Abstract:
BACKGROUND : Evidence from first world contexts support the notion that strong primary health care teams contain
family physicians (FPs). African leaders are looking for evidence from their own context. The roles and scope of
practice of FPs are also contextually defined. The South African family medicine discipline has agreed on six roles.
These roles were incorporated into a family physician impact assessment tool, previously validated in the Western
Cape Province.
METHODS : A cross-sectional study design was used to assess the perceived impact of family physicians across seven
South African provinces. All FPs working in the district health system (DHS) of these seven provinces were invited
to participate. Sixteen respondents (including the FP) per enrolled FP were asked to complete the validated 360-degree
assessment tool.
RESULTS : A total number of 52 FPs enrolled for the survey (a response rate of 56.5%) with a total number of 542
respondents. The mean number of respondents per FP was 10.4 (SD = 3.9). The perceived impact made by FPs
was high for five of the six roles. Co-workers rated their FP’s impact across all six roles as higher, compared to the
other doctors at the same facility. The perceived beneficial impact was experienced equally across the whole study
setting, with no significant differences when comparing location (rural vs. metropolitan), facility type or training model
(graduation before and ≥ 2011).
CONCLUSIONS : The findings support the need to increase the deployment of family physicians in the DHS and to increase
the number being trained as per the national position paper.
