The barriers and facilitators to undertaking continuing professional education among the private non-specialist primary care physicians in Hong Kong

Abstract

Background: Strengthening primary care is seen as an effective strategy to ensure financial sustainability of the current public healthcare system. It is also an achievable measure to alleviate disease burden within the community. In Hong Kong, private primary care physicians (PCPs) play a key role in meeting 70% of the primary care needs. They are encouraged to undertake continuing professional education (CPE) that helps upkeep their medical standards and enhance quality of care. Aims and Objectives: To understand the attitudes, barriers, facilitators and effects of undertaking CPE among the private non-specialist PCPs in Hong Kong, and to suggest policy implications that facilitate greater participation. Study Design and Methods: A combined qualitative and quantitative approach was adopted. Eight focus group interviews were conducted with a purposive sample of 36 private PCPs. The qualitative findings informed the construction of the cross-sectional survey with a questionnaire which was then mailed to a stratified random sample of 2,567 private non-specialist PCPs. Results: Among the qualitative interviews and 134 valid questionnaire returns, CME lecture (>75%) was reported to be the most frequently engaged format of CPE, followed by online searching for information (65%). Apart from learning and enhancing standards of medical care, attending CME lectures also served as means of socializing and network building. Age was a significant factor associated with the formats of CPE. While older PCPs tended to attend CME lectures more often, their younger counterparts were keener to engage in online search and learning. Certain barriers and facilitators identified were context-specific to private healthcare sector in Hong Kong, such as long clinic hours, high operation costs and organisation of small learning groups. The latter, though the least frequently attended CPE activity among survey respondents, was positively rated on account of its intensity and interactive knowledge exchange along with active support from specialists. Online access to CME learning materials and more opportunities to participate in public sector CPE activities would be welcomed by private PCPs. Conclusions: Despite similar findings from oversea studies, certain barriers and facilitators identified in the present study were contextspecific to private non-specialist PCPs in Hong Kong. Implementation of more adaptive measures, such as emphasis on self-directed and practice-based learning and support from public authorities to facilitate CPE learning for the private PCPs, may in turn help reduce the healthcare costs in Hong Kong.