Physician profiles according to determinants of scope of practice in Brazil
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Federal University of Minas Gerais, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1731
The scope of practice of physicians impacts directly the quality of health services provided, and the cost associated with health. Proposals to enhance physicians’ scope of practice have been encouraged, seeking to innovate the use of the health workforce and meet the populations needs in the most efficient and effective way. The study aimed to outline the profile of physicians in Brazil, considering the main determinants of their scope of practice. This is a cross-sectional, exploratory study conducted between December 2017 and June 2018. Data collection was carried out through an online survey with 1.418 physicians. The physicians were classified according to their main specialty. The number of procedures performed (n=32) was considered as a proxy for an expanded scope of practice. Determining variables of scope of practice were grouped into personal factors, training, and practice location practice. We used the method Grade of Membership (GoM) for generating the profiles according to the determinants of scope of practice. The results showed that the scope of practice can be described through four physician profiles. The profiles that were more likely to have a broader scope of practice showed important similarities, such as working in primary health care specialties, in basic health units, and in areas described as rural and unsafe urban areas with physician shortages. Among the three determinants analyzed (location, personal, and training factors), the location of practice was more likely to be associated with a broader scope of practice. The others showed that, in isolation, they do not necessarily impact the physicians’ scope of practice. The continuous study of the physicians’ scope of practice is important to help understand the main factors that affect them. This can allow health policy planners to develop strategies aimed to optimize physicians practice and improve population access to health.  
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