Biomaterial Database

German family physicians' attitudes toward care of involuntarily childless patients. 2000

E Ittner, and W Himmel, and M M Kochen

Department of Family Medicine, University of Göttingen, Germany. eittner@gwdg.de

OBJECTIVE Many family physicians regard fertility counseling out of their scope of practice, although key elements in the care of involuntarily childless couples fall within the theoretical framework of family practice. This study analyzed the doctors' value system concerning the care of infertile patients and whether a personal interview leads to a greater sensitivity toward fertility issues. METHODS We conducted 57 baseline and 51 follow-up interviews with family physicians in the area of Göttingen, Germany. We performed quantitative and qualitative analyses. RESULTS During the baseline interview, all family physicians placed involuntary childlessness within the domain of fertility specialists or regarded it as patients' private matter. Fourteen family physicians (27%) considered fertility counseling more important at the follow-up interview than at the time of the baseline interview. Judgmental views of infertile couples could be detected in both interviews. More than one third of the family physicians assumed a connection between the patients' childlessness and their personal behavior or way of living. Although the majority (73%) of the family physicians regarded involuntary childlessness as a disease and considered assisted conception techniques as legitimate, a recommendation for fee reimbursement for fertility services was rejected by more than half of the physicians. CONCLUSIONS Most German family physicians do not consider that care of involuntarily childless couples is within or appropriate to their scope of practice.

UI	MeSH Term	Description	Entries
D007246	Infertility	A reduced or absent capacity to reproduce.	Sterility,Reproductive Sterility,Sterility, Reproductive,Sub-Fertility,Subfertility
D010817	Physician-Patient Relations	The interactions between physician and patient.	Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D003376	Counseling	The giving of advice and assistance to individuals with educational or personal problems.
D005194	Family Practice	A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.	Family Practices,Practice, Family,Practices, Family
D005858	Germany	A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001291	Attitude of Health Personnel	Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.	Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes