[The perceptions of family physicians of the physician-patient relation]

To identify family doctors' (FD) perceptions of the doctor-patient relationship and the factors conditioning those perceptions.

A descriptive crossover study. Using the technique of the discussion group, the contributions of FD from both the rural and urban areas were collected. The discussion was taped, transcribed (language and paralanguage) and analysed inductively.

Health centres in Navarra.

12 urban and 8 rural FD were chosen in order to include those variables (sensitivity to the question, professional field, age, years of experience and gender) which would lead to both a wide-ranging discussion and joint work.

The FD felt they were little valued and had lost responsibilities. Patients were perceived negatively on the whole and doctors' relationship with them was lived as something unsatisfactory and full of obstacles. "Difficult" patients, along with the possibility of committing technical errors, were clearly matters of concern. Although the responsibility of external factors was emphasised, the need to reconsider their own behaviour was recognised, as was the need for special training to improve their relationships with patients.

The attitudes of FD do not make the construction of positive relationships with patients easy and can lead into a process of serious professional and personal frustration. Neutralising this process, through a series of measures not restricted to training, is a priority in primary care development.