Data Analysis

In accordance with the principles of grounded theory, the constant comparative method of analysis was undertaken. This involved recursive stages of data collection and data analysis (Chenitz & Swanson, 1986; Glaser & Strauss, 1967; Strauss & Corbin, 1990). As each interview was conducted, the researcher reflected on the interview and began a preliminary analysis of key issues emerging in the interview. These themes were then tested and refined within subsequent interviews. Data collection and analysis were, therefore, concurrent. Each strategy informed the other, and assisted with focusing

attention on the data and supporting conceptual developments that were grounded in GPs’ experiences of general practice.

The researcher formally analysed each transcript. The process of open coding (Glaser & Strauss, 1967) was initially used as a means of discovering, naming, and categorising themes in the data. Open coding involved the researcher making notations in the margins of interview transcripts identifying key issues or phrases that pertained to strategies they adopted for managing the demands of GP practice. At this stage of analysis, a wide variety of emergent themes for analysis were identified and either new categories were created or information was fitted into an existing category. The process then entailed comparing categories with others for overlap or duplication, and framing themes according to the level of emphasis by the GP participant.

For example, the category of “litigation” emerged as a frequent theme following comparisons of GPs’ observations of changes within the medical profession, and patient

attitudes toward the medical profession. While litigation was a topic raised by all GPs, the level of concern could be placed on a continuum from “I’m aware of it (litigation) all of the time” (Michael) to “I don’t think I allow myself to get too worried about that

(litigation).” (Jean), “I’m not troubled at all by litigation” (Mark).

At the completion of data collection from all 26 interviews, the emergent themes and propositions were assessed in the light of the data generated, and compared within and across each interview. While comparison across themes identified some similarities, efforts were made not to force themes to fit with one another.

An influential aspect of analytic thinking took place in the writing of the findings for this thesis. Although usually considered a mode of ‘telling’ about social science work, writing is better conceptualised as a method of inquiry. Writing can also be construed as a way of ‘knowing’ - a method of analysis and discovery (Richardson, 1994). The drafting and redrafting process was analytically valuable, and encouraged further consideration of evidence for particular themes. The drafting process also assisted with identifying the usefulness of case studies to illustrate the findings in context.

Initial literature searches had included references to GPs’ time related concerns and were identified as potential stressors, but there was no information about the meanings GPs attached to time. At this point the researcher began looking for verification of these elements and adopted a more deductive approach (Patton, 2002; Strauss, 1987). As the inquiry progressed with constant comparison within and between data, and back to the literature, the researcher consciously worked with separate factors (time pressure, workload, time scarcity). This included reflecting not only on the data, but the process and flow of each interview, (recorded in the researcher’s reflective journal). The researcher attempted to weave these together to form a concept that was meaningfully

relevant to identifying factors influencing GPs adaptation to general practice while trying to understand nuances and idiosyncrasies in the data (Glaser & Strauss, 1967).

The interviews aimed to elicit GPs attitudes to their work and the medical profession, and to provide an opportunity to explore their aspirations, views about personal

wellbeing, and the adaptive strategies they adopted in the work and non-work/family domain.

4.5.1 Social Context of the Interviews

The interviews took place in a seven-month period between September 2002 and April 2003. In order to give some insight and background to the period in which the interviews took place, a brief outline of the socio-political context of medical care is warranted. Issues that were topical at the time in the media may have shaped GPs views and focused the topics GPs raised in the interviews.

During the interview period there was considerable media coverage at the state and national level of issues pertaining to the medical profession. Specifically there was discussion of four issues relating to the work of doctors in Australia. These were:

•inconsistencies in the professional abilities of overseas trained doctors •concerns expressed by doctors regarding litigation, cost of insurance, and

disintegration of one insurance company involved with medical professional indemnity

•the perceived inadequacy of Medicare reimbursement to GPs to cover rising business costs

•the increasing number of doctors adopting a co-payment system instead of bulk billing10 their patients.

While there is no way of determining how much influence the media played on the content of perceptions shared by GPs in this study, media coverage of these issues may have influenced some participants’ responses. For example, in February 2003, there was extensive media coverage predicting the end of bulk billing by the majority of GPs. Two participants who were interviewed at that time expressed their views about the adequacy of Medicare reimbursement, and the benefits of utilising a co-payment rather than bulk billing system. This may not have been as salient in the interviews if the media had not been covering the topic. The role of the media in setting or reflecting the agenda can never be fully identified and disentangled from findings. It was therefore valuable for the researcher to understand participants’ responses in light of context.