A QUALITATIVE INVESTIGATION INTO WHY PATIENTS CHANGE THEIR GPS

Background. In the past patients have rarely changed doctor. The UK Go vernment has made such change easier and it appears to be becoming mor e common. Changing doctor without changing address may be indicative o f dissatisfaction with the GP service. Previous research in this area has been largely quantitative. Objective. To identify why patients cha nge their GP although they have not moved house. Method. Qualitative i nvestigation of patients' experiences. In depth interviews of 24 patie nts were conducted to determine why they had left their previous docto r. Letters describing the process of change were received from a furth er 17 patients. Analysis was performed using standard qualitative tech niques. Results. The decision to change was in most cases multi-factor ial. Interviews yielded more detailed and richer accounts than letters . For interviewees, rudeness or the attitude of the doctor was the com monest reason. Overall, 19 different reasons, in four categories, were identified. The largest single category was accessibility, closely fo llowed by attitudinal problems. Clinical issues and personal character istics of the doctor were less common. The majority of those respondin g by letter gave only one reason, usually distance. Conclusion. Patien ts change doctor after careful consideration and commonly for interper sonal reasons. There is usually one critical factor in the decision to change. Factors may be modifiable or non-modifiable. Critical event a udit may enable GPs to analyse the reasons why patients leave their li sts.