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The meaning of quality work from the general practitioner's perspective: an interview study

Strandberg, Eva-Lena LU ; Ovhed, Ingvar ; Håkansson, Anders LU and Troein, Margareta LU (2006) In BMC Family Practice 7(60).
Abstract
BACKGROUND: The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. METHODS: Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a... (More)
BACKGROUND: The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. METHODS: Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of the statements. RESULTS: Two fundamentally different ways to view quality work emerged from the statements: A pronounced top-down perspective with elements of control, and an intra-profession or bottom-up perspective. From the top-down perspective, quality work was described as something that infringes professional freedom. From the bottom-up perspective the statements described quality work as a self-evident duty and as a professional attitude to the medical vocation, guided by the principles of medical ethics. Follow-up with a bottom-up approach is best done in internal processes, with the profession itself designing structures and methods based on its own needs. CONCLUSIONS: The study indicates that general practitioners view internal follow-up as a professional obligation but external control as an imposition. This opposition entails a difficulty in achieving systematism in follow-up and quality work in health care. If the statutory standards for systematic quality work are to gain a real foothold, they must be packaged in such a way that general practitioners feel that both perspectives can be reconciled. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Family Practice
volume
7
issue
60
publisher
BioMed Central (BMC)
external identifiers
  • pmid:17052342
  • scopus:33750528902
ISSN
1471-2296
DOI
10.1186/1471-2296-7-60
language
English
LU publication?
yes
id
1f3c58da-d782-4820-b8c0-b6108d3e2212 (old id 1135267)
date added to LUP
2016-04-01 15:56:21
date last changed
2021-03-24 05:59:13
@article{1f3c58da-d782-4820-b8c0-b6108d3e2212,
  abstract     = {BACKGROUND: The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. METHODS: Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of the statements. RESULTS: Two fundamentally different ways to view quality work emerged from the statements: A pronounced top-down perspective with elements of control, and an intra-profession or bottom-up perspective. From the top-down perspective, quality work was described as something that infringes professional freedom. From the bottom-up perspective the statements described quality work as a self-evident duty and as a professional attitude to the medical vocation, guided by the principles of medical ethics. Follow-up with a bottom-up approach is best done in internal processes, with the profession itself designing structures and methods based on its own needs. CONCLUSIONS: The study indicates that general practitioners view internal follow-up as a professional obligation but external control as an imposition. This opposition entails a difficulty in achieving systematism in follow-up and quality work in health care. If the statutory standards for systematic quality work are to gain a real foothold, they must be packaged in such a way that general practitioners feel that both perspectives can be reconciled.},
  author       = {Strandberg, Eva-Lena and Ovhed, Ingvar and Håkansson, Anders and Troein, Margareta},
  issn         = {1471-2296},
  language     = {eng},
  number       = {60},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Family Practice},
  title        = {The meaning of quality work from the general practitioner's perspective: an interview study},
  url          = {http://dx.doi.org/10.1186/1471-2296-7-60},
  doi          = {10.1186/1471-2296-7-60},
  volume       = {7},
  year         = {2006},
}