‘Good’ and ‘bad’ doctors - a qualitative study of the Austrian public on the elements of professional medical identity

Figures & data

Table 1. Sampling distribution characteristics; 2020 good doctor survey.

Sampling distribution	n
Numbers used	66872
Completed interviews	1000
Refusal or drop out	5795
Answering machine/no one picks up	32418
Invalid telephone numbers	26441
Language problems	231
Not available (e.g., sick or on holiday)	590
No private household	397

Table 2. Sample selected characteristics (n = 1,000); 2020 good doctor survey.

Characteristic	Participants (n, %)
Sex
Female	515 (51.5)
Male	485 (48.5)
Age Group (years)
18–30	215 (21.5)
31–40	168 (16.8)
41–50	188 (18.8)
51–60	215 (21.5)
61–75	214 (21.4)
Country of Birth
Austria	963 (96.3)
Other	37 (3.7)

Figure 1. Categories for ‘good’ doctors by 1000 Austrians: distribution of answers through the seven main categories.

Figure 2. Categories for ‘bad’ doctors by 1000 Austrians: distribution of answers through the seven main categories.

Table 3. Definition of the categories.

Categories	Definition
Personality	Personality traits are personal factors that push people toward or away from professional behavior. Personality refers to characteristics of the person that are relatively stable and consistent. The focus is on general personality traits such as ‘being nice’ and ‘polite’.
Social skills	Social skills are dispositions of physical and psychological action; these are action-centered. The difference between social skills and the personality of a good doctor is that skills are about peak performance, whereas personality is about typical behavior. Therefore, this category contains specific behaviors, such as ‘listening’, and ‘responding empathically to patients’.
Communication	During medical treatment or consultation, communication is one of the central tasks of doctors. They have to listen carefully, understand the needs of their patients, or have them explained to them. At the same time, doctors must be able to explain medical issues adequately themselves. It includes patient-friendly language, answering questions, open communication, and explanations about treatment or medication.
Professional competence	Professional competence is at the heart of medical practice. Therefore, this includes specialist knowledge, medical skills, and abilities of diagnosis, examination, treatment, healing of diseases, and pain relief. It also contains alternative medical knowledge as a counterpart to academic medicine.
Practice organization	This category includes all tasks not directly related to medical treatment. Doctors manage teams and surgeries; they offer services, such as opening hours, home visits, and night services.
Ethical and moral behavior	The relationship between patient and doctor requires trust and honesty. Therefore, this category includes integrity, confidentiality, and independence from pharmaceutical companies, motivation, and passion for the profession as a doctor. The ability to self-reflect and recognize one’s own limits are central. At the same time, this category includes respect for and consideration of population groups, e.g., age, gender, religion, and culture.
I do not know or I have no idea	Some interviewees indicated that they could not or would not answer the interview questions. Some stated that they did not feel confident to make a judgment or did not have an answer.

Table 4. Main categories and subthemes of ‘social skills’ for a good doctor.

