Patients' accounts of being removed from their general practitioner's
list: qualitative study |
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Authors: | Tim Stokes Mary Dixon-Woods Kate C Windridge Robert K McKinley |
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Institution: | 1 Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, Leicester LE5 4PW;2 Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 6TP |
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Abstract: | Objective To explore patients'' accounts of being removed from a
general practitioner''s list.Design Qualitative analysis of semistructured interviews.Setting Patients'' homes in Leicestershire.Participants 28 patients who had recently been removed from a
general practitioner''s list.Results The removed patients gave an account of themselves as having
genuine illnesses needing medical care. In putting their case that their
removal was unjustified, patients were concerned to show that they were
“good” patients who complied with the rules that they understood
to govern the doctor-patient relationship: they tried to cope with their
illness and follow medical advice, used general practice services
“appropriately,” were uncomplaining, and were polite with doctors.
Removed patients also used their accounts to characterise the removing general
practitioner as one who broke the lay rules of the doctor-patient
relationship. These “bad” general practitioners were rude,
impersonal, uncaring, and clinically incompetent and lied to patients.
Patients felt very threatened by being removed from their general
practitioner''s list; they experienced removal as an attack on their right to
be an NHS patient, as deeply distressing, and as stigmatising.Conclusions Removal is an overwhelmingly negative and distressing
experience for patients. Many of the problems encountered by removed patients
may be remediable through general practices having an explicit policy on
removal and procedures in place to help with “difficult”
patients. |
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