Why do people with long-term health needs see more than one GP?: a qualitative study.

This study aimed to understand what barriers exist or choices are made by patients who access regular care for long-term health issues from multiple GPs. This was a qualitative interview study in Western Sydney community settings consisting of semi-structured interviews and inductive thematic analysis. Twenty participants who accessed GP care were interviewed. Sixteen had seen multiple GPs over the previous twelve months and all had seen multiple GPs over preceding years. Participants valued interpersonal continuity of care. Nevertheless, they made decisions to meet their needs by seeing multiple GPs. They considered waiting times, preference for an individual GP based on their consultation style or perception of their particular area of expertise, experiences with reception staff and the practice model of care. Participants were aware that interpersonal continuity of care was considered important by GPs and were reticent to be seen as 'doctor shoppers'. Therefore, they did not usually disclose that they saw multiple doctors and were unlikely to discuss continuity of care with a GP. Participants made considered choices about health care. Despite general practice promoting interpersonal continuity of care, it is not always achievable or desired by patients. GPs can promote care continuity through supportive practice models and dialogue about when continuity is desirable. Although interpersonal continuity of care is associated with positive health outcomes, many patients with long-term health problems see more than one GP. This study suggests patients make choices based on multiple factors, including perceived match between their health problem and GP style and expertise, and practice systems. Revealing these episodes of care to other GPs was seen as potentially stigmatising. General practitioner, practice and health system factors that affect patient decisions should be considered when promoting care continuity. [ABSTRACT FROM AUTHOR]