Changements de pratique en médecine de famille : conséquences de la féminisation et des différences générationnelles
Keywords:
Changing medecine practiceAbstract
Résumé
À partir de 48 entrevues menées auprès de médecins de famille du Nouveau-Brunswick, cet article expose le triple phénomène qui frappe cette profession : la féminisation de la médecine, le désir des jeunes médecins de famille d’avoir un équilibre entre leurs vies professionnelle et personnelle ainsi que la réduction des heures de travail des médecins plus âgés. Ces trois phénomènes entrainent des changements de pratique à considérer pour évaluer les besoins futurs des effectifs médicaux.
Abstract
Based on 48 interviews with family doctors in New Brunswick, this article exposes the three phenomena that affect this profession: the feminisation of medicine, the desire of young family doctors to find a balance between their professional and personal lives, and the reduction of work hours for older doctors. These three factors bring changes in practice that must be considered in the assessment of future needs in medical staff.
Metrics
References
Association des facultés de médecine du Canada. s. d. Données et publications. Diplômes MD décernés par les universités canadiennes de 1940 à 2008. Page consultée le 21 juillet 2008. <http://www.afmc.ca/publications-statistics-2007-f.php >
Association des facultés de médecine du Canada. s. d., Données et publications. Diplômes MD décernés par les universités canadiennes de 1960 à 2010. Page consultée le 10 janvier 2012. <http://www.afmc.ca/pdf/gradssection2011cmes.pdf>
Association médicale canadienne. 2012. Number of Active Physicians by Age, Sex and Province/Territory, Canada. Page consultée le 21 juillet 2013. <http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/04AgeSexPrv.pdf>
Beaulieu, Marie-Dominique, Marie Rioux, Guy Rocher, Louise Samson, et Laurie Boucher. 2008. « Family Practice: Professional Identity in Transition. A Case Study of Family Medicine in Canada. » Social Science & Medicine 67 : 1153-1163.
Bickel, Janet, et Ann J. Brown. 2005. « Generation X: Implications for Faculty Recruitment and Development in Academic Health Centers. » Academic Medicine 80, no. 3 : 205-210.
Campolieti, Michele, Douglas Hyatt, et Boris Kralj. 2007. « Determinants of Stress in Medical Practice: Evidence from Ontario Physicians. » Relations industrielles 62, no. 2 : 226-257.
Collège des médecins de famille du Canada, Association médicale canadienne et Collège royal des médecins et chirurgiens du Canada. 2008. « The National Physician Survey. Beyond the numbers. » MD Pulse, 56p.
Contandriopulos, André-Pierre, et Marc-André Fournier. 2007. « Féminisation de la profession médicale et transformation de la pratique au Québec. » Groupe de recherche interdisciplinaire en santé, Faculté de médecine. Montréal: Université de Montréal.
Creswell, John W. 1997. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks, London: Sage Publications.
Crossley, Thomas F., Jeremiah Hurley, et Sung-Hee Jeon. 2009. « Physician Labour Supply in Canada: A Cohort Analysis. » Health Economics 18 : 437-456.
Crossley, Thomas F., Jeremiah Hurley, et Sung-Hee Jeon. 2006. « Physician Labour Supply in Canada: A Cohort Analysis. » Center for Health Economics and Policy Analysis. Hamilton: McMaster University.
Dedobbeleer, Nicole, André-Pierre Contandriopoulos, et Sylvie Desjardins. 1995. « Convergence or Divergence of Male and Female Physicians’ Hours of Work and Income. » Medical Care 33, no. 8 : 769-805.
De Koninck, Maria. 1992. « Femmes et médecine: enquête auprès des médecins du Québec: formation, pratique, santé. » Québec: Université Laval.
De Koninck, Maria, Pierre Bergeron, et Renée Bourbonnais. 1997. « Women Physicians in Quebec. » Social Science & Medicine 44, no. 12 : 1825-1832.
