‘Quot homines, tot sententiae.’Terenz (195–159 ACE), Roman poet
There is a great variation among GPs, concerning performance, behaviour, consultation strategies, diagnostic and treatment procedures, and this variation is considered as an indicator for poor quality of the service.1–6 But variation can also be regarded as an advantage, mainly because patients can choose the GP who suits their personal needs or preferences best. This applies especially to healthcare systems without a list system, as in Germany, where patients can move from one GP to another practically as often as they want to. A doctor, for example, who has a dominating way of communicating, attracts patients who prefer a doctor who tells them frankly what they have to do. Other patients prefer doctors with a more patient-centred communication style. Due to these differences patients may have the advantage of a better choice. But what do patients actually think of this variation?
A research project on inter-doctor variation in German general practice offered the opportunity to examine this question in an additional evaluation. In the project, in which the inter-doctor variation on managing headaches was examined, university students were trained to play a standardised role of a patient with an acute headache (methods and results published elsewhere).7
In the additional study presented here, we wanted to find out about the personal views of these ‘actors’ and whether their experience changed their view on the primary healthcare service. For this purpose a focus group discussion was chosen. This does not generate universally valid results but it was seen as an adequate tool to elicit the experiences of the actors and to explore differences in opinions as well as define consensus.8