[General practitioners in private practice in the city of Quebec and the application of population responsibility]

The aim of this study is to examine the way in which general practitioners (GPs) in private practice view the idea of population responsibility, proposed by the Quebec Health and Social Services Ministry in 2004. We then look at how these views impact primary health care practice in Quebec City.

A qualitative exploratory approach was used; 18 semi-directed interviews were performed with private practice GPs, administrators and health professionals from community health and social services centres (CSSS). A content thematic analysis of the data was performed based on St-Pierre et al.'s model and grounded on Giddens' structuring theory.

Because neither the population meant to be served nor the underlying responsibility are perceived the same way by the GPs and the CSSS health professionals, the respective practices do not always converge. Consequently, methods of communication, offers of services and management of resources impact on the operationalization of the concept of population responsibility, which has to be negotiated.

In these negotiations, because physicians are the ones solicited by the other partners, the application of population responsibility increasingly becomes an opportunity to develop a medically oriented primary care organization.