All interviews were audio-recorded and transcribed Verbatim for thematic analysis. Three members of the research (HM, CW and CS) team independently read and re-read each transcript in order to achieve as broad an understanding of the content as possible. A thematic analysis was conducted using open coding and then axial coding and, in keeping with Grounded Theory, no pre-specified hypotheses were established. As the concepts arose, the three researchers, in the margins of each transcript, independently coded them. Among the various key concepts uncovered in the transcripts were: “time,” “conflict,” “concern,” “prioritization,” “defer,” “evidence-based,” “impacts,” “benefits,” “prevention visit,” Non-prevention visit,” “time consuming,” “ easy …show more content…
This was expressed in several forms such as difficulty to follow up of results, concerns regarding their knowledge about other providers’ patient and time needed to discuss. All PCPs readily acknowledged the shortage of time in the clinics. Most pointed to the effectiveness of MAs for pre-screening to increase the flow of the patient population. However, the PCPs in our study also pointed to patient questions they felt would inevitably rise resulting from these pre-screenings and screenings related such diseases as mammograms, colon cancer, prostate cancer, HIV and Hepatitis C, which demanded their time and their expertise.
As showed in the figure below, a provider’s decision is influenced by patient factors, EMR prompts and the type of visit. The majority of providers expressed time constraints, EMR inflexibility and complex health conditions as barriers to provide preventive care to their patients. Good patient provider relationship and support from their team members act as facilitators to provide preventive health. In addition to those factors, impact of the particular preventive service to the patient also influences provider’s …show more content…
Although interviews are an effective way of identifying and exploring perceptions, our results could be biased and may not represent all doctors' perceptions and attitudes. We conducted interviews in the University of Washington’s affiliated clinics, which is an academic setting; therefore, we cannot generalize the study to all settings. For instance, perceptions and approaches of a primary care provider in rural community clinic settings may be different from those in our academic environments. The use of a semi-structured interview guide and scenarios has some weaknesses. We attempted a validation, yet important and salient topics may have been inadvertently omitted. Interviewer flexibility in arrangement of the questions and wording of the questions could have resulted in variation of the responses, thereby weakening the comparability of answers. We did not set out to assess clinical outcomes—therefore we cannot be certain that what subjects reported that they did is an accurate reflection of their actual