Diversity and ambivalence in general practitioners' attitudes towards preventive health checks - a qualitative study

Systematic preventive health checks in primary care have been introduced in several countries. The Danish Health Service does not provide this service, but health checks are nevertheless being conducted unsystematically. Very little is known about the GPs' experience with this service.The purpose of our study is to describe GPs' attitudes towards and concerns about providing preventive health checks and to describe their experiences with the health checks that they provide in daily practice.

A qualitative descriptive study was conducted based on three semi-structured focus group interviews with 16 GPs from Central Region, Denmark. The focus group interviews took place at the Department of Public Health, Section for General Practice, Aarhus University in November 2010.

We found that the participating GPs all conducted some kind of preventive health checks, but also that there was great diversity in the content. The GPs were somewhat ambivalent towards health checks. Many GPs found the service beneficial for the patients. Concurrently, they had reservations about promoting ill-health, they questioned whether the health checks were a core mission of primary care, and they were concerned whether the health checks would benefit the "right" patients. The GPs felt a need for further documentation of the benefits for the patients before a possible future implementation of systematic health checks. Some GPs found that health checks could be performed in other settings than general practice.

Our study revealed that health checks are performed differently. Their quality differs, and the GPs perform the health check based on their personal attitude towards this service and prevention in general. Our analysis suggests that the doctors are basically uncertain about the best approach. Our study also uncovers the GPs' reservations about inducing negative psychological reactions and decreased well-being among the health check participants. Further studies are needed to disclose where these concerns emerge.