General Practitioners and Physical Activity Counselling: from Evidence to Practice Contingencies

Introduction: One half of the French population has an insufficient level of physical activity. General Practitioners are considered to be well-placed to promote physical activity. This article analyses how they address this issue. Methods: Semi-structured interviews were conducted on preventive care with 99 GPs from the Parisian area. Their approach to physical activity counselling was discussed in greater detail with 20 GPs. The analysis identified the diverse rationales and approaches of GPs in a grounded theory perspective. Results: Physical activity counselling is not systematically addressed and is never the subject of a specific consultation. Talking about physical activity may come up in a consultation, but not with all types of patients, and largely depends on contingencies and circumstances. A fear of sporting accidents and a negative anticipation of the patient's reactions make GPs reticent to address these issues, even in the presence of medical indications. Even when they talk about physical activity, their assessment and advice are succinct. GPs lack tools and resources to encourage physical activity. They rely on common sense and use their own sport experience, when present. General medical training is not very helpful, and incentive public policies are insufficient to make them feel both operational and legitimate. Conclusion: It is difficult to integrate physical activity preventive care in general practice. Perceived as a matter of personal taste, it is rarely part of routine medical practice, despite a favourable political context.