discussion Papers 2013-16, School of Economics, The University of New South Wales.
    20. Badi H. Baltagi & Espen Bratberg & Tor Helge Holmås, 2005. "A panel data study of physicians' labor supply: the case of Norway," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1035-1045, October.

    More about this item

    Keywords

    Labour supply; Working conditions; Group practice; General practitioners; France;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:25:y:2024:i:9:d:10.1007_s10198-024-01687-x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.