title: A qualitative investigation into why patients change their GPs.
abstract: BACKGROUND
  In the past patients have rarely changed doctor. The UK Government has made such change easier and it appears to be becoming more common. Changing doctor without changing address may be indicative of dissatisfaction with the GP service. Previous research in this area has been largely quantitative.
  
  
  OBJECTIVE
  To identify why patients change their GP although they have not moved house.
  
  
  METHODS
  Qualitative investigation of patients' experiences. In depth interviews of 24 patients were conducted to determine why they had left their previous doctor. Letters describing the process of change were received from a further 17 patients. Analysis was performed using standard qualitative techniques.
  
  
  RESULTS
  The decision to change was in most cases multi-factorial. Interviews yielded more detailed and richer accounts than letters. For interviewees, rudeness or the attitude of the doctor was the commonest reason. Overall, 19 different reasons, in four categories, were identified. The largest single category was accessibility, closely followed by attitudinal problems. Clinical issues and personal characteristics of the doctor were less common. The majority of those responding by letter gave only one reason, usually distance.
  
  
  CONCLUSIONS
  Patients change doctor after careful consideration and commonly for interpersonal reasons. There is usually one critical factor in the decision to change. Factors may be modifiable or non-modifiable. Critical event audit may enable GPs to analyse the reasons why patients leave their lists.
authors.affiliation: Department of General Practice, Medical School, University of Birmingham, UK.
authors.forename: I G
authors.initials: IG
authors.lastname: Gandhi
authors.forename: J V
authors.initials: JV
authors.lastname: Parle
authors.forename: S M
authors.initials: SM
authors.lastname: Greenfield
authors.forename: S
authors.initials: S
authors.lastname: Gould
mesh_terms: D000328:Adult; D004739:England; D005194:Family Practice; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012494:Sampling Studies; D012938:Social Perception