METHODOLOGICAL APPROACHES TO ASSESSMENT OF THE ACTIVITY OF THE GENERAL PRACTITIONER

Abstract

After the launching of the health reform in the sphere of primary medical aid and a comparatively successful 20-years' accomplishment, a need has arisen for an update of the medical standards ratifying the activity of the general medical practice (2011). The study of the work of the general practitioner in an ergonomic aspect requires the construction of a reliable complex of methodological studies providing a realistic assessment of the organization of the working process and of basic psycho-physical functions in the daily and weekly dynamics, carried out on the background of a dominant attachment of the physician to the chosen area of expertise. The basic approaches for determination of the structure and expenses of the working time, or the efficiency coefficient (EC) respectively and intensity of labour involve the photochronometric- and the method of linear timing (also tracing the synchronization of the activity of the medical team); the spatial timing measuring the working trajectories, evidencing the degree of provision of functional working equipment and the objective conditions of labour. Sociological studies provide data on the style of communication with the patient and the occurrence of dilemmas of bioethical nature, as well as the strategies for their overcoming; sanitary and hygienic conditions of the working environment and their observation in accordance with the required criteria and indicators. The methodologies enable objective assessment of the workload and structure of the physician's working time and the resulting fatigue. Preconditions are created for the implementation of optimal organizational and technological operations in the provision of medical services, aiming to increase in the efficiency of the working process, and establishment of a physiological regime of labour in the general medical practice within the framework of the effective legislation.