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BMJ. 2001 Nov 10;323(7321):1100-2.

Why general practitioners do not implement evidence: qualitative study.

Author information

  • 1Somerset and North and East Devon Primary Care Research Network, Institute of General Practice, School of Postgraduate Medicine and Health Sciences, Exeter EX2 5DW. PCRN@exeter.ac.uk

Abstract

OBJECTIVES:

To explore the reasons why general practitioners do not always implement best evidence.

DESIGN:

Qualitative study using Balint-style groups.

SETTING:

Primary care.

PARTICIPANTS:

19 general practitioners.

MAIN OUTCOME MEASURES:

Identifiable themes that indicate barriers to implementation.

RESULTS:

Six main themes were identified that affected the implementation process: the personal and professional experiences of the general practitioners; the patient-doctor relationship; a perceived tension between primary and secondary care; general practitioners' feelings about their patients and the evidence; and logistical problems. Doctors are aware that their choice of words with patients can affect patients' decisions and whether evidence is implemented.

CONCLUSIONS:

General practitioner participants seem to act as a conduit within the consultation and regard clinical evidence as a square peg to fit in the round hole of the patient's life. The process of implementation is complex, fluid, and adaptive.

PMID:
11701576
[PubMed - indexed for MEDLINE]
PMCID:
PMC59686
Free PMC Article
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