"They don't do anything" contextual factors influencing Turkish-Dutch individuals' perceptions of general practitioners and medical specialists in the Netherlands and Turkey.

OBJECTIVE: Intercultural difficulties between GPs and patients are important contributors to health disparities. Framed in an interpretivist paradigm, this paper's thematic analysis examined how Turkish-Dutch patients' expectations of Dutch GPs may result in intercultural communication difficulties. METHODS: Five focus group discussions were conducted with 21 participants of Turkish-Dutch background. Participants were asked to discuss perceived differences between GP-patient encounters in the Netherlands and Turkey. RESULTS: Our study revealed that Turkish-Dutch patients regularly expect Dutch GPs to show other behavior than they perceive to obtain on two themes, 1) dealing with patients' symptoms and 2) communication. In general, Turkish-Dutch patients expect Dutch GPs to show faster, more decisive and informative behavior in diagnostics and treatment. These expectations seem based on their experiences with practitioners in Turkey and on differences between health care systems. CONCLUSIONS: GP-patient difficulties appear primarily the result of underlying frustrations rather than clashes resulting from differences in explanatory models of illness or cultural values. PRACTICE IMPLICATIONS: Whereas systemic differences are more difficult to alter, difficulties in the communication are more readily amenable to change. Patient-centered communication and information about the reasons for being restrictive in diagnosing and treating on symptoms could alleviate these frustrations.