Les jeunes généralistes dans une zone à densité médicale élevée: une observation à Bruxelles.

Twelve GP's have been interviewed in Brussels, the capital of Belgium. Brussels is known for its extremely high doctor-population ratio. In Belgium, most doctors have a private practice with fee-for-service payment. The interviews took place in early 1998, the GP's involved were graduated between 1985 and 1994. Most GP's were not satisfied with their low income. They adopted a number of strategies to cope with the challenge: increase of activities including numerous home visits, acceptance of low qualified work, practice of "parallel medicine", decrease of referral to specialists ... and so on. These behaviors lessened as the number of patients became higher. Nearly all interviewed GP's perceived a high pressure from patients for more visits, night visits, pharmaceutical prescriptions.... In a context of manpower oversupply, a transfer of power was seemingly occurring, from doctors to patients. Instead of evidencing supplier-induced demand, oversupply of care providers likely pushed patients to take the lead and a "demand-induced" demand appeared.