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Table 4 Quotations

From: Infectious disease management in primary care: perceptions of GPs

Perception Quotations illustrating statements on which categories of description were based
A. The GP must help the patient to achieve health and well-being "The risk of complications is an important reason for starting treatment [with antibiotics]. But I also think it is reasonable to give treatment if the course of the illness is easier." GP:P "They are young parents and they are a little, well, they don't have much patience, maybe they're exhausted... you feel a bit more for them in a way, almost that I think I must do everything I can to make it [the infection] pass as quickly as possible or to make it as easy as possible." GP:N
B. The management must meet the GP's perceived personal, professional, and organisational demands "Maybe it's like this, that you have a wish to satisfy people. It's possible that's what it is, that it's more this discomfort you don't want to have." GP:B "As a physician it's wise to be passive, to wait-and-see. This is actually a useful way to work, as we do a lot in primary care, much more maybe than in some other specialities. But, at the same time, that may make you feel uncomfortable." GP:G "The face you show also creates a good client, a patient who stays with the medical centre, and this is also a way to make the finances work out. ... So, you should be very careful to take good care of your patients." GP:C
C. Restrictive antibiotic prescribing is time-consuming "Then it's like this; many times it is much easier to prescribe antibiotics than not to. [...] you don't need any discussion, you don't need to explain yourself." GP:A "But to try to persuade or convince the patient that this is nothing you should treat with antibiotics, if they have expectations of getting something, is a challenge. Often you are short of time and at the same time you want the patient to be satisfied and feel listened to and confirmed." GP:R
D. Restrictive antibiotic prescribing can protect the effectiveness of antibiotics "And often, when you explain that the guidelines are what they are and that we're trying to be cautious, to make antibiotics effective in the future, many [patients will] buy this, especially when you say that it's possible to call back and get a follow-up." GP:D "But then you must be able to contain this uncertainty, that is to say, it's like that. This is incorporated in my profession that I, I cannot x-ray all of them, totally safeguard ... I think you must have a larger safety margin when you are younger, when you haven't seen so much." GP:I
E. Patients benefit personally from restrictive antibiotic prescribing "I have this attitude then, I think and believe that the body can manage itself. It will recover better and we have also seen that the immune system will not be improved by antibiotics; on the contrary you become weaker." GP:E "They [the patients] are known here, and they know the medical centre. And so I think it has changed a lot. When I was new in this profession I think it was more difficult to motivate, but now I think they are so well-informed." GP:Q