ArticleBMJ (Clinical research ed.)1999
General practitioners' perceptions of effective health care.
Article in BMJ (Clinical research ed.), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.BMC medical education · 2017Pooled it
- Impact of short evidence summaries in discharge letters on adherence of practitioners to discharge medication. A cluster-randomised controlled trial.Quality & safety in health care · 2007Trial
- Impact on hypertension control of a patient-held guideline: a randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2006Trial
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- Article
- Implementation of targeted screening for poverty in a large primary care team in Toronto, Canada: a feasibility study.BMC family practice · 2021Article
- How general practitioners decide on maxims of action in response to demands from conflicting sets of norms: a grounded theory study.BMC medical ethics · 2019Article
- Adherence to clinical practice guidelines among three primary contact professions: a best evidence synthesis of the literature for the management of acute and subacute low back pain.The Journal of the Canadian Chiropractic Association · 2014Article
- Perceptions of quality in primary health care: perspectives of patients and professionals based on focus group discussions.BMC family practice · 2014Article
- "My approach to this job is...one person at a time": Perceived discordance between population-level quality targets and patient-centred care.Canadian family physician Medecin de famille canadien · 2014Article
- Met or matched expectations: what accounts for a successful back pain consultation in primary care?Health expectations : an international journal of public participation in health care and health policy · 2013Review
- What makes up good consultations? A qualitative study of GPs' discourses.BMC family practice · 2013Article
- What are the important components of the clinical assessment of hand problems in older adults in primary care? Results of a Delphi study.BMC musculoskeletal disorders · 2010Article
- Risk reduction before surgery. The role of the primary care provider in preoperative smoking and alcohol cessation.BMC health services research · 2010Article
- Providers' experiences treating chronic pain among opioid-dependent drug users.Journal of general internal medicine · 2009Article
- Qualitative research and its uses in health care.Sultan Qaboos University medical journal · 2008Article
- Is There a Tension between Clinical Practice and Reimbursement Policy? The Case of Osteoarthritis Prescribing Practices in Ontario.Healthcare policy = Politiques de sante · 2007Article
- Translating learning into practice: lessons from the practice-based small group learning program.Canadian family physician Medecin de famille canadien · 2007Article
- Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey.BMC public health · 2007Article
- [Stated theory of family doctors on their relationships with patients].Atencion primaria · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo 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.
designA qualitative study using semistructured interviews.
settingEight general practices in North Thames region that were part of the Medical Research Council General Practice Research Framework.
participants24 general practitioners, three from each practice.
main outcome measuresRespondents' 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.
resultsThree 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.
conclusionsThe findings suggest that the central assumptions of the evidence based medicine paradigm may not be shared by many general practitioners, making its application in general practice problematic. The promotion of effective care in general practice requires a broader vision and a more pragmatic approach which takes account of practitioners' concerns and is compatible with the complex nature of their work.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.