The limits of leadership: opinion leaders in general practice

To explore the importance and characteristics of opinion leaders in general practice, particularly in relationship to the use of laboratory tests.

Focus group discussions and a mailed survey.

Five focus groups (n = 29 participants) in four different municipalities and a random sample of 85 general practitioners (GPs) in Norway.

While Norwegian GPs recognised colleagues who were influential in determining how they practised, they found it difficult to identify opinion leaders specifically with respect to the use of laboratory tests. Opinion leaders were thought to be less important in influencing the use of laboratory tests than continuing medical education activities and practice guidelines, but more important than industry, patients or personal financial interests. Norwegian GPs recognised and characterised opinion leaders in much the same way as physicians in the USA. Influential colleagues were characterised as being good conveyers of information and willing to take time, as well as being up-to-date and having a high level of clinical expertise. GPs expressed a negative attitude towards 'superspecialists' who give advice without knowing the epidemiology of general practice, people who are arrogant and people who do not show respect towards GPs.

The potential to identify and use opinion leaders to improve the use of laboratory tests by GPs in Norway appears to be limited.