Exploring GPs' prioritisation dilemmas - 'quick wins' versus 'eating the frog': a qualitative study in primary care.

Abstract (English)

BACKGROUND: Prioritisation is an increasing part of a GP's workload, although learning this skill is usually left to on-the-job training. Little is known about how experienced GPs prioritise their workload. AIM: To explore the factors that experienced GPs consider when prioritising their acute workload. DESIGN AND SETTING: This qualitative research study used focus groups of GP educators based in central Scotland to explore the factors that they consider when prioritising their acute workload. METHOD: Participants were recruited through convenience sampling. The key inclusion criterion was being involved in the supervision of GP registrars. Five focus groups were carried out, and transcripts were analysed using reflexive thematic analysis to identify the dilemmas that GPs face when prioritising their workload. RESULTS: Thirty-nine participants took part. The following five themes emerged from the data: 1) system awareness and adapting to demand, whereby GPs maintain an awareness of their work system and adapt their consultation style to demand; 2) time management, which is where they make decisions in an order that manages their time efficiently; 3) familiarity with patients, which enables them to make quick decisions about patient care, although this can lead to bias in decision making; 4) relationships, whereby they rely on their therapeutic relationships with patients and working relationships with colleagues when making decisions; 5) personal preferences, which are important such as managing the simplest or the most complex presentations first. CONCLUSION: Prioritisation is an increasingly important skill in modern general practice. It is crucial that those involved in prioritisation are given the time and tools necessary to adequately develop this skill.