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Family Practice Advance Access originally published online on May 3, 2006
Family Practice 2006 23(4):481-487; doi:10.1093/fampra/cml015
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Seeing through the glass darkly? A qualitative exploration of GPs' drinking and their alcohol intervention practices

Eileen Kaner, Tim Rapley and Carl May

Centre for Health Services Research 21 Claremont Place University of Newcastle upon Tyne NE2 4AA, UK

Correspondence to Eileen Kaner; Email: e.f.s.kaner{at}newcastle.ac.uk

Background. Brief alcohol intervention is influenced by patients' personal characteristics as well as their clinical risk. Risk-drinkers from higher social-status groups are less likely to receive brief intervention from GPs than those from lower social-status groups. Thus GPs' perception of social similarity or distance may influence brief intervention.

Objective. To explore the role that GPs' drinking behaviour plays in their recognition of alcohol-related risk in patients.

Method. A qualitative interview study with 29 GPs recruited according to maximum variation sampling. All interviews were audio-recorded and transcribed verbatim. Analysis was inductive with constant comparison within and between themes plus deviant case analysis. Analysis developed until category saturation was reached.

Results. GPs described a range of personal drinking practices that broadly mirrored population drinking patterns. Many saw themselves as part of mainstream society, sharing in culturally sanctioned behaviour. For some GPs, shared drinking practices could increase empathy for patients who drank, and facilitate discussion about alcohol. However, several GPs regarded themselves as distinct from ‘others’, separating their own drinking from that of patients. Several GPs described a form of bench-marking, wherein only patients who drank more, or differently, to themselves were felt to be ‘at risk’.

Conclusion. Alcohol is clearly a complex and emotive health and social issue and GPs are not immune to its effects. For some GPs' shared drinking behaviour can act as a window of opportunity enabling insight on alcohol issues and facilitating discussion. However, other GPs may see through the glass more darkly and selectively recognize risk only in those patients who are least like them.

Keywords. Alcohol, brief interventions, general practitioners, primary care.


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