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J Am Board Fam Med. 2012 Jul-Aug;25(4):477-86. doi: 10.3122/jabfm.2012.04.110296.

A culture of care: the French approach to cardiovascular risk factor management.

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Center for Global Health, University of Georgia, Athens, France.



The objective of this study was to describe French primary care physicians' beliefs about cardiovascular disease (CVD) risk factors and best practices for managing CVD.


This study comprised a purposive convenience sample of 656 primary care physicians in France, recruited from contacts made through the French Society of General Medicine. We compiled the physicians' responses to free text questions taken from an Internet-based survey and analyzed them using a qualitative approach. Physician's responses were inductively analyzed using content analysis. Responses were thematically coded, tabulated, and computed for frequencies. Overall themes and verbatim examples are presented in this article.


The French physicians in our study are generally happy with their country's health care system and cite equity as the primary reason. Interestingly, along with food and lifestyle differences, they also cite equity of their health system as the reason for the lower CVD death rate in France, Japan, and Israel compared with the United States. The physicians believe that they are successful at managing CVD risk factors by emphasizing aspects of the doctor-patient relationship, including spending more time with patients and focusing on education.


Physicians who are on the front line of care and management offer a fresh perspective on best practices for CVD prevention and management. The equity of the French health care system supports a "culture of care" in France that might lead to better outcomes for CVD risk factor patients than in the United States.

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