Abstract
Between 1981 and 1987, population in the two "cantons" of Vaud and Fribourg increased by 4.5 percent (from 709200 to 740700) but private medical practitioners increased by 26.1 percent (from 971 to 1,224). How did the medical profession adjust itself to such a challenge? The average weekly number of visits reduced (e.g. from 118 to 109 in paediatrics, from 96 to 85 in internal medicine...). Nevertheless, the average duration of each visit did not significantly increase. Consequently, the weekly time devoted to contacts with patients in the office decreased in most specialities (e.g. from 33.9 hours to 31.1 hours in general practice). But the most salient feature was the reduction of time spent by private practitioners in institutions, hospitals or other "medical/social" organizations. The reduction was obvious among internists, surgeons, paediatricians... It was probably caused by the increased number of practitioners. However, "cohort effect" might have played a role in the matter: as the physicians aged, they were less attracted by activities outside their private office. It is noteworthy that all the above figures were observed among the same practitioners, in 1981 and 1987. Moreover, the proportion of patients invited to come back to the physician's office did not grow, the behaviour of the practitioners remaining unchanged during the period. The study also displayed data about a new group of physicians, who were surveyed for the first time in 1987.
Amport, Peter