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Table 4 Bottom-up – a natural and self-evident task

From: The meaning of quality work from the general practitioner's perspective: an interview study

The reasons
"Besides having a general desire to do good, so to speak, you naturally have it as a reason to try to stay updated and do the right things."
The methods
Prescription statistics
"It's rather useful, for sometimes you believe something but then you can have hard facts about what you prescribe."
Computer records
"What I would like to use is this box. But we've been feeding in things for six years now, but we never get anything out."
Personal follow-up
"because I meet every patient all the time, I meet each patient continuously year after year, so I have a continuous assessment of how the patient, how things have gone as a result of the way I handled this, which gives a different longitudinal follow-up from what these spot tests do, you know."
Collegial comparison
"I always think it's good that you have somebody and can discuss patients with and get new ideas and hear how other people think, what you would have done in this situation, if you would have done what I did, I think that helps me to develop, so that I don't get stuck in different treatment methods. There's a colleague in primary care, an older colleague who must have worked 25 years longer than I have, and I've heard that he's very good and knows his stuff, you know, in every way very competent."
Audit
"Say that you have some kind of idea about what you normally do in certain situations and perhaps that you don't always remember what compromises you make when you do it differently."
"This thing of comparing yourself with others is interesting to discuss, since we work so much on our own, you know, you don't really know so much about what your colleagues do, you guess and I think that's an important part of it, that we compare ourselves, that we look at how the others do it and how I do it."
Colleague groups
"We have FQ groups and there I think we have a certain amount of quality assurance, for we sit and discuss how we treat our patients."