title: Why general practitioners do not implement evidence: qualitative study.
abstract: OBJECTIVE
  To explore the reasons why general practitioners do not always implement best evidence.
  
  
  METHODS
  Qualitative study using Balint-style groups.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  19 general practitioners.
  
  
  METHODS
  Identifiable themes that indicate barriers to implementation.
  
  
  RESULTS
  Six main themes were identified that affected the implementation process: the personal and professional experiences of the general practitioners; the patient-doctor relationship; a perceived tension between primary and secondary care; general practitioners' feelings about their patients and the evidence; and logistical problems. Doctors are aware that their choice of words with patients can affect patients' decisions and whether evidence is implemented.
  
  
  CONCLUSIONS
  General practitioner participants seem to act as a conduit within the consultation and regard clinical evidence as a square peg to fit in the round hole of the patient's life. The process of implementation is complex, fluid, and adaptive.
authors.affiliation: Somerset and North and East Devon Primary Care Research Network, Institute of General Practice, School of Postgraduate Medicine and Health Sciences, Exeter EX2 5DW. PCRN@exeter.ac.uk
authors.forename: A C
authors.initials: AC
authors.lastname: Freeman
authors.forename: K
authors.initials: K
authors.lastname: Sweeney
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004059:Diffusion of Innovation; D004739:England; D019317:Evidence-Based Medicine; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care