Illness behaviour and influencing aspects of general practitioners in Germany and their use of the health care system: a qualitative study

OBJECTIVES: The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system. SETTING: Primary care practices in Thuringia, Germany. PARTICIPANTS: Convenience sample of 16 GPs. DESIGN: Qualitative study design with semistructured interviews and content analysis. RESULTS: Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists. Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants’ activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians. Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process. CONCLUSIONS: The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships.