Orest Mulke wonders if it would be difficult to demonstrate that GPs' workload had increased over the years.1
International research on burnout, presented at a European General Practice Research Network (EGPRN) meeting in Verona and to be managed as a workshop at the forthcoming meeting in Antwerp, has shown that GPs' workload is moving towards burnout almost everywhere in Europe.2
In Italy, GP workloads have increased in recent years, and this has not necessarily coincided with an improvement in quality of care and clinical efficacy, but, as a rule, quite the contrary with more bureaucracy, less consideration and respect for the professional role, worse organisation, and lower incomes.
Research managed by the Italian College of General Practitioners in North-east Italy, studied GP workload by looking at patients seen in GPs' surgeries.3 The work carried out by the GPs was recorded on computerised systems (not easy in Italy) and it was clear that patients were attending practices 4.7 times a year in 1996 and 7.5 times a year in 2002, an increase in workload of 57%.
This could be linked to a greater perception of ‘health needs’, which are frequently inappropriate and brought about by acts of law from the Ministry and from the Health Authorities (for example, fewer drugs prescribed on prescribing cards, modifications on free-of-charge examinations and so on).
In Italy, it's time to take care of the massive burnout and overload in primary care, beginning with workload issues and then looking at other factors.
It's time to take care of patients' health (before they are ill), through an awarding system that measures processes and results (not only structure).
Last but not least, as for Orest Mulke, if we look at income in 1982 and now, the situation is simply a disaster.
- © British Journal of General Practice, 2004.
