Abstract
This article examines general practitioners’ discretion in preventive contexts. Based on semi-structured interviews with 15 general practitioners, we examine how lifestyle is used in their discretionary practices in contexts of healthcare prevention. Despite common educational background and professional ideology, GPs’ do not share lifestyle and our analyses show that this matters to their discretion of patients’ need for lifestyle intervention. The correspondence between general practitioners’ preventive strategies and their own lifestyle preferences is interpreted as evidence of autonomy in general practice where general practitioners act relatively autonomously and differ in their interpretation of how preventive policies should be exercised in practice towards patients.Keywords: discretion, lifestyle, health prevention and promotion, street-level bureaucrats, general practitioners
Highlights
This article examines general practitioners’ discretion in preventive contexts
We have argued that general practitioners (GPs)’ discretionary practices in healthcare preventive contexts are influenced by much more than a regulative and a professional context
We identified different approaches to preventive healthcare, and different lifestyles among the interviewed GPs, with patterns of correspondence being present in most cases
Summary
The empirical data were generated through semi-structured interviews with 15 GPs. Employing this method made it possible to access their narratives concerning lifestyle preferences, their reasoning about risky lifestyle and preventive approaches. CHPP is a five-year randomized controlled trial investigating the impact of preventive general health checks performed in a municipality setting and subsequent conversations between GPs and citizens regarding health issues. The preventive program defines risky lifestyle in accordance with the recommendations of the Danish Health and Medicines Authority (DHMA), on diet, tobacco use, alcohol consumption, and physical activity. Semi-structured interviews were carried out based on an interview guide containing diverse themes, including health perceptions, approach to health prevention, GPs’ own health-seeking behavior, and everyday life practices in terms of preferences for food, spare time activities, residential area, TV and media. The interview data underwent qualitative content analysis, which made it possible to describe the GPs’ lifestyles and approaches to prevention by interpreting the content of the GPs’ narratives through a systematic classification process of coding and identifying themes and patterns. The GPs are referred to by a combination of “GP” and a number (01–15) in this paper
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