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Aim: This article examines the way in which private general practitioners take into account the social position of their patients in their preventive work., Methods: After a review of the main normative constructs supposed to equip the general practitioners to grasp the social dimension of their practice, the article used two surveys on the provision of preventive care, one epidemiological (PrevQuanti) and the other sociological (PrevQuali)., Results: Deontology, training and recommendations make it difficult to shape the social dimensions of health that pratitioners have to deal with. The PrevQuanti survey, however, revealed that the provision of preventive care is subject to almost systematic but variable social gradients. The analysis, based on the PrevQuali interview study, makes the ways in which pratitioners mobilise the social position of their patients and whether or not they adapt to it., Conclusion: The positionings of general practitioners can be modelled in a typology of six postures between which some oscillate., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Background: We sought to analyze gender differences in General Practitioners' (GP) preventive practices: variations according to the GP's and the patient's genders, separately and combined, and the homogeneity of GPs' practices according to gender., Methods: Fifty-two general practitioners volunteered to participate in a cross-sectional study. A sample of 70 patients (stratified by gender) aged 40-70 years was randomly chosen from each GP's patient panel. Information extracted from the medical files was used to describe the GPs' preventive practices for each patient: measurements of weight, waist circumference, glucose, and cholesterol; inquiry and counseling about smoking, alcohol consumption, diet, and physical activity, and dates of cervical smears and mammographies. An aggregate preventive score was calculated to assess the percentage of these practices performed by each GP for patients overall and by gender. Mixed models were used to test for gender differences., Results: Questionnaires were collected in 2008-2009 for 71% of the 3640 patients and analyzed in June 2017. Male patients and female GPs were associated with the most frequent performance of many types of preventive care. The aggregate preventive score was higher for male patients (OR = 1.60, 95% CI 1.47-1.75) and female GPs (OR = 1.35, 95% CI 1.05-1.73). There was no combined effect of the genders of the two protagonists. Female patients of male GPs appeared to receive preventive care least frequently and female GPs to deliver preventive care more consistently than their male colleagues., Conclusion: Physicians need to be aware of these differences, for both patient gender and their own.

General practitioners (GPs) do not provide enough preventive care. Nonetheless, without a detailed understanding of the logical processes that underlie their practices, it remains difficult to develop effective means of improvement. Their relationship to knowledge is one of three elements that strongly structure GPs' preventive work (together with the doctor-patient relationship and the organisation of their professional space).The objective of this article was to explore the question of GPs' relationship to knowledge about prevention. In 2010-2011, semi-directive interviews with a diverse sample of 100 GPs practising in the Paris metropolitan area were conducted. These interviews were coded according a reading grid that was developed collectively and analysed in the framework of grounded theory. The cognitive universe of GPs is neither homogeneous nor stable. It is composed of biomedical knowledge (delivered via guidelines, the professional press, opinion leaders and pharmaceutical companies), clinical knowledge (fed by individual situations from their daily experience and often conflicting with epidemiologic reasoning and data) and lay knowledge (from folk culture). Plunged into this complex cognitive universe that is difficult for them to master, doctors construct their own idiosyncratic preventive style by themselves, mostly in isolation. Two types of actions emerged as likely to help GPs better appropriate preventive knowledge: clarification of scientific data (especially from epidemiology and the social sciences) but also development of a collective analysis of the cognitive work required to integrate the different types of knowledge mobilised daily in their preventive practices.