Main categories for ‘social skills’	nb of responses, n (%)	Subthemes	Exemplar quotes
Takes time	266 (33)		‘Takes time for the patients and doesn’t switch from one person to another every 2 minutes’; ‘takes enough time for a consultation’;
Listens	169 (21)		‘If one can listen to what is wrong with the patient’; ‘Someone who listens to me about problems’; ‘Someone who can listen well’;
Taking care	126 (15.6)	To be responsive to complaints Takes care Reliable dedicated Good interaction	‘Should respond to the individual needs of the patient’; ‘Has sympathy for the concerns of his patients’/ ‘Someone who takes care of you – for a long time’; ‘He or she should take care of patients’; ‘Takes good care of patients’; ‘Dedicates himself with full passion to the patients’ / ‘If I can rely on him’; ‘Is reliable’; ‘One who intercedes on behalf of patients’ / ‘Someone who is good with patients’; ‘Good interactions with patients’;
Respond to the individual	98 (12.2)	Understanding Personal support A partner for health Attentive Helpful Reassuring Feels in good hands Patients are human beings Considerate – respectful Proactive thinking Motivating	‘Understanding of the social background of individual patients’; ‘Who understands the patient’s opinion’; ‘Understanding for my problems’/ ‘Individual support’; ‘Personal care’; ‘Supports well’;/ ‘Partner in health matters’; ‘A partner for health’; ‘Based on partnership’/ Attention to the patient’; ‘be attentive’; / ‘If he is helpful’; ‘If he is willing to help’/ ‘Is reassuring before unpleasant situations during the exam’; ‘Can take away the fear of an examination’;/ ‘When you feel in good hands in the practice’; ‘One feels in good hands’/ ‘Always keeps in mind that his patients are human beings’; ‘You get the feeling that you are a human being there’; ‘Does not see patients only as objects’/ ‘Considerate’; ‘Be prudent’; ‘Respectful interaction also with my wife’; ‘Shows respect’/ ‘Proactive thinking’/ ‘Can motivate patients’; ‘Health for motivation’; ‘Motivating’;
Empathic	69 (8.6)		‘Empathy for my medical problems’; ‘Can put himself in his patient’s shoes’; ‘Being able to empathize well with my situation’ ‘A good knowledge of human nature’; ‘Have an understanding of human nature’; ‘Someone who has a feeling for people’;
Takes someone seriously	33 (4.1)		‘If I have the feeling that I am not being taken seriously, if I am afraid of an illness or if a painful therapy is imminent’; ‘Takes the patient’s complaints seriously’; ‘Who takes the patient’s feeling seriously’;
Interested	28 (3.5)	Being there for someone She or he knows me	‘Is simply interested in how his patients are doing’; ‘Who is interested in his patients’; / ‘Someone who is there when you need him’; ‘He should be there for the people’; ‘Who is there for me’/ ‘Knows his patients’; ‘Who knows me well’;
Social skills	8 (1)		‘Have social skills when dealing with people’; ‘Social skills’; ‘Social competence’;
Negative characteristics to avoid	5 (0.6)		‘Does not seem overstrained or stressed’; ‘Not hectic’; ‘Is not too stressed’

Table 5. Main categories and subthemes of ‘professional competence’ for a good doctor.

Main categories for ‘professional competence’	nb of responses, n (%)	Subthemes	Exemplar quotes
Proper diagnostic/therapeutic skills	194 (29.9)	Correct and accurate diagnosis Precise, thorough examination Considers the patient’s circumstances Rapid and efficient diagnosis Searches for the cause of the disease	‘That he knows uncomplicatedly what the problem of my illness is and can determine that uncomplicatedly’; ‘good diagnostics and examination methods’; ‘he is supposed to be a good diagnostician’;/‘A good doctor makes the right diagnosis’; ‘makes the right diagnosis right away’;/‘Who performs a proper examination, even in case of flu’; ‘Thorough examination if necessary’; ‘someone who makes precise examinations’;/‘Involves all circumstances of the patient’s life in diagnosis (diet, exercise, work, etc.)’; ‘Involves the patient’s work and private environment in the diagnosis and treatment’;/‘When a diagnosis can be made quickly and efficiently’; ‘Good ability to recognize and heal a disease quickly’;/‘looking for the origin of diseases’;
Medical competence	172 (26.5)	Professional competence Flawlessness Practical skills	‘That they are competent and know their stuff’; ‘competent in medicine is important to me’; ‘have a medical competence’;/‘someone who has a good technical knowledge and can apply it well’;/‘Does not make mistakes’;/‘medical, practical skills’;
Expert knowledge	110 (16.9)	Professional education and training Good, extensive knowledge Has operating experience	‘can score points with specialist knowledge’;‘someone who understands his field of expertise’; ‘Knows well about his field of expertise’;/‘is always up-to-date with the latest medical developments’; ‘someone who is professionally well-trained’; ‘is at the cutting edge of science’;/‘Has extensive knowledge’;/‘good experience’; ‘good routine’;
General treatment	58 (8.9)	Helps with recovery Correct and quick treatment and therapy Treats me well Painless treatment	‘That she can help me and my wife when there are health problems’; ‘When the doctor tries to help the patient recover in the best possible way’; ‘someone who can help me when I am sick’/‘Who can help me quickly when I am sick’; ‘Effective and quick, acts without delay’; ‘treats not only symptoms but also factors of disease development’;/‘Treats people well’;/‘When it does not hurt to draw blood and vaccinate’; ‘Examination without pain and fear’;
Medication	46 (7.1)	Does not only prescribe medication Correct medication Does not immediately prescribe hard medicines Quick medication and prescription	‘not only prescribes medication but also considers other options’; ‘who is not only concerned with prescribing medication’; ‘who has alternatives to medication’; ‘prescribes as little medication as possible’;/‘asks the patient what medicines they have at home and prescribes them if needed’; ‘prescribes the right medication’;/‘does not immediately get any medication like broad-spectrum antibiotic’; ‘Does not prescribe the strongest medications right away’; ‘does not prescribe pills right away, rather thinks beforehand’;/‘Prescribes what I need in an uncomplicated way’; ‘When you get a prescription quickly’;
Offers holistic and alternative medicine	36 (5.5)		‘treats not only scientifically but quite alternatively’; ‘who shows alternatives to treatment, instead of only academic medicine’; ‘can heal on a spiritual level, e.g., acupuncture, without chemicals’; ‘who also prescribes alternative medicines, e.g., homeopathy’;
Referral to other doctors	15 (2.3)		‘All options and some basic knowledge to refer to the right specialists’; ‘who has enough connections to specialists’; ‘refers me when he does not know what to do’;
Specific doctor image	11 (1.7)		‘Private doctor, not from the regional health insurance fund’; ‘I would rather have a female doctor than a male doctor’; ‘Prefer male doctor’; ‘young doctor’; ‘general practitioner’;

