In 2022, Switzerland again participated in the Commonwealth Fund Foundation’s international health policy surveys. As in previous years, the focus was on physicians working in the field of primary care. The Covid 19 pandemic, or the associated increase in workload and stressors, is suspected as a possible cause of the documented increase in stress levels.
Based on membership data from the FMH professional association, a random sample of 4000 primary care physicians was drawn. Of these, a total of 3941 were contacted, of whom just over a quarter (n=1114)** ultimately took part in the survey. Physicians were invited to complete an online questionnaire. Overall, the survey in Switzerland lasted from March 10-May 30, 2022, while the global survey ran from March to September.
** This year’s sample is slightly larger than previous samples (2019: n=1095; 2015: n=1065; 2012: n=1025).
Stress level has increased noticeably compared to 2019
In Switzerland, the overall performance of the healthcare system has shown an unchanged high level since the 2019 survey. As a result of the Covid 19 pandemic, video consultations have increased significantly in all countries surveyed, but Switzerland has by far the least number of spatially separated consultations. With regard to the proportion of extremely stressed or very stressed physicians, a general increase can be observed. In Switzerland, just under half (45.5%) of physicians rate their work as somewhat stressful. Many of the countries surveyed show a significant increase in extremely or very stressed physicians since 2019: the highest in Australia (+22.3 percentage points) and New Zealand (+21.7 percentage points). The increase from 37.1% to 43.1% recorded in Switzerland corresponds to the second lowest value in an international comparison. Almost unchanged is the percentage of extremely stressed or very stressed physicians in Sweden (65.9% and 64.8%, respectively) and in the Netherlands (31.5% and 31.1%, respectively).
| The Commonwealth Fund (CWF) is a charitable foundation based in the USA. Since 1998, CWF has had internationally comparable surveys conducted on health policy issues. In this country, the project is managed by the Federal Office of Public Health, and the company demoSCOPE was commissioned to conduct the survey. |
Increase in workload and administrative burden
Workload has increased in all surveyed countries over the course of the Covid 19 pandemic. In Switzerland, the proportion of those for whom workload has increased significantly or somewhat is lowest at 56.4% (Table 1), while in Germany (93.5%) and the UK (90.5%) nine out of ten physicians report an increase. In Switzerland and Sweden, about one-third report that their workload has remained the same as before the pandemic, while 9.3% of physicians in Switzerland reported a decrease. The extent to which the increased workload due to the Covid 19 pandemic is actually responsible for the increase in stress levels must be interpreted with caution due to the unchanged stress levels in Sweden and the Netherlands with a simultaneous increase in pandemic-related workload.
More than two-thirds (68.0%) of physicians in Switzerland see the time required for administrative activities related to insurance or billing as a major problem. In an international comparison, this corresponds to first place ahead of Sweden (62.3%) and Germany (59.9%). A comparison over time shows a significant increase in Switzerland since 2019 (from 60.7% to 68.0%), while in Sweden there has been a significant decrease (-18.1 percentage points) over the same period.
More emotional stress during the pandemic
In Switzerland, about one-third (32.0%) report experiencing emotional distress such as anxiety, great sadness, anger, or a sense of hopelessness since the start of the Covid 19 pandemic in March 2020 (Tab. 2). This is the smallest proportion in an international comparison, with Sweden in second last place at 43.7%. In the eight other countries, the proportions are above 50%, with New Zealand and the UK exceeding 60%. Accordingly, it is physicians in New Zealand (19.2%) and the United Kingdom (16.2%) who most frequently report having sought professional help for a mental health problem since March 2020. In Switzerland, the figure is 8.7%, which is the second smallest share ahead of Germany (7.6%).
Source: Pahud O, Dorn M: Ärztinnen und Ärzte in der Grundversorgung – Situation in der Schweiz und im internationalen Vergleich. Analysis of the International Health Policy (IHP) Survey 2022 of the American Commonwealth Fund Foundation (CWF) on behalf of the Federal Office of Public Health (FOPH) (Obsan Report 01/2023). Neuchâtel: Schweizerisches Gesundheitsobservatorium, www.obsan.admin.ch (letzter Abruf 07.03.2023).
HAUSARZT PRAXIS 2023; 18(3): 40
CARDIOVASC 2023; 22(1): 40
InFo NEUROLOGIE & PSYCHIATRIE 2023; 21(2): 39
