General practitioners' experiences of patients with drug and alcohol problems.

Convergent focus groups, a qualitative research methodology, were used to determine what general practitioners considered to be the main obstacles and disincentives to the effective management of persons with drug and alcohol problems. Seven groups were conducted, involving 44 general practitioners whose practices were based in representative parts of metropolitan Sydney and a rural area of New South Wales. The study revealed that most doctors are not as threatened, resistant or pessimistic about drug and alcohol intervention as much of the previous work in the area would suggest. However, they held different views according to the drug in question. General practitioners were more sympathetic to patients with alcohol problems but only some agreed that it was a legitimate area for medical involvement and one in which they were prepared to become involved. The prescribing and use of minor tranquillisers was widely tolerated and perceived to present few problems for individuals or the community. Opiate users, by contrast, were least favoured, with hostility expressed by most towards them. A provisional typology of general practitioners was developed with three distinct groupings ('interactive problem-solvers', 'traditionalist healers' and 'technologists'), according to the model of medical practice assumed. This scheme, whilst not definitive, provides a structure for targeting general practitioners for medical education and has implications for tailoring medical training programs at both the undergraduate and postgraduate levels. General issues relating to the development of typologies are discussed.