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Family Practice Advance Access originally published online on May 15, 2007
Family Practice 2007 24(3):269-275; doi:10.1093/fampra/cmm015
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Peering through the barriers in GPs' explanations for declining to participate in research: the role of professional autonomy and the economy of time

Peter Salmona, Sarah Petersb, Anne Rogersc, Linda Gaskc, Rebecca Cliffordb, Wendy Iredaleb, Christopher Dowrickd and Richard Morrisse

a Division of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB
b Division of Psychology, Coupland Building 1
c National Primary Care R&D Centre, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL
d Division of Primary Care, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB
e Division of Psychiatry, University of Nottingham, Queens Medical Centre, Nottingham NG7 2UH, UK

Correspondence to: Peter Salmon, Division of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK; Email: psalmon{at}liv.ac.uk

Received 25 October 2006; Revised 4 February 2007; Accepted 18 March 2007.


   Abstract

Background. The level of participation in research by GPs is low internationally. Previous reports of the reasons why practitioners decline opportunities for research participation have tended to recount the barriers that they describe as if they are objective accounts.

Objective. By theoretical sampling of practitioners who had declined to participate in a research trial, we sought to interpret the functional significance and interrelationship of the barriers that they reported.

Methods. Twenty-three GPs who had declined to participate in a trial of training to manage medically unexplained symptoms were interviewed and their accounts analysed interpretatively.

Results. The practitioners described general practice and research as alien fields. Research lacked intrinsic, clinical or professional value and was linked to evidence-based medicine which they rejected as incompatible with person-centered care. Every doctor described a lack of time for research, but time was an elastic resource that payment could release from the reservoir of their ‘own time'.

Conclusion. The findings should inform the design and interpretation of future quantitative surveys to identify how common the attitudes that we report are. Doctors with the attitudes of those whom we interviewed will not be drawn into research by measures predicated on the assumption that it is intrinsically, clinically or professionally valuable. If they cannot be convinced of its utility, value could be conferred by payment for participation.

Keywords. Barriers, family practice, research, time.


Salmon P, Peters S, Rogers A, Gask L, Clifford R, Iredale W, Dowrick C and Morriss R. Peering through the barriers in GPs’ explanations for declining to participate in research: the role of professional autonomy and the economy of time. Family Practice 2007; 24: 269–275.


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