Table 2.

Experiences of wasting GP time

Heading	Subheading	Theme	Example quotations
Situations in which people feel they are wasting their GP’s time	When time constraints are visible	Long waiting times and difficulty making appointments	‘If you have to wait a week for an appointment anyway they are obviously very busy, and that sort of thing would worry me, I wouldn’t want to waste a GP’s time.’ (P13, M, 69 years; sore that does not heal) ‘Like with most of the surgeries, it’s difficult to get an appointment with a local GP. So you think, I won’t bother them, I won’t bother them.’ (P20, M, 67 years; persistent cough or hoarseness) ‘Well, we’re used to but it’s so difficult to see your own doctor here, it’s very difficult to see your own doctor.’ (P24, F, 64 years; persistent cough or hoarseness)
		Negative GP interactions deter, positive GP interactions encourage help-seeking	‘I don’t know what the doctor feels. I don’t want to waste her time. But I don’t consciously waste her time.’ (P38, F, 77 years; change in bowel habits, change in bladder habits) ‘As I say, in the last 3 months she’s been making appointments for me to make sure I attend.’ (P38, F, 77 years; change in bowel habits, change in bladder habits)
		One item per visit/sticking to 10 minutes	‘I try not to barrage them with lots of things because I know it’s only a 10-minute appointment’ (P40, F, age missing; change in bladder habits, difficulty swallowing, persistent cough, rectal bleeding) ‘I don’t want to take up too much of their time.’ (P53, M, 58 years; unexplained lump) ‘I suppose you do feel time-constrained. I mean, certainly the last time I went, because I felt I could fit something in within that time, I mentioned it. So you have, like, an awareness of the amount of time that’s there and then it’s almost seeing what happens during that.’ (P6, F, 61 years; persistent unexplained pain, unexplained lump)
	When symptoms are perceived as not serious enough	Symptom characteristics not disrupting/life-threatening/persistent	‘But now, you see, that’s the sort of thing that I think oh I won’t bother to tell the doctor, it’s peripheral.’ (P16, F, 77 years; change in bladder habits, abdominal bloating, change in bowel habits) ‘It’s more that this isn’t something serious enough to bother a doctor with.’ (P27, M, 62 years; difficulty swallowing) ‘But then you feel, if you are not actually suffering, are you wasting the GP’s time by going down and asking if you can, you know …’ (P14, M, 68 years; abdominal bloating) ‘Well, persistence of the symptoms, say, sort of longer than 3 or 4 weeks. Or worsening of the symptoms. Then I would go and see a doctor. Well, it’s just to see how things settle down. I don’t want to go unnecessarily.’ (P39, F, 64 years; change in bowel habits, blood in urine) ‘I don’t think you should go to the doctor’s as soon as you are not feeling well, but if there’s something that’s persistent, then yeah.’ (P50, F, 63 years; abdominal bloating, persistent unexplained pain)
		Symptoms that have previously received medical attention	‘I mean, if you are in really dire pain or really, really worried about yourself, then you’d go back quicker than if it was something that you might think, well, perhaps giving it a bit longer, it might right itself.’ (P37, F, 88 years; unexplained weight loss, change in bladder habits, persistent cough or hoarseness, abdominal bloating). ‘I have the arthritis, and I have so many aches here, there, and everywhere. And the GP, there’s nothing he can do. I am already taking medications for that through the hospital, you know. So I don’t bother the GP with all my symptoms every time, just what I think is pertinent.’ (P19, F, 67 years; unexplained weight loss, persistent cough or hoarseness)
		Comparing with hypothetical others or others with similar diagnoses	‘I think it would be my own feeling that it is not a very big problem and lots of people that go to the doctor have far worse things, you know.’ (P59, F, 65 years; abdominal bloating) ‘I think GPs are generally overstretched, overworked. And I think if there are people who are more generally ill, in need of doctors, then they shouldn’t really tie up resources.’ (P7, M, 51 years; persistent cough or hoarseness, rectal bleeding) ‘And quite often Saturday appointments you, sort of, avoid because you think that’s really for emergency or something very serious.’ (P7, M, 51 years; persistent cough or hoarseness, rectal bleeding) ‘So then you back up again and you think, okay, I won’t take the emergency appointment because there’s somebody who might really need that. So you wait. And that’s not good either.’ (P21, F, 67 years; change in bowel habits, abdominal bloating, change in appearance of mole)
	When an alternative healthcare practitioner could provide necessary diagnosis or treatment	Nurse practitioner or pharmacist can offer suitable support	‘When you walk in [to see the nurse], you feel at ease, whereas when you walk in to the doctor’s you feel, “Well, I’ve got to be going in about 3 minutes because I’m wasting his time.” And I mean, I probably spend exactly the same time with her, but I don’t have that pressure, or I don’t feel that I have that pressure.’ (P24, F, 64 years; persistent cough or hoarseness) ‘So my first thought would be to try to deal with it myself by using a patent medicine, or whatever, and, if that doesn’t work, then go to the GP.’ (P5, M, 62 years; sore that does not heal)
Accounts and beliefs of people who do not feel that they are wasting their GP’s time	It is the GP’s responsibility to be available to those in need	GP responsibilities	‘A doctor is not there just for Christmas … What on earth is a doctor there for other than to look after patients?’ (P11, M, 69 years; change in bowel habits) ‘I think that would have been true for me more so many years ago, but I think less so now because, after all, the doctor is there to do their job. So they are doing a job and you need to look on it that way. But I know if I go right back in history, obviously coming from Scotland we had this very old-fashioned view that you didn’t trouble the doctor unless it was serious. So somewhere in my psyche, that’s probably still there.’ (P21, F, 67 years; change in bowel habits, abdominal bloating, change in appearance of mole)
	GPs offer a service financed through taxes paid by patients	Financial contributions towards medical services	‘I mean, they are paid to do a service and that’s how it is.’ (P5, M, 62 years; sore that does not heal) ‘I don’t feel overawed or deep reverence of my doctor. I mean, they are paid to do a service and that’s how it is.’ (P5, M, 62 years; sore that does not heal) ‘They are well paid, doctors. [They] are a very well paid profession since Mr Blair looked after the profession.’ (P11, M, 69 years; change in bowel habits)
		Awareness of adequate service use	‘I wouldn’t like to abuse the service.’ (P11, M, 69 years; change in bowel habits) ‘I don’t want to be a time-waster. But having said that, I’m very aware that I’ve paid a great deal of money into the service and I’ve had very little back.’ (P44, M, 54 years; change in appearance of mole, unexplained lump)
	GPs care about their patients	Positive relationship with GP	‘No, no. I mean, he encourages it, you know, “If there’s any problems, come and see me.” So I don’t have any problems that way at all. And I’m not certainly an NHS basher, or anything like that. It’s just that that’s the way it is.’ (P2, M, 74 years; change in bladder habits)