[Impact of adverse events on the practices of 15 general practitioners]

General practitioners are sometimes faced with adverse events, which we define here as "all untoward or unfortunate events occurring unintentionally during the provision of health care services, but also all such events related to any kind of intervention during care." While their social, economic, and health repercussions are often studied, little is known about their effects on general practitioners, except perhaps for their legal consequences. Our principal objectives here were to study the impact of adverse events (including medical errors) on the practices of general practitioners and to study their representations of the concepts of adverse events and medical errors.

This qualitative work is based on interviews with 15 general practitioners in the Rhone-Alpes region.

This study collected 66 real situations experienced and identified as adverse events by the subjects. Analysis shows that these events had a major impact on these practitioners: they caused changes in their procedures for diagnosis and treatment, had sometimes important psychological consequences, induced them to participate in targeted continuing education, and increased their awareness of the legal aspects of some practices, including, for example, record-keeping. Most expressed a need to discuss these situations, especially in peer groups.

It appears essential to study adverse events and professional practices in primary care and to facilitate their ongoing study, especially in the area of family care.