Exploring the Roles and Responsibilities of General Practitioners in Iran's Healthcare System: A Qualitative Study

Background: General practitioners (GPs) play a crucial role in providing primary healthcare services. However, there is limited understanding of the specific roles and responsibilities of GPs in Iran's healthcare system. The objective of this qualitative study is to explore the various roles and responsibilities of GPs in Iran's healthcare system by gathering insights from different stakeholders. Methods: Semi-structured interviews were conducted with 32 health policymakers and GPs in Iran between April and December 2021. Participants were selected using a purposive sampling method. The interviews, conducted in Persian, were transcribed verbatim. Data analysis was performed using both deductive and inductive content analysis. Initially, deductive coding was applied based on the research questions, followed by inductive coding to allow new concepts to emerge from the interview data. Qualitative analysis was conducted using MAXQDA 22. Results: The study included a diverse group of participants in terms of age, gender, experience, and workplace. During data analysis, 173 primary codes were identified, which were categorized into four themes: "The evolving role of GPs," "rhe skills and competencies of GPs," "GPs' perspectives on their role," and "requirements for general practitioner reinforcement." Conclusions: Recognizing GPs as gatekeepers within Iran's healthcare system requires significant measures in both health policy and public attitudes. It is crucial to shift public perception so that individuals rely more on GPs as their first point of contact in the healthcare system, using secondary services only through referrals. This shift should be accompanied by a greater emphasis on strengthening primary care and the role of family physicians in service delivery.