Table 6. Main categories of ‘personality’ for a good doctor.

Main categories for ‘personality’	nb of responses, n (%)	Exemplar quotes
kind – nice	61 (33)	‘Deals with every patient in a friendly manner’; ‘Friendly competent manner’; ‘Friendly charisma’; ‘Nice to all no matter young or old, educated or not’; ‘Is nice’; ‘Neatness’; ‘He should be friendly’;
patient – calm	31 (16.8)	‘Devote themselves with patience to the patients’; ‘Shows patience’; ‘Has patience for the patient’; ‘Radiating restfulness’; ‘Restful and understanding demeanor’; ‘Calm charisma’;
humanity	24 (13)	‘Humanly outstanding’; ‘Humanity in social matters’; ‘Should be human’; ‘Humanly, simply humanly’;
open – honest	19 (10.3)	‘Is open to the patient’; ‘Has an open manner’; ‘He is supposed to be honest’; ‘Is honest’; ‘Honest’;
polite	10 (5.4)	‘If he is polite’; ‘Politeness’;
likable	9 (4.9)	‘Be sympathetic’; ‘That the first impression is good’; ‘Chemistry must fit’;
precise	8 (4.3)	‘Should try to get a precise picture of what the patient wants’; ‘He should be precise’; ‘Precise work’
negative characteristics to avoid	6 (3.2)	‘Is not God in white’; ‘Not a snob’; ‘Not too strict’; ‘Not complicated’; ‘Not to be preachy’;
fond of children	6 (3.2)	‘Be fond of children’; ‘Is kind to children’;
conscientious	4 (2.2)	‘Be conscientious’; ‘Is conscientious’;
doctors’ personality	2 (1.1)	‘Is suitable for the medical profession in terms of personality’; ‘Depends on the personality’;
humorous	2 (1.1)	‘Humorous’; ‘Has humor’

Table 7. Main categories and subthemes of ‘communication’ for a good doctor.

