Table 1.

Types of GPs and their specific needs.

Type	Knowledge	Attitude	Practice	Needs
Type 1: rejecting	Lacking	Medium level	Lacking
		Weak problem awareness. Partly trivializing, paternalistic. Rejection of accountability of GPs.	No reference to own prescription practice. No integration of Planetary Health arguments.	Wish for problem solution by other health care institutions.
	“I do not have much of an idea about the term […]. But simply that you look at the whole thing in the big picture” (P1.1, female, 54 years).	“I’m too modest for that. I do not think about the planetary things. […] But nobody would want [global influence] either” (P1.2, male, 56 years).	“[I: To what extent do you bring Planetary Health into your consultation?] Rarely. […] I’m not there to give lectures or go through the lifestyle in detail” (P1.1, female, 54 years).	“I think that these […] topics may unfortunately not have a proper place in a GP practice. Perhaps it’s more up to the school, the university, the training center to introduce young people to these topics” (P1.1, female, 54 years).
Type 2: resigned	Medium level	Medium level	Low level
		Moderate or strong problem awareness Threatened, pessimistic, frustrated, skeptical Attribution of accountability to other stakeholders of the health system	In favor of evidence-based prescribing Limited integration of Planetary Health arguments to justify rational antibiotic use in consultation Emphasis on time pressure and the concern of patronizing patients	Training offers from scientific, economically independent institutions
	“The first thing that comes to mind is […] hygienic conditions, drinking water supply and food supply” (P2.3, male, 63 years).	“I feel like these societal decisions […] are a major cause of the problem and that I cannot influence them […]. Education is certainly important, but […] I’ve become a bit pessimistic about that” (P2.1, female, 41 years).	“I am skeptical. […] If there is a specific case, you speak out against antibiotics and then you must argue that, […], then I do see the possibility. But I do not see an explicit Planetary Health consultation as possible in the current time situation” (P2.2, male, 40 years).	“Independent training from interested parties or from institutes […]. Medical self-administration […], the universities […] [or] state bodies such as health authorities [could offer something like this]. Independent institutes, training institutes could also be set up to offer this” (P2.3, male, 63 years).
Type 3: unconscious and open-minded	Medium level	High level	Medium level
		Strong problem awareness. Open-minded and interested. Partial acknowledgement of responsibility of GPs for own patient clientele. Partial attribution of accountability to other stakeholders in the health system.	In favor of evidence-based prescribing. Occasion-related, patient-dependent integration of Planetary Health arguments to justify rational antibiotic use in consultation. Partial unconscious introduction of the topic without using the Planetary Health framing. Emphasis on time pressure and the concern of patronizing patients.	Training offers regarding the interlinkages between AMR and Planetary Health. Concrete tips for action regarding education.
	“These pharmaceuticals [antibiotics] also have an impact on nature. […] There are connections between the environment and […] medication and medical practice” (P3.2, male, 74 years).	“The GPs, […] [and] the veterinarians. […] Those are the two that are important. […] The other point is to improve the healthcare system. And then we would probably soon have the resistant germs under control” (P3.7, male, 56 years).	“First, you look at […] the patient when you prescribe the antibiotic. […]But I think if you reflect on it critically, the other things [the inclusion of Planetary Health] come naturally” (P3.4, female, 52 years).	“GPs, like me, need to know exactly: What are the areas where we should and can educate? Where are sensible intersections where the two things can perhaps be combined? The individual health advice, but also the link to Planetary Health” (P3.6, male, 38 years).
Type 4: motivated and resilient	High level	High level	High level
		Strong problem awareness. Concerned, but resilient and motivated. Acknowledgement of the necessity of systemic changes, linked with acknowledgement of responsibility for own patient clientele.	In favor of evidence-based prescribing. Regular integration of Planetary Health arguments to justify rational antibiotic use in consultation, Co-Benefit arguments are used. Partly voluntary engagement for Planetary Health outside of the work context.	Compulsory integration of AMR and Planetary Health into education systems. Changing framework conditions to take planetary health more seriously.
	“How to maintain the health of all living creatures on this earth and the health of our climate […]. By ensuring that humans, who exert the greatest influence of all living beings, think about the interactions between the individual living beings” (P4.2, female, 41 years).	“It’s our job to talk to the patients about it [Planetary Health contexts], even if they do not necessarily come with that concern” (P4.1, male, 65 years).	“Primarily […] to make the patient understand why I am so critical about prescribing antibiotics […] Then you must weigh things up with the patient […] and, […] take them along with you in a shared decision-making process […]. On the other hand, educating colleagues […] in quality circles or […] mixed GP get-togethers, where I’ve also given a presentation on this topic” (P4.2, female, 41 years).	“If we set framework conditions that show that we as a society are taking this issue seriously […], then we as doctors […] have a great influence in making this a recurring theme” (P4.1, male, 65 years).