Attachment in the doctor–patient relationship in general practice: A qualitative study

Abstract

Objective. To explore why interpersonal continuity with a regular doctor is valuable to patients. Design, setting, and subjects. A qualitative study based on 22 interviews with patients, 12 who saw their regular general practitioner (GP) and 10 who saw an unfamiliar GP. The patients were selected after an observed consultation and sampled purposively according to reason for encounter, age, and sex. The research question was answered by means of psychological theory. Results. A need for attachment was a central issue for the understanding of the value of interpersonal continuity for patients. The patients explained that they preferred to create a personal relationship with their GP and the majority expressed a degree of vulnerability in the doctor–patient relationship. The more sick or worried they were the more vulnerable and the more in need of a regular GP. Furthermore, patients stated that it was difficult for them to change GP even if they had a poor relationship. Conclusion. Attachment theory may provide an explanation for patients' need to see a regular GP. The vulnerability of being a patient creates a need for attachment to a caregiver. This need is fundamental and is activated in adults when they are sick or scared.

Key Words::

• Attachment
• doctor–patient relationship
• family practice
• interpersonal continuity
• qualitative study

Acknowledgements

The authors are very grateful to the patients who agreed to be interviewed and would like to acknowledge the doctors and their practice staff who participated.

Conflicts of interests: None.