Main categories for ‘communication’	nb of responses, n (%)	Subthemes	Exemplar quotes
Comprehensible explanations	48 (37.2)	Simple conversation Outlook on treatment possibilities Tells the diagnosis immediately	‘Be able to explain complicated issues simply’; ‘Understandable explanations of the clinical picture and medicines’; ‘Can understandably explain complex medical matters’;/‘Someone you can talk to on a normal level and not throw around Latin words’;/‘Someone who conveys a positive image when talking about the diagnosis’;/‘explains well what disease you have, understandable for laypeople’;
Communicative	38 (29.5)	Good communication skills Friendly, good atmosphere for conversation	‘Someone with whom you can also talk confidentially at eye level’; ‘detailed conversation about the reason for my visit’; ‘also talk about nonmedical topics’/‘that there is a good communication’; ‘bring along communication skills’/‘trustful and nice conversation like with a good friend’; ‘Trusting and warm basis for conversation’;
Advice	24 (18.6)	Good, competent, personal advice Gives tips and advice	‘Good advice when I travel abroad, regarding vaccinations and prophylaxis’; ‘Can advise me well’; ‘personal advice’/‘Advises for healthier living’; ‘Advises on better health’; ‘Tips about preventive care’;
Questioning and answering	19 (14.7)	Answers questions Asks questions	‘Responds to the patient’s questions’; ‘Who patiently answers the questions’; ‘Gives useful answers’;/‘Ask about diagnostic findings’; ‘asks questions where necessary’;

Table 8. Main categories and subthemes of ‘practice organization’ for a good doctor.

Main categories for ‘practice organization’	nb of responses, n (%)	Subthemes	Exemplar quotes
Reachability	86 (68.3)	Quick appointments Good opening hours	‘Easy to reach when you need an appointment’; ‘someone easy to reach’;/‘gives appointments, no long waiting times for appointments’;/‘has long opening hours’;
Practice	23 (23)	Equipment of the practice Local practice Good team	‘Modern and well-equipped practice at the cutting edge’; ‘modern equipped practice rooms’; ‘well-equipped practice’;/‘located near me’; ‘Is not far away’;/‘Good team’; ‘teamwork’;
Availability	17 (13.5)	House calls and night duties Sick notes In-house pharmacy	‘Quick and uncomplicated home calls’; ‘Shall make home calls’; ‘night services’;/‘who writes me sick sometimes if I feel bad or had trouble with my girlfriend’; ‘writes me a sick note uncomplicated’;/‘an in-house pharmacy so that I can save myself the trip to the pharmacy’

Table 9. Main categories and subthemes of ‘ethical and moral behavior’ for a good doctor.

Main categories for ‘ethical and moral behavior’	nb of responses, n (%)	Subthemes	Exemplar quotes
Morals	80 (73.4)	Trustworthy Doctor by passion and not for profit Role model No prejudices	‘A basis of trust that you can tell all your problems without taboos etc.’; ‘That I have the feeling that I can trust him’; ‘is trustworthy’;/‘does it not only for money and social position but for patients’; ‘practices the profession with passion’; ‘Is it for passion and not for profit’;/‘Is a role model’; ‘Is a fatherly friend’;/‘Does not have a prejudice against lesbian partnerships’; ‘without prejudices’;
Ethics	20 (18.3)	Discretion and confidentiality Treats all patients equally Independence from the pharmaceutical industry No experiments with medicines or therapies Adheres to his oath	‘That I don’t have to be afraid when I go to the doctor, and he passes on something’; ‘I can talk confidentially without it being passed on’; ‘Discreetly’;/‘who takes care of the patient, no matter what the patient’s origin, at any time of the day or night’; ‘Treats all patients equally’;/‘must do something good for people and not for pharmaceutical companies’; ‘does not let himself be driven by pharmaceutical companies’;/‘No experiments with patients, e.g., drugs, therapies’; ‘Does not experiment on patients’;/‘Adheres to the Hippocratic oath’;
Altruism	9 (8.3)	Has a heart for people Has the well-being of the patients in mind	‘who has a heart for people’; ‘Someone dear to one’s heart’; / ‘the well-being of the patients is in the foreground’; ‘who has the patient’s well-being in mind’; ‘Strives for the well-being of patients’;

Table 10. Main categories and subthemes of ‘social skills’ for a bad doctor.