De Koninck, Maria, Renée Bourbonnais, Pierre Bergeron, et Marc-Adélard Tremblay. 1993. « Femmes et médecine: enquête auprès des médecins du Québec sur leur formation, leur pratique et leur santé: rapport de recherche. » Québec: Université Laval.
Flynn, Gillian. 1996. « Xers vs. Boomers: Teamwork or Trouble? » Personality Journal 75 : 86-89.
Frank, Erika, Lynn Harvey, et Lisa Elon. 2000. « Family Responsibilities and Domestic Activities of US Women Physicians. » Archives of Family Medicine 9, no. 2 : 134-140.
Gjerberg, Elisabeth. 2003. « Women doctors in Norway: the challenging balance between career and family life. » Social Science & Medicine 57, no. 7 : 1327-1341.
Gjerdingen, Dwenda, Patricia McGovern, Marrie Bekker, Ulf Lundberg, et Tineke Willemsen. 2000. « Women’s Work Roles and Their Impact on Health, Well-being, and Career: Comparisons Between the United States, Sweden, and The Netherlands. » Women Health 31, no. 4 : 1-20.
Heiligers, Phil J.M., et L. Hingstman. 2000. « Career Preferences and the Work-Family Balance in Medicine: Gender Differences Among Medical Specialists. » Social Science & Medicine 50, no. 9 : 1235-1246.
Incitti, Filomena, James Rourke, Leslie L. Rourke, et Mary-Ann Kennard. 2003. « Rural Women Family Physicians. Are They Unique? » Canadian Family Physician 49 : 320-327.
Jovic, Emily, Jean E. Wallace, et Jane Lemaire. 2006. « The Generation and Gender Shifts in Medicine: An Exploratory Survey of Internal Medicine Physicians. » BMC Health Services Research 6 : 55.
Kennedy, Marilyn Moats. 2003. « Managing Different Generations Requires New Skills, Insightful Leadership. » Physician Executive 29 : 20-23.
Keane, David, Christel A. Woodward, Barbara M. Ferrier, May Cohen, et Charles H. Goldsmith. 1991. « Female and Male Physicians: Different Practice Profiles. » Canadian Family Physician 37 : 72-81.
Lapeyre, Nathalie. 2003. « Professional and Domestic Work Arrangements of Women General Practitioners in France. » International Journal of Sociology and Social Policy 23, no. 4/5 : 97-122.
Lapeyre, Nathalie, et Nicky Le Feuvre. 2004. « Concilier l’inconciliable? Le rapport des femmes à la notion de ‘conciliation travail-famille’ dans les professions libérales en France. » Nouvelles questions féministes 23, no. 3 : 42-58.
Lapeyre, Nathalie, et Nicky Le Feuvre. 2005. « Féminisation du corps médical et dynamiques professionnelles dans le champ de la santé. » Revue française des affaires sociales 59, no. 1 : 59-82.
Lapeyre, Nathalie, et Magalie Robelet. 2007. « Les mutations des modes d’organisation du travail au regard de la féminisation. L’expérience des jeunes médecins généralistes. » Sociologies Pratiques 1, no. 14 : 19-30.
Mobilos, Sophia, Melissa Chan, et Judith Belle Brown. 2008. « Women in Medicine: The Challenge of Finding Balance. » Canadian Family Physician 54 : 1285-6.
O’Neil, Edward. 2002. « Shaping America’s Health Care Professions: How the Health Sector Will Respond to ‘Generation X’. » Western Journal of Medicine 176 : 139-141.
Radomsky, Nellie A. 2000. « Women family doctors. An emerging force in the 21st century. » Canadian Family Physician 46 : 1273-1283.
Robelet, Magali, Nathalie Lapeyre, et Emmanuelle Zolesio. 2006. « Les pratiques professionnelles des jeunes générations de médecins. Genre, carrière et gestion des temps sociaux. Le cas des médecins âgés de 30 à 35 ans. Note de synthèse pour le Conseil national de l’ordre des médecins: GRAPHOS. » Université de Lyon III et Équipe Simone-SAGESSE. Université Toulouse II.
