Primary Care Physicians' Comfort in Managing Complexity: Predictors, Gaps and Opportunities
Applied/Translational Research
Care Continuum
Training ＆ Education
Singapore Health Biomedical Congress
National Healthcare Group
13 January 2026
We aim to identify factors associated with PCPs comfort in managing complexity, as well specific measures that are deemed. Structured training may be more impactful than systemic exposure in building PCPs confidence in managing complexity.
Year Submitted: 2025
Published Date: 13 January 2026
Tags: Quantitative Research, Ambulatory Care (Outpatient Care), Outpatient Care, Primary Care, Education Research, Applied/Translational Research, Care Continuum, Training ＆ Education
About this Content
Aims
We aim to identify factors associated with PCPs comfort in managing complexity, as well specific measures that are deemed helpful in supporting complexity management in primary care in Singapore.
Background
Patients with complex care needs are prevalent in primary care, with a recent local study showing that 33.5% of primary care encounters are complex with high care needs1. The prevalence of complexity is expected to increase with the ageing population and rising multimorbidity. Much is unknown about how comfortable Primary Care Physicians (PCPs) are in managing complexity, and how they can be better supported in doing so.
Methods
We conducted a survey on experienced PCPs with postgraduate Family Medicine (FM) qualification(s) at NHG Polyclinics to assess their comfort level and the usefulness of various measures in managing complex patients in primary care. We compared physician characteristics and conducted an ordinal logistic regression to determine the independent predictors of comfort in managing complexity.
Results
Of the 69 PCPs who responded (80.2% response rate), 55 (79.7%) were comfortable or very comfortable in managing complexity, with 12 (17.4%) expressing neutrality and 2 (2.9%) who felt uncomfortable or very uncomfortable. Having a Fellowship [FCFP(s)] (OR = 27.04, p = 0.003) or Masters [MMed(FM)] (OR = 7.48, p = 0.016) in FM or a geriatrics, mental health or palliative graduate diploma (OR = 7.44, p = 0.02) were significantly associated with greater comfort. Primary care experience or involvement in multi-disciplinary team discussions, teamlet care, or special clinics showed no significant association. Longer consultation times, having better communication channels with hospital specialists and better remuneration for managing complex patients were rated most useful in managing complexity in primary care.
Lessons Learnt
Structured training may be more impactful than systemic exposure in building PCPs confidence in managing complexity. Continued professional development and targeted structural support like allocation of longer consultation times, building better communication channels with specialists, better remuneration for managing complex patients, having a dedicated case manager, and having shared medical records with specialists and community partners can be important mitigating factors.
Keywords
Complexity, Family Medicine, Medical Education
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | National Healthcare Group Polyclinics |
Platform(s) | Singapore Health Biomedical Congress |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | General Practice |
Project Lead(s) | Quek Jing Sheng |
Project Member(s) | Sabrina Wong Kay Wye |
Connect with this contributor!
Quek Jing Sheng - jing.sheng.quek@nhghealth.com.sg