Main categories for ‘social skills’	nb of responses, n (%)	Subthemes	Exemplar quotes
Has no time	187 (32.5)		‘the doctor does not take time’; ‘If you have the feeling that there is no time available’; ‘A doctor who has no time for me’; ‘that he or she does not take time’; ‘then doctor takes only a short time’;
Social incompetence	102 (17.7)	Arrogant/Condescending Super-teachy Prejudiced Too theoretical	‘talk down to people’; ‘he must not be conceited’; ‘if he is arrogant’; ‘to be condescending’ / ‘To be super-teachy and wants to improve you’; ‘has a teacher-like demeanor’; ‘teacher-like’; / ‘someone who is not willing to think outside the box’; ‘a preconceived opinion’; ‘prejudiced thinking’/ ‘too theoretical’; ‘out of touch with reality’; ‘too factual’; ‘unworldly’; ‘abstract’;
Does not listen	69 (12)		‘When a doctor cannot listen to patients’; ‘if he/she cannot or will not listen’; ‘does not listen to the patient’; ‘Only listen superficially’; ‘cannot listen well’; ‘if he/she does not have an open ear’;
Is not responsive to the individual	64 (11.1)	Does not go into detail Has no understanding Not soothing No personal contact Does not suit me	‘no attention is paid to the specific problems of the patient’; ‘does not go into the patient’s complaints’/ ‘pretending to understand you, but in reality, it comes across differently’; ‘shows no understanding’; / ‘Does not spread panic in times like these, debunk media scaremongering’; ‘scares unnecessarily’; / ‘no individual support’; ‘no personal contact’; ‘no personal contact with the patient’; / ‘to personally assess whether he suits me or not’; ‘is personally unsuitable’;
Disinterest	63 (10.9)	Is not on a par with patients No eye contact Does not know patients Does not recognize patients	‘When no interest is shown in people’s symptoms and problems’; ‘When he is not interested in patients’;/‘My doctor must be able to communicate on a par’; ‘is not at eye level’;/‘only stares at computers instead of looking at the patient’; ‘when he does not look at me in conversation’; ‘no eye contact’;/‘if he does not know you’; ‘Confuses patients during surgery’;/‘where you don’t really feel noticed’; ‘does not recognize’; ‘does not deal with the patients’;
Does not take seriously	52 (9)		‘If one gets the feeling not to be taken seriously concerning the complaints because of which one has made an appointment’; ‘When you think the other person does not take you seriously or thinks you are faking something.’; ‘when the doctor does not take the patient’s statements seriously’;
Not empathic	33 (5.7)		‘He has no empathy’; ‘Is unable to put himself in the patient’s shoes’; ‘cannot empathize with patients’; ‘lacks empathy’: ‘not empathic’; ‘empathy is missing’;
No care	4 (0.3)		‘if you do not feel well taken care of’; ‘not in good hands’; ‘one should not feel left out’;

Table 11. Main categories and subthemes of ‘professional competence’ for a bad doctor.

