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Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study

BACKGROUND: In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born...

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Autores principales: Kuusio, Hannamaria, Lämsä, Riikka, Aalto, Anna-Mari, Manderbacka, Kristiina, Keskimäki, Ilmo, Elovainio, Marko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139137/
https://www.ncbi.nlm.nih.gov/pubmed/25103861
http://dx.doi.org/10.1186/1478-4491-12-41
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author Kuusio, Hannamaria
Lämsä, Riikka
Aalto, Anna-Mari
Manderbacka, Kristiina
Keskimäki, Ilmo
Elovainio, Marko
author_facet Kuusio, Hannamaria
Lämsä, Riikka
Aalto, Anna-Mari
Manderbacka, Kristiina
Keskimäki, Ilmo
Elovainio, Marko
author_sort Kuusio, Hannamaria
collection PubMed
description BACKGROUND: In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born physicians migrating to Finland and their employment sector, ii) examined, based on qualitative interviews, the foreign-born GPs’ experiences of accessing employment and work in primary care in Finland, and iii) compared experiences based on a survey of the psychosocial work environment among foreign-born physicians working in different health sectors (primary care, hospitals and private sectors). METHODS: Three different data sets were used: registers, theme interviews among foreign-born GPs (n = 12), and a survey for all (n = 1,292; response rate 42%) foreign-born physicians living in Finland. Methods used in the analyses were qualitative content analysis, analysis of covariance, and logistic regression analysis. RESULTS: The number of foreign-born physicians has increased dramatically in Finland since the year 2000. In 2000, a total of 980 foreign-born physicians held a Finnish licence and lived in Finland, accounting for less than 4% of the total number of practising physicians. In 2009, their proportion of all physicians was 8%, and a total of 1,750 foreign-born practising physicians held a Finnish licence and lived in Finland. Non-EU/EEA physicians experienced the difficult licensing process as the main obstacle to accessing work as a physician. Most licensed foreign-born physicians worked in specialist care. Half of the foreign-born GPs could be classified as having an ‘active’ job profile (high job demands and high levels of job control combined) according to Karasek’s demand-control model. In qualitative interviews, work in the Finnish primary health centres was described as multifaceted and challenging, but also stressful. CONCLUSIONS: Primary care may not be able in the long run to attract a sufficient number of foreign-born GPs to alleviate Finland’s GP shortage, although speeding up the licensing process may bring in more foreign-born physicians to work, at least temporarily, in primary care. For physicians to be retained as active GPs there needs to be improvement in the psychosocial work environment within primary care.
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spelling pubmed-41391372014-08-21 Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study Kuusio, Hannamaria Lämsä, Riikka Aalto, Anna-Mari Manderbacka, Kristiina Keskimäki, Ilmo Elovainio, Marko Hum Resour Health Research BACKGROUND: In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born physicians migrating to Finland and their employment sector, ii) examined, based on qualitative interviews, the foreign-born GPs’ experiences of accessing employment and work in primary care in Finland, and iii) compared experiences based on a survey of the psychosocial work environment among foreign-born physicians working in different health sectors (primary care, hospitals and private sectors). METHODS: Three different data sets were used: registers, theme interviews among foreign-born GPs (n = 12), and a survey for all (n = 1,292; response rate 42%) foreign-born physicians living in Finland. Methods used in the analyses were qualitative content analysis, analysis of covariance, and logistic regression analysis. RESULTS: The number of foreign-born physicians has increased dramatically in Finland since the year 2000. In 2000, a total of 980 foreign-born physicians held a Finnish licence and lived in Finland, accounting for less than 4% of the total number of practising physicians. In 2009, their proportion of all physicians was 8%, and a total of 1,750 foreign-born practising physicians held a Finnish licence and lived in Finland. Non-EU/EEA physicians experienced the difficult licensing process as the main obstacle to accessing work as a physician. Most licensed foreign-born physicians worked in specialist care. Half of the foreign-born GPs could be classified as having an ‘active’ job profile (high job demands and high levels of job control combined) according to Karasek’s demand-control model. In qualitative interviews, work in the Finnish primary health centres was described as multifaceted and challenging, but also stressful. CONCLUSIONS: Primary care may not be able in the long run to attract a sufficient number of foreign-born GPs to alleviate Finland’s GP shortage, although speeding up the licensing process may bring in more foreign-born physicians to work, at least temporarily, in primary care. For physicians to be retained as active GPs there needs to be improvement in the psychosocial work environment within primary care. BioMed Central 2014-08-07 /pmc/articles/PMC4139137/ /pubmed/25103861 http://dx.doi.org/10.1186/1478-4491-12-41 Text en Copyright © 2014 Kuusio et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kuusio, Hannamaria
Lämsä, Riikka
Aalto, Anna-Mari
Manderbacka, Kristiina
Keskimäki, Ilmo
Elovainio, Marko
Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title_full Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title_fullStr Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title_full_unstemmed Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title_short Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study
title_sort inflows of foreign-born physicians and their access to employment and work experiences in health care in finland: qualitative and quantitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139137/
https://www.ncbi.nlm.nih.gov/pubmed/25103861
http://dx.doi.org/10.1186/1478-4491-12-41
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