gms | German Medical Science

Background and status of (inter)national research: Primary care in Germany by large part is performed by physicians in the outpatient sector. During the Covid-19 pandemic, first governmental measures led to massive restrictions of public life in March and April 2020. General practitioners (GPs) and other medical specialists in the ambulatory setting suddenly were confronted with a dynamic pandemic situation on the one hand and had to struggle with administrative measures and a decline of patient numbers on the other hand.

Question and objective: The aim of this cross-sectional study was to measure impacts of the pandemic on GPs’ work climate and to ask, if GPs with a deteriorated work climate report a worsened provision of patient care. Moreover, several burdening effects for GPs and other medical specialists were analysed.

Method or hypothesis: In the course of the publicly funded project COVID-GAMS (funding code: 01KI2099) more than 18,000 physicians had been invited to take part in a quantitative cross-sectional online survey. The survey covered the physicians’ experiences in March and April 2020 and was carried out retrospectively in Summer 2020. Analyses were conducted separately for the groups of GPs and other medical specialists from the outpatient sector. Mann-Whitney U test was performed to detect possible group differences. To investigate the relationship between provision of care and working climate, ANOVA was performed and a further post hoc pairwise t-test was conducted.

Results: 1,703 participants could be included in the analysis, among them 535 GPs. Most of the physicians reported no change in the work climate (GPs: 62.6%, Other medical specialists: 64.9%) and 22.2% of GPs (Other medical specialists: 19.9%) stated, their work climate had deteriorated. Physicians with a deteriorated work climate show a tendency towards poorer personal supply of patient care (M=3.75, SD=0.98 vs. M=3.93, SD=0.99). The lack of protective material in March and April 2020 together with changes made in practice management and possible economic impacts on the practice were the most burdening effects reported by GPs.

Discussion: GPs who reported a negative impact on the work climate in the course of the first pandemic lockdown also tend to perceive own deficits in the provision of patient care. Moreover, most of the pandemic related challenges questioned in the survey are reported the most burdensome within this group.

Practical implications: The study provides first insights on how physicians in the outpatient sector perceived early impacts of the Covid-19 pandemic. Especially, the needs of physicians who are not able to provide adequate patient care need to be met.

Appeal for practice (science and/or care) in one sentence: Work climate may influence the quality of patient care and can be influenced by stressors such as the Covid-19 pandemic.