A medical profession towards empowerment? The uncertain future of digitalization in private general practice

The aim of the paper is to understand what drives private general practitioners (GPs) to introduce digital technologies, and to use them extensively. While prior research has highlighted barriers to adoption for practitioners when digital tools are introduced by managers and policy makers, we explore how GPs having their own practice introduce digital innovation and how they integrate them into their practices. Our qualitative study focuses on liberal emergency medicine in France, providing a unique context to examine how GPs at the front lines of health system failures and changes introduce and adopt digital technologies. Through in-depth ethnographic research conducted from 2021 to 2023, we reconstruct three sequences of digital innovation since the 1990s and observe current digital tool usage among GPs. We put forward two major findings. First, the introduction of digital tools is driven in this context by the organization of GPs as a professional group that aims to enhance its capacity for action and gain recognition for its expertise. Second, the adoption of digital innovations depends on how the changes in practices involved align with the professional culture of these doctors. Tensions between the most recent digital innovation initiatives that take place during and post-Covid 19 crisis, and doctors' understanding of practicing medicine as an "art", leads to the weak adoption and even contestation among GPs.