Objectives To explore general practitioners'perceptions of effective health care and its application in their own practice ; to examine how these perceptions relate to assumptions about clinicians'values and behaviour implicit in the evidence based medicine approach.
Design A qualitative study using semistructured interviews.
Setting Eight general practices in North Thames region that were part of the Medical Research Council General Practice Research Framework.
Participants 24 general practitioners, three from each practice.
Main outcome measures Respondents'definitions of effective health care, reasons for not practising effectively according to their own criteria, sources of information used to answer clinical questions about patients, reasons for making changes in clinical practice.
Results Three categories of definitions emerged :
Clinical, patient related, and resource related.
Patient factors were the main reason given for not practising effectively ; others were lack of time, doctors'lack of knowledge and skills, lack of resources, and « human failings. » Main sources of information used in situations of clinical uncertainty were general practitioner partners and hospital doctors.
Contact with hospital doctors and observation of hospital practice were just as likely as information from medical and scientific literature to bring about changes in clinical practice. (...)
Mots-clés Pascal : Système santé, Questionnaire, Médecin généraliste, Perception, Relation médecin malade, Impact environnement, Communication information, Qualité service, Homme, Pratique professionnelle, Organisation santé
Mots-clés Pascal anglais : Health system, Questionnaire, General practitioner, Perception, Physician patient relation, Environment impact, Information communication, Service quality, Human, Professional practice, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0321936
Code Inist : 002B30A05. Création : 16/11/1999.