Sandra C Jones
Research suggests that older patients may be reluctant to engage
general practice registrars (GPRs) in their care. The authors
undertook a qualitative study of the attitudes of older patients to GPRs
to investigate this issue.
Thirty-eight patients aged 60 years and over from three training
practices participated in semistructured telephone interviews, which
explored patients responses to GPRs. The interviews were recorded,
transcribed and analysed using a template analysis approach.
Analysis of the interviews produced five major themes concerning
patients’ attitudes to GPRs: ‘desire for continuity’, ‘desire for access’,
‘openness’, ‘trust’ and a ‘desire for meaningful communication’.
Older patients’ attitudes to GPRs cannot be viewed in isolation from
their relationship with their usual general practitioner, and this needs
to be taken into account when engaging GPRs in the care of older
patients. Systems need to be developed to maintain relational and
informational continuity with older patients’ ‘regular’ GP.
The patient-doctor relationship is so central to the discipline of general practice that for some authorities the relationship defines the discipline itself.1 The sum of personal knowledge and human interaction shared over time can develop into something of significant worth to both the patient and the doctor, forming what Balint termed a ‘mutual investment company’.2 Older patients,3 those with chronic illness,3–6 and those who have shared significant life events with their general practitioner7 place particular importance in maintaining continuity of care with their personal doctor. General practitioners in turn value continuity with ‘their’ patients.6,8
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