The aim of this study is to examine the way in which general practitioners (GPs) in private practice view the idea of population responsibility, proposed by the Quebec Health and Social Services Ministry in 2004. We then look at how these views impact primary health care practice in Quebec City.
A qualitative exploratory approach was used; 18 semi-directed interviews were performed with private practice GPs, administrators and health professionals from community health and social services centres (CSSS). A content thematic analysis of the data was performed based on St-Pierre et al.'s model and grounded on Giddens' structuring theory.
Because neither the population meant to be served nor the underlying responsibility are perceived the same way by the GPs and the CSSS health professionals, the respective practices do not always converge. Consequently, methods of communication, offers of services and management of resources impact on the operationalization of the concept of population responsibility, which has to be negotiated.
In these negotiations, because physicians are the ones solicited by the other partners, the application of population responsibility increasingly becomes an opportunity to develop a medically oriented primary care organization.
This paper describes drug development based on pharmacogenetic experiences and the inherent implications for the health professions in the primary health care service sector. Pharmacogenetics involves increased demands for competence in extracting the newest knowledge for the benefit of the patients, and the need for advising patients about of usage and the ethical aspects of drugs, which are prescribed on the basis of the genetic profile of a specific patient. International experiences show that the health professions in general are poorly trained to handle this task. There is no evidence that the health professionals in the primary health care service sector in Denmark are any better prepared. This paper concludes that if the positive prospects of pharmacogenetics are to benefit patients, systematized training of the health professionals in the primary health care sector is needed.