Categories of difficulties | Associated themes (arguments) | Example of verbatim transcript |
---|---|---|
Personal for GPs (16 GPs/108 verbatim) | Emotional/psychological (13 GPs, 43 verbatims) (Uselessness/frustration/discouragement/stress/weakening doctor status/discomfort/wearing out) | “Being in a repeated failure without capacities to analyse this…Is hopeless. If we can make sense of it, working on it with partners, psychologist and social workers, it is a little bit different.” “They deprive doctors from their power.” “Working with homeless is a school of frustration.” |
Practical (14 GPs, 65 verbatims) (Money/time/reception/management of consulting) | “For a liberal doctor… it's complicated to manage. A doctor has the duty to ensure a secure place to receive other patients.” “I cannot do that in private. I cannot…in fifteen minutes.” | |
Care management (18GPs/60 verbatim) | Complexity (11 GPs, 30 verbatims) (Multiple issues/context of homelessness/means required) | “It's hard to put back these patients on common primary care. Even if you open social rights for them, they require more time, in terms of understanding, or because of multiple pathologies. That's why doctors have difficulties to care for them.” |
Importance of care management required (5 GPs, 10 verbatims) (Over investment for doctors/lack of autonomy for patient) | “But I cannot take this patient and go with her in hospital, right?” (About a pregnant patient who need to have a follow in hospital because of risk pregnancy) | |
Retrieving medical information (16 GPs, 20 verbatims) | “So here, this is very important, we often do not know, we know nothing.” | |
Interaction with homeless patients (14 GPs/34 verbatim) | Physical appearance (10 GPs, 15 verbatims) | “When they can't physically be like a person who has a home, already they are seen differently.” |
Communication/relation (8 GPs, 11 verbatims) | “When I treat a homeless person, sometimes I see from him a reaction to which I didn't expect.” “We have difficulties to communicate with these persons, because of language barrier, but also because they are big outsiders.” | |
Comprehension of patient (5 GPs, 8 verbatims) (Observance, different views) | “They don't do what we want them to do…There are resistances from them, associated with social problems or…(other problems). Doctors can misinterpret that.” |
GP, general practitioner.