ObjectiveTo explore general practitioners’ (GPs) views on leadership roles and leadership challenges in general practice and primary health care.DesignWe conducted focus groups (FGs) with 17 GPs.SettingNorwegian primary health care.Subjects17 GPs who attended a 5 d course on leadership in primary health care.ResultsOur study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement.ConclusionsGPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance.Key pointsLittle is known about doctors’ experiences and views about leadership in general practice and primary health care. Our study suggests that:There is a lack of preparation and formal training for the leadership role.GPs experience tensions between the clinical and leadership role.GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

IntroductionTo explore Norwegian general practitioners’ experiences with care coordination in primary health care.MethodsQualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data.ResultsThe general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality.DiscussionGeneral practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.