Roter, Debra L., Judith A. Hall, et Yutaka Aoki. 2002. « Physician Gender Effects in Medical Communication: A Meta-analytic Review. » JAMA: The Journal of the American Medical Association 288, no. 6 : 756-764.
Sarma, Sirira, Amardeep Thind, et Man-Kee Chu. 2011. « Do New Cohorts of Family Physicians Work Less Compared to their Older Predecessors? The Evidence from Canada. » Social Science & Medecine 72 : 2049-2058.
Shangraw, Robert E., et Charles W. Whitten. 2007. « Managing Intergenerational Differences in Academic Anaesthesiology. » Current Opinion in Anaesthesiology 20 : 558-563.
Shields, Mark C., et Margaux T. Shields. 2003. « Working With Generation X Physicians. » Physician Executive 29, no. 6 : 14-18.
Smith, Lawrence G. 2005. « Medical Professionalism and the Generation Gap. » The American Journal of Medicine 118, no. 4 : 439-442.
Sondage national des médecins de famille/National Physicians Survey: National Results by Province and Canada. 2007. Page consultée le 21 juillet 2008. .
Sondage national des médecins de famille/National Physicians Survey: National Results by Province and Canada. 2010. Page consultée le 10 janvier 2012. <http://nationalphysiciansurvey.ca/fr/surveys-fr/sondage-2010/resultats-du-sondage-2010/>.
Swanson, V., Katharine G. Power, et Richard J. Simpson. 1998. « Occupational Stress and Family Life: A Comparison of Male and Female Doctors. » Journal of Occupational and Organizational Psychology 71, no. 3 : 237-260.
Verlander, Glese. 2004. « Female Physicians: Balancing Career and Family. » Academic Psychiatry 28, no. 4 : 331-336.
Williams, A. Paul, Karen Dominick-Pierre, Eugene Vayda, H. Michael Stevenson, et Mike Burke. 1990. « Women in Medicine: Practice Patterns and Attitudes. » Canadian Medical Association Journal 144, no. 1 : 194-201.
Williams, A. Paul, Christel A. Woodward, Barbara Ferrier, et May Cohen. 1997. « Cohort, Gender and Practice Organization: Examining the Bounds of Collaborative Medicine among Newly Established Female and Male Family Physicians in Ontario. » Health Service Management Resource 10, no. 2 : 121-131.
Woodward, Christel A., May Cohen, et Barbara M. Ferrier. 1990. « Career Interruptions and Hours Practiced: Comparison Between Young Men and Women Physicians. » Canadian Journal of Public Health 81, no. 1 : 16-20.
Woodward, Christel A., Barbara Ferrier, May Cohen, et Judy Brown. 2001. « Professional Activity. How is Family Physicians’ Work Time Changing? » Canadian Family Physician 47, no. 7 : 1414-1421.
Woodward, Christel A., et Jeremiah Hurley. 1995. « Comparison of Activity Level and Service Intensity of Male and Female Physicians in Five Fields of Medicine in Ontario. » Canadian Medical Association Journal 153, no. 8 : 1097-1106.
Woodward, Christel A., A. Paul Williams, Barbara Ferrier, et May Cohen. 1996. « Time Spent on Professional Activities and Unwaged Work. Is it Different for Male and Female Primary Care Physicians who have Children at Home? » Canadian Family Physician 42 : 1928-1935.
Wright, Bruce, Ian Scott, Wayne Woloschuk, et Fraser Brenneis. 2004. « Career Choice of New Medical Students at Three Canadian Universities: Family Medicine versus Specialty Medicine. » Canadian Medical Association Journal 170, no. 13 : 1920-30.
Downloads
Additional Files
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication, with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2. Authors are aware that articles published in Atlantis are indexed and made available through various scholarly and professional search tools, including but not limited to Erudit.
3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
4. Authors are permitted and encouraged to preprint their work, that is, post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process. This can lead to productive exchanges, as well as earlier and greater citation of published work. Read more on preprints here.