Main categories for ‘professional competence’	nb of responses, n (%)	Subthemes	Exemplar quotes
Poor diagnostic and technical skills	118 (23.6)	Superficial, not thorough, inaccurate examination Too quick or self-provided conclusions Inaccurate diagnosis Uncomfortable or painful examination	‘Incorrect or inaccurate diagnosis’; ‘Does not make correct diagnoses’; ‘Poor diagnostician’;/ ‘Makes a diagnosis from 1 meter away’; ‘Who does not bother to examine’; ‘Only superficial examination is done’; ‘Makes a diagnosis without having examined the patient’; / ‘When I, as a patient, have to say what is wrong with me’; ‘Where you have to make the diagnosis yourself’; ‘A rash diagnosis is made’; ‘Making diagnoses too quickly’;/‘Who is uncertain about the diagnoses’; ‘Inaccurate diagnosis’; ‘Cannot make proper diagnoses’;/‘If you still have pain or more pain after treatment’; ‘Causes even more pain’; ‘Rough during examination’;
Poor medication	109 (21.8)	Only medication Too fast and too many medicaments Wrong medication Too strong medicines	‘A bad doctor prescribes only medicines’; ‘Who prescribes pills without proper diagnosis’;/ ‘When you have a problem, and he gives medication right away’; ‘When he prescribes too much medication too quickly’; ‘When unnecessary medication is prescribed’; ‘Too much chemistry’; / ‘When you get new drugs every time you visit again’; ‘Prescribes the wrong medication’; / ‘Prescribes medical bombs’; ‘Immediately starts antibiotics’; ‘Works with heavy drugs’;
Medical incompetence	85 (17)	No medical expertise Works too fast and makes mistakes	‘If professional competence is missing, he is a bad doctor’; ‘Not professionally good and competent’; ‘Does not master his art sufficiently’;/‘Without technical knowledge’; ‘Have no expertise’;/‘Is only fast’; ‘Works half-heartedly’; ‘Makes mistakes’;
Mass processing	77 (15.4)	Gets rid of patients short and quick Patients are just numbers	‘Only want to dispatch as many patients as possible as quickly as possible without examination’; ‘When there is mass processing’;/‘If he checks in quickly and immediately goes for the next patient’; ‘Where you are dealt with in fast-track procedure’;/‘Who treats patients as if they were a number’;
Poor therapy and treatment	53 (10.6)	Sloppiness Poor treatment Wrong treatment Only symptom treatment No treatment recommendation	‘He must not be sloppy’; ‘Who is forever meddling’; ‘Works sloppily’; ‘Sloppiness’; / ‘Poor advice and treatment’; ‘Treats patients poorly’; ‘Performs surgery poorly’;/ ‘Provably treats patients wrongly’; ‘Performs surgery, although it’s not necessary’;/ ‘Only symptom treatment’; ‘A doctor who treats the symptom and not the whole person’; / ‘He dismisses the patients again without any treatment recommendation, without them knowing what to do afterward’; ‘Is not caring about a sensible and feasible therapy’;
Lack of alternative medicine	27 (5.4)		‘Does not offer a medical alternative’; ‘Is completely against alternative medicine’; ‘No alternatives to medicines’; ‘Involves only academic medicine in healing’;
Lack of continuing education & training	16 (3.2)		‘Has no interest in continuing education’; ‘Is not up-to-date with the latest scientific findings’; ‘Has deficits concerning the state of research’; ‘Stops to educate further’; ‘Poor education’;
Referral behavior	12 (2.4)		‘Unnecessary referrals’; ‘When she does not send you to a specialist’; ‘When you are referred from one doctor to another’; ‘He should refer if he is unsure’;

Table 12. Main categories of ‘personality’ for a bad doctor.

Categories for ‘personality’	nb of responses, n (%)	Exemplar quotes
Impatient/Stressed	89 (39.4)	‘when he has stress and transfers it to the patients’; ‘When he makes a stressed impression’; ‘Should not be impatient’; ‘The doctor is impatient’; ‘in stress all the time’; ‘stressed appearance’
Aloof	43 (19)	‘Being aloof, is God in white’; ‘appears aloof’; ‘Be aloof’
Unfriendly	35 (15.5)	‘Is unfriendly’; ‘Unfriendliness’;
Superficial	26 (11.5)	‘a superficial impression’; ‘be superficial’; ‘Too superficial’;
Rude	15 (6.6)	‘where you have the feeling that you are being waved off’; ‘when he is rude’; ‘extremely rude’; ‘dismissive’; ‘rude’;
Insecure	5 (2.2)	‘He should not be insecure’; ‘If he is so insecure’; ‘Insecurity’;
Lack of self-care	4 (1.8)	‘a cardiologist who is a chain smoker; I don’t take such a person seriously’; ‘a doctor who has a burnout after 30 years’;
Overconfidence	4 (1.8)	‘When he has overconfidence’; ‘self-opinionated’; ‘Overestimates himself’;
Not conscientious	2 (0.9)	‘Not acting conscientiously’; ‘Not acting in the patient’s best interest’;
Not fond of children	2 (0.9)	‘Is not fond of children’;

Table 13. Main categories and subthemes of ‘ethical and moral behavior’ for a bad doctor.

