Over the years there has been increasing support from a number of diff
erent sources for General Practitioners and their primary health care
teams to have greater involvement in prevention. However, while attent
ion has been paid to what leading figures and official bodies such as
the Royal College of General Practitioners say there has been less emp
hasis upon what the rank-and-file of GPs themselves think and feel abo
ut prevention. Hence, this paper reports on the results of a small-sca
le exploratory study of 40 GPs' perceptions of coronary heart disease
(CHD) prevention. In particular it addresses three main issues: first,
the value which GPs place upon prevention and their concepts of preve
ntion; second, the extent to which they view prevention as problematic
and the reasons given; finally, in the light of these issues, the man
ner in which they attempt to resolve these dilemmas. Whilst GPs appear
ed to positively endorse the principle of prevention, they nonetheless
tended to view it as problematic and had limited personal involvement
. In this respect five key themes emerged in GPs' accounts: i) that he
alth promotion and prevention was tedious, dull and boring; ii) the co
nstraints of time and the manner in which it detracted from curative m
edicine; iii) the uncertainties of risk factor identification and inte
rventions; iv) ambivalence towards the effectiveness of behavioural ch
ange and the problem of patient motivation, and finally; v) a concern
that it represented a moral intrusion and inflated patients anxiety le
vels unnecessarily. Beyond the voicing of these concerns, the main way
in which GPs attempted to resolve these dilemmas was by delegating mu
ch of this work to a new and relatively low-status member of the prima
ry health care team: the practice nurse.