Table 3. Summary of the themes and sub-themes
Theme 1. Primary care physicians take pride in being expected to address SDoH
Integrability with primary careAddressing SDoH is essential to primary care.Underlying factors are:
  • Affinity with biopsychosocial model

  • Best position (accessibility, comprehensiveness)

Excellence in primary careExcellent primary care includes addressing SDoH.
  • Experienced physicians: reaffirmation of the value in their practice

  • Novice physicians: identity formation

Theme 2. Primary care physicians rely on the recommendations as a partner even in difficult situations
Authoritative supporterRecommendations validate:
  • What primary care physicians have done

  • Frustration and hesitation about patients’ social issues

Background: addressing SDoH would be disregarded by other professionals
Encouraging friendBusy practice leads physicians to ignorance of SDoH
  • In supportive surroundings, they favour SDoH recommendation

3. Primary care physicians consider the recommendations to be bothersome, with unreasonable challenges and demands, especially when supportive surroundings are lacking
Excessive burdenRecommendations impose on enormous challenges.Negative effects:
  • Physicians disregard the importance of SDoH

  • Physicians feel guilty

  • Physicians underestimate their skills

Antipathy driven by unsupportive surroundingsBusy practice leads physicians to ignorance of SDoH
  • In unsupportive surroundings, they disfavour SDoH recommendation

4. Primary care physicians reconstruct the recommendations on the basis of their experience
Not following the recommendations literallyRecommendations are transformed and contextualised
Learning and practice based on real-world experienceRecommendations trigger multi-layered learning and practice
  • SDoH = social determinants of health.