Main categories for ‘ethical and moral behavior’	nb of responses, n (%)	Subthemes	Exemplar quotes
Immoral & unethical behavior	90 (82.6)	Financial focus Not trustworthy/not confidential Moral attitude Discriminating Dependence & influence from the pharmaceutical industry	‘Has become a doctor only because of money’; ‘Has designs on financial success and fame’; / ‘When he tells my daughter about my illness’; ‘Is violating medical confidentiality’; ‘One has no trust’; ‘Lack of trust’; ‘Is telling confidential things to others’; ‘Does not have trustworthiness’; / ‘My doctor is supposed to help me, not lecture me morally’; ‘No moral speeches’; ‘Moral lectures’; / ‘If he does not like foreign people’; If older people are treated differently (worse) than younger people because of their age; ‘Makes a difference in treating patients’; / ‘When people are not at the center of decisions, but rather profit or pharmaceutical companies’; ‘Dependent on pharmaceutical companies’; ‘No pharmaceutical servant’;
Self-interest	19 (17.4)	Not a philanthropist Not altruistic Practices only the profession Egoistic	‘Who does not care about humans’; ‘Misanthropic’; ‘Far from humankind’; ‘Not philanthropist’; / ‘Who does not care about the person’; ‘Does not care about the well-being of the patient’; / ‘Someone who rests on his laurels’; ‘When he is simply doing a job’; ‘Less idealism’; / ‘He is not even-handed’; ‘Selfish’

Table 14. Main categories and subthemes of ‘communication’ for a bad doctor.

Main categories for ‘communication’	nb of responses, n (%)	Subthemes	Exemplar quotes
Incomprehensible, complicated language	45 (42.1)	Speaking or explaining in a complicated & incomprehensible way Insufficient or no explanations. Unobjective comments	‘Explains something in a complicated way, throw around torch vocabulary and in the end, it makes a complicated confusing impression on me’; ‘when technical vocabulary is used’; / ‘Without taking the time to explain’; ‘Does not explain sufficiently’; ‘Does not explain’; / ‘Unobjective attacks’; ‘Unobjective’;
Poor atmosphere for conversation	29 (27.1)	Does not speak or speaks too little Superficial conversation	‘When he speaks almost nothing, nothing at all’; ‘you cannot have a conversation with him’; ‘If he does not discuss everything in detail with the patient’; ‘Only superficial conversation’;
Poor question and answer behavior	23 (21.5)	Too many questions Does not inquire Does not answer questions.	‘Asks hundreds of complicated questions’; ‘Asks many questions’; ‘Superfluous questions’; ‘Who does not inquire about the patient’s condition’; ‘Without inquiring’; / ‘Ignores questions or answers them incomprehensibly’; ‘Who avoids my questions’;
Poor counselling & information	10 (9.3)		‘Someone who does not counsel the patients’; ‘Without objective counselling’; ‘Gives false information’; ‘Bad advice’; ‘Does not offer any information’; ‘Bad info’;

Table 15. Main categories and subthemes of ‘practice organization’ for a bad doctor.

Main categories for ‘practice organization’	nb of responses, n (%)	Subthemes	Exemplar quotes
Poor accessibility	66 (66.7)	Waiting times for appointments Receptionist behavior Short opening hours	‘During calls, you only and always reach the audiotape’; ‘Poor accessibility’; ‘If he is not accessible’; / ‘Does not manage to prevent waiting times’; ‘Long waiting times for appointments and in the waiting room’; / ‘If only the receptionist finds time for a prescription without a conversation’; / ‘Strongly changing opening hours’; ‘Poor opening hours’; ‘Short surgery hours’;
No availability	18 (17.2)	Too many patients No house calls/night duties Work-to-rule No sick note	‘Does not look at the number of patients who come by in a day’; ‘Has too many patients’; / ‘Does not make house calls’; ‘He should come to our house at night when you need him urgently’; / ‘Works only according to the timetable’; ‘Stubbornly proceeds according to duty’; ‘Duty by the book’;/ ‘If she does not write me a sick note, even though I am unable to perform at the moment’; ‘Send me to work’;
Equipment of the practice	14 (14.1)	Poor structure Health insurance	‘Poor organization’; ‘Poor structure’; ‘Seems disorganized’; ‘Has no coordination’; / ‘Is bound to a certain health insurance’; ‘He costs something, so he is working in private practice’;