SMS text messaging to measure working time: the design of a time use study among general practitioners.

Background: Measuring the working hours of general practitioners (GPs) is an important but complex task due to the effects of bias related to self-reporting, recall, and stress. In this paper we describe the deployment, feasibility, and implementation of an innovative method for measuring, in real time, GPs' working time, plus the response to the study.

Methods: A Short Message Service (SMS) application was developed which sent messages at random to GPs during their working week.

Age-related differences in working hours among male and female GPs: an SMS-based time use study.

Background: In several countries, the number of hours worked by general practitioners (GPs) has decreased, raising concern about current and impending workforce shortages. This shorter working week has been ascribed both to the feminisation of the workforce and to a younger generation of GPs who prefer more flexible working arrangements. There is, however, limited insight into how the impact of these determinants interact.

Assessing the precision of a time-sampling-based study among GPs: balancing sample size and measurement frequency.

Background: Our research is based on a technique for time sampling, an innovative method for measuring the working hours of Dutch general practitioners (GPs), which was deployed in an earlier study. In this study, 1051 GPs were questioned about their activities in real time by sending them one SMS text message every 3 h during 1 week. The required sample size for this study is important for health workforce planners to know if they want to apply this method to target groups who are hard to reach or if fewer resources are available.

The accuracy of general practitioner workforce projections.

Background: Health workforce projections are important instruments to prevent imbalances in the health workforce. For both the tenability and further development of these projections, it is important to evaluate the accuracy of workforce projections. In The Netherlands, health workforce projections have been done since 2000 to support health workforce planning.

Motives for early retirement of self-employed GPs in the Netherlands: a comparison of two time periods.

Background: The high cost of training and the relatively long period of training for physicians make it beneficial to stimulate physicians to retire later. Therefore, a better understanding of the link between the factors influencing the decision to retire and actual turnover would benefit policies designed to encourage later retirement. This study focuses on actual GP turnover and the determining factors for this in the Netherlands.

Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example.

Introduction: In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years.

Primary care nurses: effects on secondary care referrals for diabetes.

Background: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with the introduction of primary care nurses, and whether these changes were related to the number of diabetes-related contacts in a general practice.

Methods: Healthcare utilisation was assessed for a period of 365 days for 301 newly diagnosed and 2124 known T2DM patients in 2004 and 450 and 3226 patients in 2006 from general practices that participated in the Netherlands Information Network of General Practice (LINH).

[Entry into general practice training: no relation with focus on primary care in the undergraduate curriculum].

Objective: To investigate differences between medical faculties in the proportion of graduates entering general practice (GP) training, and to analyse whether this is related to the degree of orientation towards general practice of Dutch medical undergraduate curricula.

Design: Retrospective cohort study.

Methods: Several databases were used to investigate which percentage of medical graduates per faculty entered the GP training programme between 1989 and 2001.

Dying from cancer or other chronic diseases in the Netherlands: ten-year trends derived from death certificate data.

Background: For the further development of palliative care, it is relevant to gain insight into trends in non-acute mortality. The aim of this article is twofold: (a) to provide insight into ten-year trends in the characteristics of patients who died from cancer or other chronic diseases in the Netherlands; (b) to show how national death statistics, derived from physicians' death certificates, can be used in this type of investigations.

Methods: Secondary analysis of data from 1996 to 2006 on the "primary" or "underlying" cause of death from official death certificates filled out by physicians and additional data from 2003 to 2006 on the place of death from these certificates.

Gender shift in realisation of preferred type of GP practice: longitudinal survey over the last 25 years.

Background: An increasing number of newly trained Dutch GPs prefer to work in a group practice and as a non-principal rather than in a single-handed practice. In view of the greater number of female doctors, changing practice preferences, and discussions on future workforce problems, the question is whether male and female GPs were able to realise their initial preferences in the past and will be able to do so in the future.

Methods: We have conducted longitudinal cohort study of all GPs in the Netherlands seeking a practice between 1980 and 2004.

Gender-related differences in general practice preferences: longitudinal evidence from the Netherlands 1982-2001.

The proportion of female doctors is increasing. Yet, there is little evidence that demonstrates changing career preferences over a long period, nor do we know the long-term impact of changing male-female ratios in medicine. We explored this within the GP profession.