Linköping University Post Print to Make a Difference -how Gps Conceive Consultation Outcomes. a Phenomenographic Study Bmc Family Practice to Make a Difference – How Gps Conceive Consultation Outcomes. a Phenomenographic Study

Background: Outcomes from GPs' consultations have been measured mainly with disease specific measures and with patient questionnaires about health, satisfaction, enablement and quality. The aim of this study was to explore GPs' conceptions of consultation outcomes. Methods: Interviews with 17 GPs in groups and individually about consultation outcomes from recently performed consultations were analysed with a phenomenographic research approach. Results: The GPs conceived outcomes in four ways: patient outcomes, GPs' self-evaluation, relationship building and change of surgery routines. Conclusion: Patient outcomes, as conceived by the GPs, were generally congruent with those that had been taken up in outcome studies. Relationship building and change of surgery routines were outcomes in preparation for consultations to come. GPs made self-assessments related to internalized norms, grounded on a perceived collegial professional consensus. Considerations of such different aspects of outcomes can inspire professional development. Background GPs' consultation outcomes have, to a great extent, been evaluated by measurable illness parameters such as HbA1c or blood pressure. As GPs meet all sorts of patients with all sorts of problems there has also been a need to understand and systematize GPs' consultation outcomes without relating them to diagnoses, disease or illness. For this, non-disease-specific outcome measures have been used. Most used are satisfaction instruments such as MISS [1] and CSQ [1] and health instruments such as SF-36 [2] or EQ5D [3,4]. An instrument for measuring if the patient has been enabled to cope with illness and life is Patient Enablement Instrument, PEI [5]. During the last decades quality assessment has been increasing. The Europep studies [6] as well as the instruments GPAQ [7] and IPQ [8] that are currently used in UK, are examples. They contain questions about the doctor's professional performance and attitudes, care settings and consultation outcomes. Thus, there is great variation both as to parameters and to methods, when GPs' consultation outcomes are being studied. An important question is then whether the measures or instruments are sensitive enough to capture a sufficient scope of possible outcomes. The questions in the health instruments are difficult to connect to the specific Published: 16 January 2009 BMC Family Practice 2009, 10:4 doi:10.1186/1471-2296-10-4 Received: 24 October 2008 Accepted: 16 January 2009 This article is available from: http://www.biomedcentral.com/1471-2296/10/4 © 2009 Andén et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.